Document ID: chunk:federal_register_of_legislation:C2024C00534:section:34l:p2
Version: federal_register_of_legislation:C2024C00534
Segment Type: section
Provision Reference: s 34L (pt 2/2)
Character Range: 97869–99865

to a public patient in a public hospital—see section 34N; or
(e) if the claim relates to a series of incidents some, but not all, of which occurred after the exceptional claims termination date—see section 34O.
Note 2: For the purpose of subparagraphs (f)(i) and (ii), payments and liabilities to pay must meet the ordinary course of business requirement set out in subsection (3).

Who the indemnity is payable to
 (2) The indemnity is to be paid to the person who applies for it.
Note: For who can apply, see section 37A.

Ordinary course of business test for insurance payments
 (3) An amount that an insurer has paid, or is liable to pay, under a contract of insurance does not count for the purpose of subparagraph (1)(f)(i) or (ii) unless it is an amount that the insurer paid, or is liable to pay, in the ordinary course of the insurer's business.

What if the insurer is a Chapter 5 body corporate?
 (4) If an insurer is a Chapter 5 body corporate:
 (a) a reference in paragraphs (1)(e) and (f) to an amount that the insurer is liable to pay under a contract of insurance is a reference to an amount that the insurer is liable to pay under the contract and that is a provable amount; and
 (b) a reference in subsection (3) to an amount that an insurer is liable to pay in the ordinary course of the insurer's business is a reference to an amount that the insurer is liable to pay, and would be able to pay in the ordinary course of the insurer's business if it were not a Chapter 5 body corporate.

ART review of decision to refuse, or to pay a particular amount of indemnity
 (5) An application may be made to the Administrative Review Tribunal for review of a decision of the Chief Executive Medicare to refuse an application for exceptional claims indemnity, or a decision of the Chief Executive Medicare to pay a particular amount of exceptional claims indemnity.
Note: Section 266 of the Administrative Review Tribunal Act 2024 requires notification of a decision that is reviewable.