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MEDICAL INDEMNITY ACT 2002 - SECT 52D

Medical indemnity insurer may be required to offer interim cover until complaint is finalised

  (1)   A medical indemnity insurer must offer to enter into a contract of insurance with a medical practitioner to provide professional indemnity cover if:

  (a)   a contract of insurance between the insurer and the practitioner provides professional indemnity cover (the initial cover ); and

  (b)   the insurer refuses to enter into a contract of insurance with the practitioner to provide professional indemnity cover (the subsequent cover ) starting after the initial cover ceases; and

  (c)   the practitioner makes a complaint to AFCA in relation to the refusal; and

  (d)   the initial cover, or professional indemnity cover provided as a result of an offer made for the purposes of this section, ceases before the complaint finalisation date.

  (2)   The offer must comply with any requirements specified in the rules.

  (3)   However, the insurer is not required to offer to enter into a contract of insurance that provides professional indemnity cover after the complaint finalisation date.

  (4)   In this section:

"complaint finalisation date" means the earlier of:

  (a)   the day the subsequent cover starts; and

  (b)   the day 60 days after the complaint is finalised.

"finalised" : a complaint is finalised when:

  (a)   the complaint is resolved by agreement between the insurer and the practitioner; or

  (b)   the complaint is withdrawn; or

  (c)   AFCA closes the complaint because:

  (i)   it has excluded the complaint, or decided not to continue to consider the complaint, and the timeframe in which the practitioner may object to the decision has expired; or

  (ii)   it has made a preliminary assessment in relation to the complaint and the timeframe for requesting a determination of the complaint has expired; or

  (iii)   it has determined the complaint; or

  (d)   the complaint otherwise ceases to be dealt with by AFCA.



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