52CRisk surcharge requirements

52C Risk surcharge requirements

(1) Subject to subsections (3) and (4), a medical indemnity insurer may require a medical practitioner (the practitioner) to pay, as part of the amount payable for professional indemnity cover provided by a contract of insurance with the practitioner, an amount (the risk surcharge): (a) to reflect that, because the practitioner engages, or has engaged, in conduct that deviates from good medical practice, the practitioner’s private medical practice is likely to pose a higher risk to patients than similar practices (see subsection (2)); or (b) in circumstances specified in the rules. (2) The private medical practice of another medical practitioner (the comparison practitioner) is a similar practice if the insurer reasonably considers that the practitioner and the comparison practitioner have similar practice profiles for the purposes of calculating premiums for professional indemnity cover, except that the comparison practitioner does not engage, and has not engaged, in conduct that deviates from good medical practice. (3) The risk surcharge must not exceed the amount: (a) specified in the rules; or (b) worked out in accordance with a method specified in the rules. (4) The offer to enter into the contract of insurance to provide the professional indemnity cover must: (a) identify the amount of the risk surcharge; and (b) state the reason for requiring payment of the risk surcharge; in accordance with any requirements specified in the rules.