Document ID: chunk:federal_register_of_legislation:C2023C00421:section:23:p1
Version: federal_register_of_legislation:C2023C00421
Segment Type: section
Provision Reference: s 23 (pt 1/3)
Character Range: 45300–48242

23  Additional offer of run‑off cover when particular events happen during claims period for regulated insurance contract

Offence—compulsory offer
 (1) A person (the insurer) commits an offence if:
 (a) the insurer provides medical indemnity cover for a health care professional under a regulated insurance contract; and
 (b) an event prescribed by the regulations for the purposes of this paragraph occurs during the claims period for the regulated insurance contract; and
 (c) the insurer does not make an offer (the compulsory offer) to the client that satisfies all of the following subparagraphs:
 (i) the offer is an offer to provide medical indemnity cover for the health care professional in relation to compensation claims that are made against the health care professional in relation to the health care professional's otherwise uncovered prior incidents and the offer satisfies the requirements specified in the regulations for the purposes of this subparagraph;
 (ii) the offer is made within 28 days after the insurer becomes aware of that event;
 (iii) the offer is a complying offer.
Note: For complying offer, see section 24.
Penalty: Imprisonment for 12 months.
 (2) Without limiting subparagraph (1)(c)(i), the regulations made for the purposes of that subparagraph may specify requirements in relation to:
 (a) the compensation claims to be covered by the contract being offered; and
 (b) the limits on the amounts payable by the insurer under the contract being offered (whether in relation to an individual compensation claim or in relation to compensation claims made during a particular period).
Without limiting paragraph (a), the regulations may specify the compensation claims by reference to the period during which the compensation claims can be made.

Offence—entering into new contract before response to compulsory offer received
 (2A) For the purposes of making an offer to provide the cover referred to in subparagraph (1)(c)(i) for a health care professional, disregard the regulated insurance contract referred to in paragraph (1)(a) in determining the health care professional's otherwise uncovered prior incidents.
 (2B) In determining whether an offer made by an insurer to provide medical indemnity cover for a health care professional satisfies subparagraph (1)(c)(i), disregard:
 (a) an otherwise uncovered prior incident of the health care professional; or
 (b) a compensation claim in relation to an incident of that kind;
if it is reasonable and appropriate for the insurer to exclude the incident or claim from the cover being offered, having regard to:
 (c) the nature of the health care provided by the health care professional during the period during which the otherwise uncovered prior incident occurred; and
 (d) the kinds of exclusions that are usually provided for in contracts of insurance that provide similar cover to the cover being offered; and
 (e) any other relevant consideration.