Document ID: chunk:federal_register_of_legislation:C2019A00105:clause:6_34zzb:p1
Version: federal_register_of_legislation:C2019A00105
Segment Type: clause
Provision Reference: sch 6 cl 34ZZB (pt 1/2)
Character Range: 92646–95284

34ZZB  Circumstances in which allied health high cost claim indemnity payable

Basic payability rule
 (1) Subject to section 34ZZC, an allied health high cost claim indemnity is payable to an eligible MDO or eligible insurer under this section if:
 (a) a claim is, or was, made against a person (the practitioner); and
 (b) the claim relates to:
 (i) an incident that occurs or occurred; or
 (ii) a series of related incidents that occur or occurred;
  in the course of, or in connection with, the practice by the practitioner of an allied health profession; and
 (c) if the allied health profession is midwifery:
 (i) the incident occurs or occurred; or
 (ii) all of the incidents in the series occur or occurred;
  in the course of, or in connection with, practice of a kind in relation to which eligible midwives are ordinarily, or could reasonably be expected in the ordinary course of business to be, engaged as employees (and therefore indemnified from liability by their employer); and
 (d) either:
 (i) the incident occurs or occurred; or
 (ii) one or more of the incidents in the series occurs or occurred;
  in Australia or in an external Territory; and
 (e) either:
 (i) the incident occurs or occurred; or
 (ii) all of the incidents in the series occur or occurred;
  on or after 1 July 2020; and
 (f) the MDO or insurer is first notified of:
 (i) the incident; or
 (ii) the claim; or
 (iii) an eligible related claim;
  on or before the date specified in the rules as the termination date for the allied health high cost claim indemnity scheme; and
 (g) the MDO or insurer has a qualifying allied health payment in relation to the claim, or qualifying allied health payments in relation to:
 (i) the claim; or
 (ii) the claim and one or more eligible related claims; and
 (h) the amount of the qualifying allied health payment, or the sum of the amounts of the qualifying allied health payments, exceeds what was the allied health high cost claim threshold at the earliest of the following times:
 (i) when the MDO or insurer was first notified of the incident;
 (ii) when the MDO or insurer was first notified of the claim;
 (iii) when the MDO or insurer was first notified of an eligible related claim; and
 (i) a high cost claim indemnity is not payable in relation to the claim; and
 (j) any other requirements (however described) that are specified in the rules have been met.
 (2) Any rules made for the purposes of subsection 11(3A) of the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Act 2010 apply for the purposes of determining whether practice is of a kind mentioned in paragraph (1)(c).
 (3)