ROCS - What Every Doctor Should Know

The Run-Off Cover Scheme (ROCS) is a government initiative designed to provide secure insurance for eligible doctors who have left private practice.

In line with earlier measures to address the affordability of medical indemnity and the long-term viability of the industry, ROCS provides cover at no cost, for retired doctors and others who have left the workforce (permanently or temporarily).

ROCS has been in operation since 1 July 2004, successfully providing free cover to eligible doctors. However, as with all insurance, it is important to understand how it works.

Who provides ROCS and who is eligible?

Under ROCS, medical indemnity insurers are required to grant indemnity to eligible doctors, based on their last contract of insurance.

Insurers issue notices of indemnity to doctors and manage any claims that emerge under those contracts. The Government pays the costs of valid claims including the costs of managing claims.

Funding for the scheme is via a levy charged by the government. It is a percentage of the premiums that medical indemnity insurers charge for providing cover. The percentage has recently reduced to 5% of your base premium.

Nobody wants to see a situation where doctors find themselves without cover when a claim is made. The key to avoiding this lies in understanding the following key features of ROCS:

1. Eligibility - you are eligible for ROCS immediately when leaving private practice, whether due to permanent retirement (65 or older), maternity, permanent disability or when leaving the country after working on a Medical Practitioner or Business (long stay) visa (class 422 or 457). If ineligible on these grounds, you become eligible after 3 consecutive years of not practising privately.
   
   You should notify your current insurer immediately if you become eligible under any of these classes, or if your eligibility changes (evidence will be required.)
   
   If a doctor dies, his estate becomes eligible.
   
   
2. Ceasing to be eligible - If you resume paid medical practice in the private sector (or any paid medical practice if you became eligible through maternity or disability), even part-time or short-term (e.g. locum) work, you will no longer be eligible for ROCS. You will need to buy insurance for your current work and run-off/tail (see article Is My Tail Covered? Tail Cover Demystified ) cover for earlier periods.
   
   Note that paid medical practice technically includes work for which you received payment in kind (like a bottle of wine), and may include work other than medical treatment, which requires medical expertise (like drafting a medicolegal report). If in doubt, contact us.
   
   Gratuitous practice, i.e. practice for which no remuneration is received, will not affect your ROCS cover, but this practice will not itself be covered by ROCS, and you will need to take out separate cover for it.
   
   
3. Notification - Once notified of your eligibility, your current insurer is obliged to send you a ROCS notice. This will contain details of the cover provided and its terms and conditions.
   
   
4. Cover - ROCS cover is based on the policy in force, immediately prior to your being eligible for ROCS.
   
   This means that it is important to ensure you have adequate medical indemnity cover (including retroactive cover) before leaving the workforce. If you do not, ROCS will mirror only your previous cover, and you will have to buy additional run-off cover to fill the gap.
   
   
5. Claims - from your viewpoint, the transition to ROCS should be seamless, i.e. claims will be handled exactly as they would under the medical indemnity insurance policy you were paying for while still in practice. Claims which would have been payable in the ordinary course of business, i.e. under pre-ROCS cover will still be payable under ROCS, provided they are covered by a ROCS contract or insurance/MDO arrangement as above, and notified while the doctor is eligible.

It should be noted of course, that ROCS is a government run scheme and that the ROCS legislation also contains provisions for its termination. Despite this possibility, doctors should know that there is not currently any indication that the scheme will end. And should it happen, we would of course endeavour to put alternative arrangements in place for doctors who have entered ROCS through Invivo.

Remember, if you're uncertain about any aspect of ROCS or medical indemnity cover, talk to us on 1800 103 779.

Source article courtesy of:

Department of Health and Ageing,
Medical Indemnity Branch, Canberra
http://www.health.gov.au/