This report presents data on Australia's medical indemnity claims in the public sector from 2006-07 to 2010-11, and in the public and private sectors combined from 2007-08 to 2010-11. There is more information available on public sector claims than on private sector claims, and most private sector claims data were not provided to the Institute for separate reporting.

Western Australia did not report its public sector claims data for 2010-11.

Claim numbers 

Claims arise from allegations of problems in health service provision. A new claim is created when a reserve amount is placed against the costs expected to arise in closing the claim.

In 2010-11, about 1,500 new public sector claims and 1,400 closed public sector claims were reported. Between 2006-07 and 2009-10, there were between 1,000 and 1,600 new claims and between 1,000 and 1,700 closed claims (figures exclude Western Australia). Including Western Australia's public sector claims, there were between 1,100 and 1,700 new claims and between 1,100 and 1,800 closed claims between 2006-07 and 2009-10.

In the private sector there were about 1,300 new claims and 1,450 closed claims in 2010-11. For both types of claims, claim numbers were similar in 2008-09 and 2009-10, and more than the 1,000 new claims and 800 closed claims in 2007-08. In each year the total number of private sector claims open at some time during the year was smaller than the total number of public sector claims.

There was an increase in the combined number of public and private sector claims between 2007-08 and 2010-11. Total claims open at some time during the year increased from about 7,500 to 9,500 (figures exclude Western Australia).

Cost and duration 

Of the public sector claims closed in 2010-11, 38% cost less than $10,000, 31% cost between $10,000 and $100,000, 22% cost between $100,000 and $500,000 and 9% cost $500,000 or more. Including private sector claims closed in 2010-11, 53% of combined public and private sector claims cost less than $10,000, 25% cost between $10,000 and $100,000, 16% cost between $100,000 and $500,000 and 6% cost $500,000 or more.

In 2010-11, as in previous years, claims associated with alleged incidents in public hospitals and day surgeries were often more costly than claims associated with private medical clinics. They respectively accounted for 75% and 11% of claims closed for $100,000 or more.

Of the public and private sector closed claims in 2010-11, 3% were finalised through a court decision, 49% were finalised through a negotiated settlement and 48% were discontinued. In both the public sector and public and private sectors combined, 73% of closed claims were finalised within 3 years of being opened, and 9−10% took more than 5 years to be settled.

Length of time between incident and claim closure 

Public sector claims were grouped into cohorts based on their year of alleged incident. The length of time between incident and when the claim was opened was typically 1 to 2 years, and 3 to 4 years between the incident and when the claim was closed. For the claims of cohorts with incident years between 2001-02 and 2005-06, the proportion of claims closed within 5 years after the incident fluctuated within the narrow range of 74-79%.