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MEDICAL INDEMNITY (PRUDENTIAL SUPERVISION AND PRODUCT STANDARDS) ACT 2003 - SECT 24

Complying offer

Complying offer test--general

  (1)   For the purposes of section   22 or 23, a person (the insurer ) who provides medical indemnity cover under a regulated insurance contract makes a complying offer to the client to provide medical indemnity cover for a health care professional if and only if:

  (a)   the offer is to provide medical indemnity cover for the health care professional under a contract of insurance; and

  (b)   the offer complies with subsection   (2).

The offer must be made to the health care professional's legal personal representative if the health care professional has died.

  (2)   The offer complies with this subsection if and only if:

  (a)   the offer is made in writing; and

  (b)   the offer remains open for acceptance by the client for a period of at least 28 days after the day on which the offer is made; and

  (c)   the procedures for dealing with claims under the contract being offered are substantially the same as those provided for in:

  (i)   the proposed regulated contract (if the offer is made for the purposes of section   22); or

  (ii)   the current regulated contract (if the offer is made for the purposes of section   23); and

  (d)   the claims and incidents covered, and the exclusions from the claims and incidents covered, by the contract being offered are reasonable and appropriate having regard to:

  (i)   the nature of the health care provided by the health care professional during the period or periods during which the incidents covered by the contract occurred; and

  (ii)   the kinds of claims and incidents that are usually covered by contracts of insurance that provide similar cover to the cover being offered; and

  (iii)   the kinds of exclusions that are usually provided for in contracts of insurance that provide similar cover to the cover being offered; and

  (iv)   any other relevant consideration; and

  (e)   the offer specifies the premium payable by the client for the cover being offered; and

  (f)   if the offer is made for the purposes of section   22--the premium payable by the client for the cover being offered is reasonable (see section   7A); and

  (fa)   if the offer is made for the purposes of section   23--the premium payable by the client for the cover does not exceed the amount specified in, or worked out in accordance with, the regulations; and

  (g)   the other terms and conditions of the contract being offered comply with the requirements (if any) prescribed by the regulations for the purposes of this paragraph; and

  (h)   the offer includes a clear, concise and effective explanation of:

  (i)   the significant characteristics and features of the cover being offered; and

  (ii)   the significant rights, terms and conditions and obligations attaching to the cover being offered; and

  (iii)   the risks involved for the health care professional in not accepting the offer; and

  (iv)   the options that will be available to the health care professional if the health care professional does not accept the offer; and

  (v)   any other matters prescribed by the regulations.

Premiums for run - off cover

  (3)   Regulations made for the purposes of paragraph   (2)(fa) may specify different amounts, or different ways of working out amounts, in relation to different classes of practitioners or different classes of insurance contracts.

  (4)   An amount specified in regulations made for the purposes of paragraph   (2)(fa) may be a nil amount.

Definitions

  (5)   In this section:

"current regulated contract" means the regulated insurance contract referred to in paragraph   23(1)(a).

"proposed regulated contract" means the regulated insurance contract referred to in paragraph   22(1)(a).


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