Summary

Background

This report presents the first 12 months’ data from the combined Medical Indemnity National Collection (MINC) of public and private sector medical indemnity claims. Public sector medical indemnity data have been published alone in three previous publications, for the periods January to June 2003, 2003–2004 and 2004–05. This report is the first report on medical indemnity in Australia to combine public and private sector data. The data in this report cover claims current at any time during the reporting period 1 July 2004 to 30 June 2005, that is, claims that were open at the start of the period, new claims that arose during the period, and claims finalised during the period. There is information on the incidents that give rise to claims, the medical specialties involved in claims, the people affected by these incidents, the nature of injury, and the size, outcome and length of time claims have been open.

The data presented in this report are not complete. Due to incomplete coverage of claims databases in some jurisdictions, data for approximately 85% of all public sector claims in scope are included. The private sector has reported 100% of claims in scope for this report.

This report presents data concerning claims where a formal demand for compensation for harm or other loss that allegedly resulted from a health care incident has been received by a private sector medical indemnity insurer or a public sector claim manager.

Incidents

The most common incident/allegation type leading to any claim against a clinician in 2004–05 was ‘procedure’ (30.5%) which includes all surgical interventions, followed by ‘diagnosis’ (23.6%) and ‘treatment’ (13.2%).

Claims

A claim is finalised when the claim is settled, a final court decision is made, or the claim is closed. ‘Total claim size’ is the amount agreed to be paid to the claimant in total settlement, including any interim payments, claimant legal costs and defence costs.

Over three-quarters of claims finalised in the 2004–05 financial year were finalised for less than $100,000 (77.1%). Claims with sizes in excess of $500,000 constituted 1.7% of all finalised claims. Neuromusculo-skeletal and movement–related functions and structures were the most commonly recorded as the primary body function/structure affected as a result of the incident for new claims (21.3%). The next most common category for new claims was mental functions and structures of the nervous system (12.2%), followed by genitourinary and reproductive functions and structures (11.0%).

People

Babies <1 year old were the subject of 3.6% of new claims, 4.7% of claims related to children, and 62.0% involved adults.