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Medical indemnity claims highest in general practice: AIHW

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18th May 2012
Mark O'Brien   all articles by this author

GENERAL practice has again topped the list of specialties associated with medical indemnity claims according to a report from the Australian Institute of Health and Welfare (AIHW).

The report found general practice was associated with 18% of new claims in 2009–10, ahead of obstetrics and gynaecology (9%), continuing a trend seen in 2007­–08 and 2009–10.

Diagnosis and medication-related claims accounted for 21% and 18% of new claims associated with general practice.

Overall, the number of claims (2900) rose in 2009–10 compared to previous years, but the majority (58%) were settled for less than $10,000 and no payment was made in 17% of cases.

About 51% of claims in 2009–10 were finalised through a negotiated settlement and just 3% through a court decision, while the remaining 46% of cases were discontinued.

Just 6% were settled for $500,000 or more.

Two-thirds of claims were finalised within three years of being opened, while 14% took more than five years to be settled.

AIHW spokesperson Nigel Harding said the most common allegation for loss in 2009–10 related to a procedure, “for example failure of a procedure, or post-operative complications,” he said.

“Diagnosis and treatment were the next two most common claim categories.”

The most common allegation of harm was neuromusculoskeletal and movement-related body functions and structures and almost three-quarters of allegedly affected patients were adults, with female patients outnumbering males.

Where the patient was a baby, almost one-third of new claims were associated with mental and nervous system effects.

The number of public sector claims rose more sharply than the total number of claims and the proportion closed for $500,000 or more (9%) was also higher than in any of the previous four years (4–8%).

MDA National president Professor Julian Rait said the data didn’t take into account the fact GPs were over-represented in terms of the number of consultations conducted.

“Our experience is that GPs are less likely, on average, to be included in an indemnity claim than proceduralists,” he said.

“That can be seen in the premiums for each specialty. Because there is no cross-subsidisation of premiums anymore you can look at the premiums paid by obstetricians and neurosurgeons compared to the premiums paid by GPs and get a good idea of the level of risk.

“I would also expect most of the claims involving GPs to fall into the category of claims settled for less than $10,000."

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