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Membership

Benefits Handbook
2016/2017

Combined Financial Services Guide and


Product Disclosure Statement

“ Excellence is never an accident.


It is always the result of high
intention, sincere effort, and
intelligent execution; it represents
the wise choice of many
alternatives – choice, not chance,
determines your destiny.”
1 May 2016Benefits Handbook
Membership

About this handbook


This handbook is a combined financial services About MIPS 3
guide (FSG) and product disclosure statement Membership benefits 4
(PDS) and is an important legal document Important features 12
designed to help you make an informed
Conditions of membership 20
decision when applying for MIPS membership.
Financial Services Guide 24
You should read this handbook before making
a decision about joining MIPS. Membership classification guide 26
Privacy 43
This handbook describes the features and
benefits of MIPS membership for the
2016/17 year.
Information in this handbook may change from
time to time. Where the change is not material,
you will be able to find that new information by
visiting the MIPS website at mips.com.au or by
contacting MIPS on 1800 061 113. A paper
copy of any updated information will be given
to you on request. When necessary we will
issue a supplementary or replacement PDS.
To assist with timely membership responses
and our efforts to reduce paper use, MIPS
provides membership correspondence
electronically with all members who have
provided their email address to MIPS. If you
wish to obtain a hardcopy of documents free
of charge please contact MIPS. See the inside
back cover for contact details.

About the cover


The quotation on the cover is sometimes misattributed to Aristotle, however, it is in fact more closely related to a summation of
Aristotle’s Nicomachean Ethics which appears in The Story of Philosophy (1926) by Will Durant. Durant’s book included these words
commonly misattributed to Aristotle “…we are what we repeatedly do. Excellence, then, is not an act but a habit”. It is from Durant’s
interpretation of Aristotle that the quote appearing on the cover is likely derived, however, the source itself is unknown.

This booklet is issued by Medical Indemnity Protection Society Ltd (MIPS) ABN 64 007 067 281 | AFSL 301912.
Cover for the MIPS Members' Indemnity Insurance Policy and the MIPS Members’ Practice Entity Insurance Policy are provided under
separate master insurance policies arranged with MIPS Insurance Pty Ltd (MIPS Insurance) ABN 81 089 048 359 AFSL 247301.
Cover for the MIPS Members' Personal Accident Policy is provided under a master insurance policy arranged with Accident & Health
International ABN 26 053 335 952 | AFSL 238261.
This Combined FSG and PDS was prepared on 1 May 2016.
This MIPS Membership Benefits Handbook is printed on Revive Pure Silk 100% Recycled and is certified carbon neutral. It is
process chlorine free (PCF) manufactured by an ISO 14001 certified mill.

2
About MIPS Why do
healthcare
professionals
need MIPS
membership?

Why do MIPS:
Healthcare healthcare About MIPS over 25 years
professionals in MIPS was established of service. Exists
clinical practice professionals
in 1988 as a medical solely to protect
face significant risk need MIPS
defence organisation and support its
of complaints, membership? that protects, supports
legal action and members
and safeguards the
investigation. professional character and
This is the reason every interests of its members.
healthcare practitioner should have the MIPS is a not for profit mutual. MIPS assets
MIPS:
comprehensive protection and support provided are ultimately owned by its members and
through MIPS membership. over 25 years membership concerns are the primary
Having the right protection andof support,
service. Exists consideration when decisions are made.
such as our 24-hour Clinico-Legal
solelySupport,
to protect MIPS exists to promote honourable and
gives members the peace of mind they needits
to discourage irregular practice and to protect
and support
practise with confidence. Adverse or unexpected the interests of its members.
members
events can affect any practising healthcare MIPS’ commitment to members is derived from
professional. That’s why caution, good clinical the Constitution of MIPS. The Constitution sets
risk management and MIPS membership, out the rules which form the basis of how MIPS
including indemnity cover, is essential. operates, including providing that:
It is important to remember that even if your • all surplus income is added to the
employer provides indemnity for negligent membership’s total reserves
actions or omissions, you may not be covered • no dividends are distributed, however
for your individual professional risks – such investment income is used to offset the cost of
as a coronial inquest, or a complaint to, or members’ membership fees
investigation by an Australian Health Practitioner • subscribing members have a right to
Regulation Agency (AHPRA) health board, MIPS reserves.
your employer or education provider.
A copy of the Constitution of MIPS is available
It is a mandatory AHPRA registration requirement at mips.com.au/publications or on request
for healthcare practitioners to hold appropriate free of charge.
professional indemnity insurance to cover all
aspects of their healthcare practice. MIPS objectives are to:
• grant indemnities to members in respect of
claims or demands
• advise, assist and defend in cases arising out of
clinical practice which may affect the professional
character or interests of our members
• provide and obtain advice on any legal or
other matter
• consider, originate, promote and support,
or oppose legislative or other measures
affecting members.
3
Membership benefits

Membership of MIPS Who can join?


MIPS membership affords you a number of MIPS membership is available to:
entitlements and benefits, including: • qualified healthcare practitioners and persons
• comprehensive indemnity insurance cover legally entitled to practise medicine, surgery,
for your provision of healthcare to patients dentistry, oral health or nuclear medicine
• MIPS Protections which can provide technology in Australia
assistance including indemnity for non-insured, • students studying a course that will lead them
non-medical indemnity matters arising from to become a registered healthcare practitioner
your professional or educational activities as a medical doctor, dentist, oral healthcare
• 24-hour Clinico-Legal Support provided by practitioner or nuclear medicine technologist
experienced clinicians in Australia
• accredited risk education • students currently studying a healthcare
• personal accident insurance (including travel discipline at a recognised education provider
cover) for approved healthcare placements outside of Australia and undertaking a
outside of Australia. temporary elective placement in Australia.

These benefits have been specifically tailored All membership applications are subject to
to meet the needs, including Australian Health eligibility rules and processes. An annual
Practitioner Regulation Agency (AHPRA) membership fee applies for members other
requirements, of healthcare professionals than students.
and students.

Indemnity Insurance MIPS Protections Practice Entity


Policy (non-healthcare matters) Policy

  Q
Personal Cover for
Accident Policy international placement

(
24-hour Clinico- Accredited risk
Legal Support education

4
Membership benefits

Insurance benefits Cover under this policy meets the professional


indemnity requirements
MIPS has acquired on behalf of its members the
of AHPRA for healthcare practitioners. For full
following group policies of insurance:
details of the terms and conditions of the
• MIPS Members’ Indemnity Insurance Policy Indemnity Insurance Policy see the Members’
(Indemnity Insurance Policy) Insurance Covers Handbook.
• MIPS Members’ Practice Entity Insurance Policy
(Practice Entity Policy) Extension of indemnity cover for practice
• MIPS Members’ Personal Accident Insurance outside of Australia
Policy (Personal Accident Policy). Cover under the MIPS Members’ Indemnity
Cover under these insurance policies is a benefit Insurance Policy can be extended to members
of MIPS membership that is available only to conducting MIPS approved temporary
members of MIPS. MIPS itself is not an insurer placements outside of Australia. For example:
and is not authorised by Australian Prudential
Scenario Indemnity cover
Regulation Authority (APRA) to carry on insurance
business. These insurance policies are all issued Student elective placement under
1
by APRA authorised insurers. appropriate supervision
2 ✕
Your entitlement to cover, under the insurance Employer indemnified placement (eg
1
policies, is subject to the terms and conditions of employee in a hospital) 3
the policies. This includes your membership 2 ✕
Gratuitous aid healthcare services in a 4
classification, whether your membership is current 1
developing country 3
and any endorsements or exclusions that apply. 5
2 ✕
These are important to the operation of the policies. Healthcare services when accompanying4 an
1
6
Australian sporting and/or cultural group.
3
The policy documents can be found in the 5
2 ✕
Members’ Insurance Covers Handbook available Cover can be extended for placements4in all
6
at mips.com.au/publications or on request free 3 applies.
countries except the US or where US law
5
of charge. Non-student members are required to 4complete
6
an Application for Cover for Healthcare5Services
Indemnity Insurance Policy
Outside of Australia form and student members
The Indemnity Insurance Policy insurer is MIPS 6
are required to complete a Student Elective
Insurance. The Indemnity Insurance Policy Application form in advance for this cover
provides cover for claims made against any MIPS to be considered. You can apply online at
member arising out of the provision of healthcare mips.com.au/forms
by the member. This covers claims made against
a member during the period of insurance and If approved, an endorsement will be placed on
notified to MIPS in the period of insurance (or any your membership to reflect the extension of
extended reporting period). cover which may require an additional fee.
Australian Health Practitioner Regulation If you are undertaking an approved placement
Authority (AHPRA) requires that all registered outside of Australia you may also be eligible for
healthcare practitioners have professional personal accident (and travel insurance) covers
indemnity insurance. (see the 'Personal Accident Policy’ section).

5
Membership Benefits Handbook

Key features Included

Indemnity cover that meets AHPRA's requirements for registration 1


The total available insurance limit for each member under the Indemnity Insurance Policy 2 ✕
is $20 million.
3
For those members who require an automatic reinstatement to comply with AHPRA indemnity
requirements of registration, the insurance cover provided will be shown on your Member Benefit 4
Statement as a $10 million limit plus an automatic reinstatement of that amount. This means that5 if
during the policy period the $10 million cover is exhausted that the same amount of cover will be
automatically reinstated so that the total cover available is $20 million. For other members, the limit
6
of cover will be $20 million per claim and for all claims, in the aggregate, in the policy period.
No standard excess or pre-set cover sub-limits apply.

Defence costs and investigations for disciplinary proceedings, administrative proceedings 1or
investigations that relate to claims or incidents covered under the policy. These are included in
the limits described above. 2 ✕

3
Good Samaritan healthcare is where you provide healthcare voluntarily, without remuneration, 1
4
in relation to unexpected events and where you wouldn’t normally be expected to be available
2
to provide healthcare. This may include events such as assisting a passenger on an international
5 ✕
flight or attending the scene of a car accident. 3
6
4
Clinical trials: Members requesting cover for non-employer indemnified clinical trials are 1
required to complete and return for consideration and approval a Clinical Trial Notification form
5
with supporting documentation such as ethics committee approval, trial protocols and 2 ✕
6
proposed patient consent forms. 3

4
Practice entity excess cover for any excess up to $10,000 that might be payable under a 1
separate practice entity insurance policy with an insurer other than MIPS Insurance. 5
2 ✕
6
Telehealth: Members requesting cover for non-employer indemnified telehealth services are3
1
required to complete and return for consideration and approval a Practice Assessment
4
2 ✕
Questionnaire. Telehealth is defined as healthcare provided over the internet, by video
conference or telephone in Australia in accordance with AHPRA, college and Medicare 5
3
requirements. Under Australian law, the location of the patient is where the healthcare is 6
4
considered to be provided. Cover for telehealth requires the same care as any other provision
of healthcare and if the medium is not appropriate for a patient, members are expected not 5to
offer telehealth consultations.
6

6
Membership benefits

Practice Entity Policy The following examples help illustrate whether a


The insurer of the Practice Entity Policy is practice is covered under the Practice Entity Policy.
MIPS Insurance. This cover is only applicable
to members who are undertaking private = MIPS member and working practitioner
(non-employer indemnified) practice. It is not
applicable to student members. = Non MIPS member and working practitioner

The Practice Entity Policy provides cover for a


= Silent non-working partner
member’s practice entity and their practice staff.
Practice staff includes any administrative or
management staff that work in your practice Healthcare practice covered under the
(eg receptionist, clerk, practice manager). Practice Entity Policy
Other healthcare practitioners that are required
to be AHPRA registered are excluded (eg nurses,
physio-therapists and other allied health
professionals). See the MIPS Members’ Practice Ownership 25% 25% 25% 25%
Entity Insurance Policy for a definition of ‘Practice
staff’ and full policy details. Working 25% 25% 25% 25%

To be entitled to cover under the Practice Entity1 The majority of owners of the entity are MIPS
Policy your practice entity must fit one of the
members
following scenarios: 2 ✕
The majority of working practitioners of the
• you are a sole practitioner and/or only 3 entity are MIPS members
shareholder of your practice (ie you own 100%)
4
• MIPS Members hold the majority of ownership Healthcare practice not covered under the
in the company or partnership AND where the 5 Practice Entity Policy
majority of healthcare provided in the practice
6
is undertaken by MIPS members
• an entity or practice structure approved
by MIPS. Ownership 25% 25% 25% 25%
If you are unsure if your practice structure meets Working 33.3% 33.3% 33.3% 0%
the required definition under the Practice Entity1
Policy, you can complete the Practice Entity 2 The majority of owners of the entity are NOT

Enquiry form at mips.com.au/forms MIPS members (must be a majority of greater
3 than 50%)
4 The majority of working practitioners of the
entity are MIPS members, however, an entity
5
must meet both the ownership and working
6 MIPS member requirements to be eligible.
For the policy definition of a practice entity see
the Practice Entity Policy in the Members’
Insurance Covers Handbook.

7
Membership Benefits Handbook

Personal Accident Policy Benefits include:


• death benefit of $125,000 (or $200,000 for
Personal accident members of five or more consecutive years
The Personal Accident Policy provides certain of membership)
benefits for members under age 75 (and/or their • a lump-sum payment (benefit varies) for a
families subject to the terms, conditions and permanent loss of healthcare board registration
limitations of the policy). due to accident or sickness (as defined)
It is important to note that not all benefits under • funeral expenses of up to $10,000
the policy apply to all members (ie some • payment of outstanding credit card balance
exclusions apply based on your category, basis or of up to $10,000 if a death benefit is payable
endorsement/s which are on your Member • replacement staff recruitment supplement of
Benefit Statement). Benefits do not extend to up to $10,000
members in the healthcare student membership
• education fund supplement of up to $15,000 in
category or those with a basis of ‘non-practising’
the event of your death for any dependent
unless stated otherwise (eg students are eligible
children
for travel cover connected with electives outside
of Australia). • communicable diseases (ie AIDS, HIV, Hepatitis
B or C) cover of $25,000 for student and recent
Benefits include lump-sum payments for graduate members when the disease is
accidental bodily injury, sickness or death due to acquired through undertaking an authorised
defined events. The policy does not cover loss healthcare activity and appropriate for your
of income. membership classification.
See the Personal Accident Policy in the Members’
Insurance Covers Handbook for full details.

8
Membership benefits

Travel cover Eligibility for travel cover


Travel cover is provided under the Personal Members may apply for travel cover when the
Accident Policy subject to eligibility (see table on main purpose of their travel is providing
following page to check eligibility) and approval healthcare outside Australia.
by MIPS prior to travel commencing. For example, if you are undertaking an approved
To receive travel cover, non-student members are four week clinical placement followed by one
required to complete an Application for Cover for week holiday, the travel extension will apply to
Healthcare Services Outside of Australia form and the whole period outside of Australia (five weeks).
student members are required to complete a If you are uncertain whether you will be covered
Student Elective Application form in advance for for the particular circumstances please provide
this cover to be considered. You can apply online full details to MIPS (info@mips.com.au).
at mips.com.au/forms Examples of eligibility are as follows:
If approved, cover is limited to travel for the
specified purposes of providing healthcare Indemnity cover Travel cover
outside Australia and to one trip per year.
Student member undertaking an
Insured events include: approved elective placement
1
• medical expenses up to $2 million for 24 months 2 ✕
(and some additional expenses up to $100,000) Recent graduate member undertaking
1
• loss of baggage, traveller’s cheques, travel an approved clinical placement in an 3
documents, credit cards up to $10,000 employer indemnified arrangement 2 4

• kidnap, detention, ransom and extortion Non student member providing gratuitous 3
5
1
up to $500,000 healthcare services (includes cover for any
4
• hire car excess up to $2,000 family member travelling with you) 6
2 ✕
• personal liability up to $1 million 5
Cover is limited to one pre-approved overseas
3
• extra territorial workers compensation trip per annum, per member. Student and6 recent
up to $500,000 4
graduate cover is capped to a trip length of six
• evacuation cover and personal safety calendar months. The travel cover does5not apply
up to $25,000. to any travel undertaken in Australia.
6
See the page over for details about when travel
This is a summary only. See the Personal Accident
insurance cover applies.
Policy in the Members’ Insurance Covers Handbook
for full policy terms, conditions and exclusions.

9
Membership Benefits Handbook

Cover to Unique to
$20 million in MIPS and
aggregate with available to
NO sub-limits all members

Provides A common
Other
Cover to member Unique to one-off However,
payments the24-Clinico-Legal
Board has request is for
discretion to accept or by assistance with
benefits
$20 million in MIPS and for events that Support
refuse assistance in
aggregate with available tolead to disabilities experienceddisputes involving
MIPS Protections whole or in part, or
NO sub-limits all members such practitioners colleagues or
mayasdecide not to
MIPS Protections may paraplegia an employer
provide assistance for accept a MIPS
non-medical indemnity, Protections claim, or
personal and professional risks withdraw cover, if you
arising from your clinical activities that may not misrepresent any information to MIPS, or
otherwise be covered by insurance withhold information, about a material matter.
Provides A arrangements.
common MIPS may refuse to pay or reduce the amount it
one-off This
payments request
may include disputes that arise is for
in connection will pay, for a claim MIPS
if it is any way fraudulent. If
with employment,
for events that assistance
training, industrial with
relations MIPS exercises its discretion not to pay your MIPS
disputes
and non-clinical registration and board involving
issues. education
ead to disabilities Protections claim or to pay only part of your
is accredited
Foras
such example, if you have a dispute about your
colleagues or claim, or withdraw cover, we will inform you of
contract with your employer. an employer
paraplegia that decision.
MIPS Protections is not insurance cover and does
Why MIPS Protections? not include assistance for any claims covered by
MIPS introduced MIPS Protections to provide any insurance policy under which you are entitled
additional protection for well-intentioned to claim and does not apply to risks that MIPS is
members for matters that may not otherwise legally prohibited from protecting, such as
be covered including matters where their medical indemnity claims.
career might be jeopardised. This added
discretionary cover is in addition to the APRA regulates insurance companies under the
insurance covers that are part of MIPS Insurance Act 1973 (Cth), which establishes a
membership. MIPS assists over 100 members system of financial supervision of general insurers
each year, on average, through MIPS in Australia. It does not regulate discretionary
Protections. mutual organisations such as MIPS.
For this reason, MIPS and the MIPS Protections
This membership benefit is unique to MIPS and are not subject to the Insurance Act or APRA
available to all members. MIPS will consider your regulation and supervision. MIPS is not
claim for protection in accordance with the MIPS authorised to carry on insurance business in
Constitution and the law. Australia. MIPS is regulated by the Australian
Securities and Investment Commission as an
You can have a realistic expectation that claims Australian Financial Services licensee.
under MIPS Protections will be accepted if the
claim comes within the scope of the protection
provided by MIPS.

10
Membership benefits

Cover to Unique to 24-Clinico-Legal


$20 million in MIPS and Support by
aggregate with available to experienced
NO sub-limits all members practitioners

Provides A common
24-hour
Unique Clinico-
to one-off Accredited
payments 24-Clinico-Legal request is for CPD
Legal MIPS
MIPS andSupport
for events that Support by assistance
MIPS with
takes an active
education
available tolead to
As a member youdisabilities
have experienceddisputesrole
involving
in helping
members or better is accredited
all members
access to experienced
such as practitioners colleagues
fellow practitioners,
paraplegia manage their day-to-
an employer
to discuss claims, day working life, to help
complaints, professional avoid adverse outcomes to
challenges, risks and problems patients or, in the event they
you experience. MIPS prides itself on the quality occur, to help mitigate those outcomes. MIPS
of the independent and confidential advice that
A common education also focusses on minimising the risk
its expert
request is for advisers provide. healthcare practitioners face from complaints and
assistance withneed to be under threat ofMIPS
You don’t being
regulatory body investigations.
disputessued
involving education
to call. Approximately 90% of requests Ongoing Continuing Professional Development
colleagues or
for assistance is accredited
are concerned with problems (CPD) is a mandatory AHPRA registration standard
an employer
unrelated to being sued. for all healthcare practitioners and can be subject
to audit by the AHPRA healthcare boards.
For example, our advisers can help members
with: MIPS is an accredited education provider for the:
• mandatory notifications • Australian College of Rural and Remote
• preparation of coroner’s reports (and similar Medicine (ACRRM)
clinico-legal reports) • Royal Australian College of General
• ethical issues Practitioners (RACGP)
• potential or actual complaints by patients (to • Royal Australian College of Surgeons (RACS).
members directly, or to their employer/ hospital) MIPS has developed a range of risk education
• complaints by members’ employer(s) workshops, webinars and online training units
or education providers and as a member you can access these resources
• healthcare services, health rights and at no additional cost. Completion of risk
Healthcare Complaints Commission matters education activities may assist you to meet your
• other healthcare practitioner legal matters, not CPD requirements. Membership records are
covered by an insurance policy. updated with a record of participation and
participants receive a certificate of attendance to
Where appropriate MIPS will access its national assist with CPD evidence.
independent panel of legal advisers that
specialise in and understand the healthcare My Membership – online access
profession and State and Territory jurisdictions. The My Membership portal provides a
Members can request assistance or lodge convenient way for you to view and amend your
a claim notification by contacting MIPS on contact and membership details, print your
1800 021 223 or claims@mips.com.au Certificate of Currency (membership), Member
or complete an online notification form at Benefit Statement (tax invoice) or summary of
mips.com.au/forms completed MIPS risk education. Online access
is automatically provided once your application
has been approved and payment finalised.
Log in at mips.com.au
11
Important features

Claims made policy


This summary highlights some of the Medical indemnity insurance in Australia is
important features of membership, including provided on a claims-made basis. This approach is
the insurance covers. However, this is a different to some other countries, such as the UK
summary only. Full details of the insurance where cover is generally provided on a claims-
covers that are a benefit of MIPS incurred basis.
membership can be found in the Members’
Insurance Covers Handbook available at The Indemnity Insurance Policy and the Practice
mips.com.au/publications or on request by Entity Policy are claims-made insurance policies.
post free of charge. Claims-made insurance policies cover claims
made in the period of insurance and notified to
Your membership classification the insurer in the period of insurance.
You should take particular care to select the This means that MIPS members are only covered
membership category that best describes your under the Indemnity Insurance Policy and the
area of specialisation. You must also provide Practice Entity Policy if they are a member at the
MIPS with all relevant information regarding your time the claim is made against them. Also, you are
practice to assess your practice classification. not covered for incidents prior to your retroactive
Members must have appropriate recognised date or previously known to you or matters that
qualifications, training and experience for the have been notified to you or your previous insurer
healthcare services they provide including or medical/dental defence organisation.
appropriate supervision if required. You are You must notify MIPS as soon as reasonably
not covered under the Indemnity Insurance practicable after you first become aware a claim
Policy for any healthcare provided outside your or investigation is made against you,
membership classification. in accordance with the terms and conditions of
There are some types of practice that require the policy.
you to have an endorsement placed on your To the extent provided in section 40(3) of the
membership (eg spinal surgery). Insurance Contracts Act 1984 (Cth) where you
More information regarding membership give notice to an insurer of facts that might give
classification, including endorsements, can be rise to a claim as soon as was reasonably
found in the ‘Membership classification guide’ practicable after you become aware of those
section of this handbook. facts, but before the policy period expires; you
are covered for any claim made against you
arising from those facts even if it is not made
against you until after the policy period has
expired.

12
Membership benefits

Retroactive cover
Example of cover (cover for previous practice)
MIPS cover is claims-made. This diagram The Indemnity Insurance Policy and Practice Entity
illustrates a claim under both claims incurred Policy will only cover you for claims that arise from
and claims-made. incidents that occur after the retroactive cover
• If the policies were claims-made then the date set out in your Member Benefit Statement.
incident would be covered by Insurer B Cover is not provided for incidents prior to that
because the incident was first notified in retroactive cover date.
period 2 and occurred after the
retroactive date You must nominate a retroactive cover date in
your application.
• If the policies were claims-incurred then
the incident would be covered by Insurer Retroactive cover is extremely important for all
A because the incident occurred within healthcare professionals because of the length of
the period covered by Insurer A. time it may take for a claim or complaint to be made
from a prior incident. In many cases, a claim or
Insurer A Insurer B complaint can be first made years after the incident.
Policy period 1 Policy period 2 It is an AHPRA requirement that you have
professional indemnity cover for previous
Retroactive Incident Date both insured private practice.
date (claims date and insurer first
made only) notified

13
Membership Benefits Handbook

Run-off cover (cover for previous practice


when ceasing healthcare in Australia) Returning home?
When you cease practice in Australia, the International healthcare practitioners
potential for claims relating to your past clinical sometimes overlook the difference between
practice continues. insurance covers for healthcare practice in
Australia and their home country and leave
To ensure you remain covered for claims made Australia without cover. It is important to realise
after you cease practice you will need to continue that doing so leaves you vulnerable, as your
your MIPS membership and select an appropriate liability for past practice continues even after
‘run-off’ cover membership category. MIPS run-off you cease practice in Australia. This is why it is
cover provides benefits of membership, including common practice for healthcare practitioners
cover under the Indemnity Insurance Policy. to acquire ‘run-off’ cover when they leave
MIPS can offer you run-off cover for your past Australia, either temporarily or permanently.
practice in an extended reporting period (ERP)
membership classification. The cost of ERP cover Policy limits
is calculated on your individual risk history and
There are limits that apply to cover under the
will vary for each member. If you have been with
insurance policies.
MIPS for five continuous years and you are
permanently retiring from all healthcare practice Indemnity Insurance Policy
you will be eligible for ERP loyalty cover which is
The maximum MIPS will pay in the aggregate for
offered at $50 per annum.
all claims notified in a membership period under
After three years of no private practise in the Indemnity Insurance Policy, including defence
Australia, medical practitioners may become costs, is $20 million OR if your registration requires
eligible for the Run-off Cover Scheme (ROCS), an automatic reinstatement to meet AHPRA’s
an Australian Government scheme that offers requirements for registration the limit per claim is
run-off cover at no cost to eligible practitioners. $10 million plus one reinstatement of the same value.
In some circumstances, such as maternity leave
Your Member Benefit Statement sets out the
or retirement over the age of 65, medical
limits that apply to you. See the Insurance Covers
practitioners may be immediately eligible for
Handbook for policy details.
ROCS from the date they cease practice.
See ‘Government assistance schemes’ for
more information.
To advise MIPS of your cessation of practice
please complete the Ceasing Practice form
online at mips.com.au/forms
Run-off cover is not provided under the Practice
Entity Policy.

14
Important features
Section

Practice Entity Policy Exclusions


The maximum MIPS will pay in the aggregate for The Indemnity Insurance Policy and Practice
all claims notified in a membership period under Entity Policy do not cover all events and
the Practice Entity Policy, including defence costs, circumstances or all types of claims.
is $20 million less any amount paid or payable
Examples of circumstances where cover does not
under the Indemnity Insurance Policy. See the
apply include:
Insurance Covers Handbook for full policy details.
• any matters previously notified to you or your
Personal Accident Policy previous insurer/medical defence organisation
There is a limit for claims under the Personal at the time of application
Accident Policy and these are set out in the Table • for any practice incident prior to the nominated
of Benefits of the Personal Accident Policy in the retroactive cover date
Members’ Insurance Covers Handbook. • the provision of healthcare outside of your
AHPRA registration, including any conditions
Excess or restrictions
When you make a claim under the insurance • the provision of healthcare outside of Australia
covers or MIPS Protections, there is generally no or its Territories, unless previously agreed in
excess payable. However, an exception may writing by us
apply to some members. In the unlikely event an • proceedings brought against you outside
excess is required, the amount of any excess will Australia or under, or to apply to enforce,
be shown in your Member Benefit Statement. any law other than Australian law
This excess will apply to all of the insurance • the provision of healthcare outside the
covers and MIPS Protections. See the ‘Calculating membership classification stated on your
an excess’ section for further details. Member Benefit Statement
• business-related issues or incidents that are not
directly related to your provision of healthcare
• where you are not registered but the law
requires you to be
• if you are a student member, the provision
of healthcare in any capacity other than as a
student, trainee or observer or other than
under the supervision of an appropriate
registered healthcare practitioner.

15
Membership Benefits Handbook

The Personal Accident Policy also contains policy Premium Support Scheme (PSS)
exclusions. Where these exclusions apply, cover The PSS is an Australian Government scheme
will not be available under the policy. designed to help eligible doctors with the costs
Please refer to the Members’ Insurance Covers of their medical indemnity insurance. MIPS
Handbook for comprehensive details of administers this scheme on behalf of the
exclusions that apply to the Indemnity Policy, Government. Eligible doctors will see the benefit
Practice Entity Policy and Personal Accident Policy. of the PSS as a reduction in the total membership
fee payable.
Government assistance schemes You may be eligible for the PSS if:
Run-Off Cover Scheme (ROCS) • your gross medical indemnity costs exceed 7.5%
ROCS is an Australian Government scheme of your estimated gross income generated from
designed to provide run-off cover free of charge private practice gross billings, or
to eligible medical practitioners who leave the • you are a procedural general practitioner in a
private medical workforce. The cover under rural area (ie Rural, Remote and Metropolitan
ROCS is the same as your last medical indemnity areas 3-7), or
insurance contract prior to or at the time of • you previously applied and were deemed to
eligibility for ROCS. be eligible for a subsidy under the Medical
Indemnity Support Scheme (ie former MISS
MIPS Insurance is required to pay a percentage
participant), or
of the yearly medical practitioner insurance
premium to the federal government to fund • you have retired from private practice
ROCS. The part of your membership fee that ($0 private medical income for the full
relates to this payment is shown in your Member membership year), but continue to practise in
Benefit Statement. the public sector and your medical indemnity
costs include run-off cover for incidents relating
To assess your eligibility for ROCS please to your prior period of private practice.
complete the Ceasing Practice form online at
mips.com.au/forms If you are eligible and choose to participate you
will need to provide your estimated gross private
For more information, please visit the Department medical income. Based on this information you
of Health website and refer to the ROCS may be advanced an estimated subsidy.
Frequently Asked Questions at health.gov.au
If you are advanced a subsidy, it is a Government
requirement that you complete a Final
Determination Statutory form verifying your
'actual gross private medical income' within
12 months of the relevant PSS subsidy period.

16
Important features

This figure will be used to determine the actual Making a claim


subsidy you are eligible for. Any change to
Claims can be notified as follows:
your income may result in either receiving
an additional subsidy or repaying part of Cover Who to lodge with
or the entire subsidy advanced.
Indemnity MIPS
Failure to provide the information within the
Insurance Policy 1800 021 223
required timeframe will also require any subsidy
advanced to be repaid. claims@mips.com.au
Practice Entity
Policy mips.com.au/claim
Any PSS subsidy advanced to you that you are no
longer eligible for must be repaid to MIPS before
MIPS will offer an invitation to apply for a renewal MIPS Protections
of membership. If you fail to repay this subsidy,
Personal A&H International
MIPS is required to notify Medicare Australia
Accident 1800 618 700
which will likely impact any future entitlements
Policy claims@acchealth.com.au
to the PSS.
acchealth.com.au
PSS details will be outlined in your Member
Benefit Statement. GPO Box 4213
Sydney NSW 2001
To assess your eligibility for a PSS subsidy please
Quote policy number: 26102
complete the Premium Support Scheme (PSS)
Application form online at mips.com.au/forms
For more information, please visit the
Department of Health website and refer to the
PSS Frequently Asked Questions at health.gov.au

17
Membership Benefits Handbook

Claims process For claims under the Indemnity Insurance Policy


The MIPS process for claims (other than those and Practice Entity Policy, the insurer may take
under the Personal Accident Policy): over and conduct the defence or settlement of
any claim or respond to legal proceedings for
1 Consider contacting MIPS: Even if you’re damages in accordance with the policy terms and
not sure an incident will result in a claim or conditions. If a claim has been accepted, you
2 ✕
complaint you must contact MIPS. The must give MIPS the information and assistance
3 earlier we know of a potential issue, the required to investigate, settle or defend the
better placed we are to offer timely, claim. You must also cooperate in any action
4 professional advice and support. MIPS takes if there is a right to recover any money
1
5 payable from any other person.
2 Contact
✕ MIPS: Call Clinico-Legal Support
6 on 1800 021 223 or claims@mips.com.au or If the matter escalates, MIPS has the authority to
3
1 submit an Incident Notification form found appoint lawyers from its panel to represent and
at mips.com.au/claim defend the interests of a member. Depending on
4
2 ✕ the complexity of a claim, it may take several
5
3 Triage: Each week MIPS assesses all new months or years to resolve if legal proceedings
incidents and grades the likelihood of them are initiated.
6
4 to escalate, the value of cost likely to be Your full rights and obligations are set out in the
5 incurred defending the incident, or if Members’ Insurance Covers Handbook available
immediate action is required (eg appointing free of charge at mips.com.au/publications or on
1
6 a legal representative). This is done by request. Also set out is what the insurer will do,
2 experienced
✕ MIPS Claims Division staff and what you must do, in the event of a claim.
including qualified clinicians.
3
1
4 Appoint file manager: After receiving your
notification, MIPS will appoint a file manager
2
5 ✕
who is an experienced healthcare
3
6
1 practitioner and clinico-legal adviser
to handle your claim.
4
2 ✕
5 Provide further details: If the incident
3
is escalated, eg you receive a letter
6
4 from AHPRA or a notice of legal action,
contact MIPS.
5

6 Appoint legal representative:


If appropriate, MIPS will appoint a legal
representative.

18
Important features

MIPS Protections claims


Example of indemnity claim For claims under MIPS Protections, MIPS may take
MIPS member Joanna is a GP working over and conduct the defence or settlement of
in a suburban clinic. She recently treated any accepted claim or respond to/issue legal
a patient, Kevin, for a wrist injury. proceedings for damages in the member’s name.
Joanna advised an X-ray and after this was MIPS has full discretion in the conduct of any legal
performed reasoned there was no fracture proceedings and the settlement of any claim.
and that it was soft-tissue damage. You are required to assist MIPS with the conduct
She referred Kevin to a physiotherapist. of any claims under MIPS Protections. This
Kevin found the physio treatment painful assistance may include providing MIPS with
and it did not assist in healing the injury. details by completing an Incident Notification
He returned to Joanna who referred Kevin form or appearing in court and giving evidence.
for a bone-scan at the local hospital. You must notify MIPS of any other cover you have
This scan revealed a broken scaphoid bone for the same loss, damage or liability.
in the wrist. Kevin’s wrist was placed in The following is an example of how a claim under
plaster at the local hospital. MIPS Protections is paid.
Kevin called Joanna to complain and said
she should have known about this earlier Example of a MIPS Protections claim
and should not have referred him to the
physio which caused him more pain. Kevin MIPS member Peter has Parkinson’s disease.
said he would be seeking compensation While he has known about this for some
from Joanna for his pain. time, his condition has recently worsened.
AHPRA notify him that he should cease work
Joanna notifies the matter under the as a healthcare practitioner due to the
Indemnity Insurance Policy and the claim impairment that the Parkinson’s disease has
is accepted. Legal proceedings are caused. Peter disagrees and thinks he is still
commenced against Joanna seeking capable of practising safely despite suffering
compensation of $100,000. MIPS, on behalf from Parkinson’s disease. He approaches
of the insurer, appoints a lawyer to act for MIPS to assist him with the costs of legal
Joanna. The claim against Joanna is settled expenses associated with defending his
for $40,000 plus legal costs. The cost for ability to practise safely as a registered
the lawyer to defend Joanna is $20,000. healthcare practitioner.
Both of these amounts are paid under the
Indemnity Insurance Policy. The Board of MIPS exercises its discretion to
cover Peter for the cost to defend his
registration. MIPS agrees to meet the costs
of an agreed lawyer to represent Peter in his
negotiations with AHPRA. The cost of the
lawyer is $12,500. MIPS meets this cost.

19
Conditions of membership

How to apply for membership Your duty of disclosure


To apply for membership, you must complete a Before you enter into membership for the first time
membership application form. You can do this or apply to renew, extend, vary or reinstate your
online at mips.com.au/join membership you must disclose to MIPS anything
that you know, or could reasonably be expected to
When you apply you must nominate a retroactive
know, that is relevant to MIPS’ decision to provide
cover date and provide details of your prior
membership to you and the terms and conditions
healthcare practice(s) for which you require cover.
on which membership is offered.
You will be asked to select a membership
category. You must also provide details regarding For example, your previous claims history or
your practice for MIPS to assess your membership previously unreported incidents or circumstances
classification. from your healthcare activities that could lead to
complaints, claims, investigations or legal actions
Communicating with MIPS or AHPRA, healthcare board investigations or
MIPS communicates with its members by Health Ombudsman or State and Territory health
telephone, post, email and online. complaints body complaints against you, must be
disclosed.
We will ask for your email address when you
apply for membership. When you apply for membership you will be
required to complete a series of mandatory
When we have your email address we will send
questions including:
all your membership material and information
by email to your nominated email address. • what membership classification best describes
Any documents we send to your email address your current and past practice for which you
are considered to have been received by you have appropriate qualifications, training and
24 hours from when we send them. experience
• details of your registration history
If you tell us not to send your membership
• your previous MDO (if applicable)
material and information to you electronically,
then we will send them by post to the mailing • your medical indemnity insurance history.
address you gave us. Your duty of disclosure does not require you to
You are responsible for making sure the email disclose any matter:
and mailing address we have for you are up to • that diminishes our risk
date. You should advise us of any changes by • that is common knowledge
completing the Change of Details form online at • that we know or in the ordinary course of
mips.com.au/forms or via my membership online business ought to know
services at mips.com.au/mymembership • where we have waived compliance with your
duty of disclosure.
Member Benefit Statement
If your application is accepted, you will receive MIPS will consider the information you provide
written confirmation by email of your MIPS when deciding to accept your application or
membership benefits, including insurance covers, renewal.
in the form of a Member Benefit Statement
(tax invoice).

20
Important features

If you fail to comply with your duty of disclosure Acceptance, renewal and suspension of
this may affect your entitlement to cover under membership
MIPS Protections and the insurance policies. A full membership year is from 1 July to 30 June.
MIPS may be entitled to refuse or withdraw cover Membership commences upon acceptance
under MIPS Protections or cancel your of a completed application. Alternatively,
membership, or both. a later commencement date can be nominated.
Further, an insurer may be entitled to reduce its All MIPS memberships expire on 30 June.
liability under the insurance policy (possibly to nil) Renewal is not automatic. Membership is
or cancel your insurance cover, or both. If your reviewed each year before a Member Benefit
non-disclosure is fraudulent, the insurer may be Statement, inviting a renewal application, is sent.
entitled to void your insurance cover. MIPS may accept or refuse any application for
membership or renewal of membership with the
Keeping us informed
exception of applications under the Universal
A member must notify MIPS in writing when any Cover arrangement that MIPS has with the
of the following occur: Government and other medical defence
• change of membership category organisations for applicants from the ACT
• any change in practice or the nature of the and Tasmania.
healthcare you provide and/or the location in
which healthcare is provided Paying your membership fee
• any change in the primary location in which Payment of your membership fee is due when
healthcare is provided you first join and by 1 July in subsequent years.
• start and/or cessation of practice Payment may be made by cheque, BPAY or
• cancelling MIPS membership credit card.
• requesting extended reporting period or Members may also elect to pay their membership
run-off cover fee by direct debit in monthly instalments.
• requesting cover for student electives Payment by monthly instalments does not incur
• requesting cover for practice outside of any additional fees but members are required to
Australia complete and return a Direct Debit Instalment
Request form. The form is available at
• any change in AHPRA details or registration
mips.com.au/forms or on request.
conditions.
If your membership fee payment or other liability
If you do not inform MIPS of a change, it may
to MIPS is in arrears for more than one month,
prejudice your right to member benefits,
you shall cease to be entitled to any of the
including insurance cover under the insurance
benefits of membership of MIPS from the date
policies. A change may also affect your
when the payment or other liability fell due.
membership fee. A new Member Benefit
That means your rights to membership benefits,
Statement will be issued when your membership
including MIPS Protections and insurance covers
fee has changed.
may be prejudiced.

21
Membership Benefits Handbook

Cooling-off period How a membership fee is calculated


You may cancel your MIPS membership within MIPS uses a blended approach when calculating
30 days of membership having commenced, membership fees to reflect the contribution
unless you have made an incident notification required to appropriately cover your risk arising
to, or claim against MIPS, under MIPS Protections from both current and past practice.
or under any of the insurance policies. If you
The membership fee is individually calculated
choose to do this the membership fee you paid
based on your membership classification,
will be refunded.
including location, for your current and past
practice. Currently, the fee for retroactive cover is
Cancellation of membership
calculated on your previous practice in Australia
The Board of MIPS may, by resolution, and in for up to three previous membership periods.
accordance with the MIPS Constitution, cancel a
member’s membership if that member does not The location and classification of your practice
comply with MIPS’ Constitution, such as when in the previous four years is used to assess the
their conduct is deemed to be prejudicial to the level of risk of your practice and affects your
interest of MIPS. membership fee. Members who remain in the
same classification and location reach a ‘mature
Members may cancel at any time. If you cancel membership fee’ in four years.
your membership, MIPS will refund the value of
your membership fee from the day of cancellation If you are moving from a low risk classification to
until 30 June, less an administration fee of 20% of a high risk classification (eg commencing private
your membership fee or $50, whichever is greater. practice), you can expect to see a stepped
increase in your membership fee until you reach
the mature membership fee. When you move
Example of cancellation
from a high risk classification to a low risk
Lee’s membership fee is $1,000 pa. classification you can expect to see a stepped
Half-way through the year, he cancels his decrease in your membership fee until you reach
membership. The prorated value of the the mature membership fee.
membership period remaining is $500. The following factors are taken into account
Lee’s cancellation fee will be $100 when calculating your membership fee:
(ie 20% x $500). • actuarial advice and recommendations
Upon cancellation, Lee’s refund will be $400. received by MIPS
• the membership classification that best
If you pay your membership fee via direct debit describes your current and past practice
instalments and you cancel your MIPS • whether you perform procedural or
membership you may have an outstanding non-procedural healthcare services
balance to pay depending on your date of • any endorsements applied to your
cancellation. Please contact MIPS for an estimate membership
prior to cancelling your MIPS membership. • any employer indemnity for healthcare services
you provide
All membership benefits, including MIPS
Protections and insurance covers, cease when
membership is cancelled.
22
Conditions of membership
Section

• your billings and salary from any non-employer Will additional contributions ever be
indemnified (private) practice work you required?
undertake MIPS maintains financial accounts that include
• your current and prior practice locations estimates of its future payments to members, as well
• your personal claims and registration history as estimates of its future liabilities. This ensures
• your nominated retroactive cover date MIPS has adequate financial resources to meet its
• the approach to management of risk shown financial obligations as they fall due, as well as
ensuring that it has financial resources to discharge
by you
its future liabilities or make future payments to its
• the number and nature of claims already members. MIPS will manage these future liabilities
accepted in previous membership years and payments through its own insurance program
• the membership benefits that are provided and through its claims reserving policy. MIPS will
to you calculate members’ contributions on the basis
• the cost of the insurance policies arranged that it will have adequate financial resources to
by MIPS discharge future liabilities and make future
• administration costs associated with providing payments to its members.
membership benefits The Constitution of MIPS allows it to make a limited
• any government taxes or charges such call on its members for additional contributions if
as GST and ROCS levy. such a need ever arises. For example, if the funds
held by MIPS are not adequate. The amount
The total costs of membership are determined of any call that may be made is limited by the
following consideration of: Constitution of MIPS to the amount of a member’s
• the current reserves and surplus members’ total membership fee for the membership year
funds retained by MIPS; and during which the call is made.
• expected investment returns from those funds.
Estimating future liabilities
See the ‘Category selection guide’ in the Each year MIPS receives actuarial advice on MIPS
Membership classification guide in this handbook claims costs, operational costs, investment returns
for detail about how we assess your practice. and member reserves. This advice includes an
analysis of the anticipated costs of the insurance
Calculating an excess covers arranged by MIPS and requests under
Any excess that applies to the MIPS Protections MIPS Protections, adjustments to reserves for
or the insurance covers will be calculated by known matters and pricing recommendations for
MIPS, or the insurer, by taking into account the membership fees.
factors that are considered in the calculation MIPS Insurance also manages its risk exposure
of the membership fee as set out above. through reinsurance coverage that it obtains
Your MIPS membership fee and any excesses from Australian authorised reinsurers.
that apply to cover will be set out in your
Member Benefit Statement. MIPS ensures that it has adequate financial resources
to discharge its future liabilities or make future
payments to members by maintaining funds in
reserve. MIPS’ financial position is shown in its annual
reports, available at mips.com.au/publications
and shows MIPS’ significant accumulated net assets.

23
Financial Services Guide

The services described in this Financial Services General insurance


Guide (FSG) are provided by the Medical MIPS has acquired a number of general insurance
Indemnity Protection Society Limited (MIPS) policies that will provide insurance cover, subject
ABN 64 007 067 281 AFSL 301912. to their terms and conditions, to MIPS members.
This FSG contains information about who pays for The general insurance covers in place for MIPS
the financial services provided to you, how MIPS members are underwritten by Australian
deals with complaints and explains any associations Prudential Regulation Authority (APRA)
or relationships that could influence MIPS. authorised licensed general insurers. Cover under
these policies is issued by each insurer, under a
What financial services does master policy arrangement with MIPS. When
MIPS provide? MIPS arranges cover under these policies it will
MIPS is authorised to: be doing so on behalf of MIPS members.
• provide financial product advice for general Some of these covers, including the Indemnity
insurance products and mutual risk products to Insurance Policy, are underwritten by MIPS
retail and wholesale clients Insurance Pty Limited. MIPS Insurance is a
• deal in a financial product for retail and wholly owned subsidiary of MIPS.
wholesale clients by: issuing, applying for,
acquiring, varying or disposing of general MIPS Protections
insurance products and mutual risk products The discretionary risk protections available to
• apply for, acquire, vary or dispose of a financial members of MIPS (MIPS Protections) are a
product on behalf of another person in respect miscellaneous risk product.
of general insurance products and
Custodial services
miscellaneous (mutual) risk products
The insurance policies that MIPS has in place for
• operate custodial or depository services other
its members, and the benefits under those policies,
than investor directed portfolio services for
are held on trust by MIPS for MIPS members.
retail and wholesale clients.
This is a custodial service provided by MIPS. This
MIPS is responsible for the financial services it service is incidental to the insurance arrangements
provides and MIPS and its representatives will that MIPS has put in place for its members.
provide you with the financial services.
Will I get a statement of advice?
Other than in special circumstances MIPS will
not provide advice that takes into account
your objectives, financial situation and needs.
Because our advice does not take these matters
into account, you should consider your own
circumstances before choosing MIPS membership.

24
Conditions of membership

When will I get a product disclosure If the complaint is not resolved to your
statement (PDS)? satisfaction you can contact the MIPS Dispute
You will receive a PDS for each financial product Manager, who will examine your complaint and
issued to you or if you receive personal financial our decision and advise you in writing within
product advice. Each PDS contains information 10 business days of the action MIPS proposes
that will enable you to make an informed decision to take regarding the complaint.
about the financial product. It sets out the If the matter is still not resolved to your satisfaction
significant features of the financial product as well you can contact the Financial Ombudsman
as other information and details required by law Service (FOS), an independent body approved
to be in a PDS. by ASIC. Access to the FOS is also free.

What does MIPS charge? Financial Ombudsman Service


MIPS charges a membership fee for MIPS 1300 780 808
membership which includes the cost of GPO Box 3, Melbourne VIC 3001
membership benefits, including insurance covers fos.org.au
and MIPS Protections. MIPS does not charge any
additional fee or receive any other remuneration What arrangements does MIPS have in
for its custodial services. MIPS staff receive market place to compensate clients for losses?
based salaries and are not paid commissions. MIPS has professional indemnity insurance in
place that will cover MIPS for claims made against
What should I do if I have a complaint? MIPS in relation to the conduct of MIPS or its
MIPS deals openly and efficiently with complaints, representatives in the provision of MIPS financial
expressions of dissatisfaction and disputes services. This insurance will also cover MIPS for
relating to financial services. MIPS has an internal claims relating to the conduct of representatives
complaint and dispute resolution process which who are no longer employees of MIPS.
is free. You can download a copy of the process
on mips.com.au/forms
If you have an enquiry or complaint contact MIPS
on 1800 061 113.
We will respond to your complaint within
15 business days. If we need to receive more
information, or to undertake investigations
about your complaint, we will agree reasonable
timeframes with you of up to 45 days.

25
Membership classification guide

Category groups Page Your membership classification


Your MIPS membership classification is made up of
Your membership classification 26 your category, practice basis and endorsements.
Your category 27 This determines the extent of your practice that is
Your practice basis 27 indemnified. For example:

Your endorsements 29 Category: General practitioner


Basis: Gross private billings/salary
Employer indemnified practice 30 Endorsements: Gratuitous services outside
of Australia, Minor cosmetics
Private practice billings 31
and salary You are required to take particular care to
ensure your membership classification best
Cosmetic procedures 31 describes the healthcare services you provide.
If you select the incorrect category or do not
Shared antenatal care 32 provide the necessary information for MIPS to
determine your basis or endorsements you
Changing your practice type 32 may prejudice the membership entitlements
or location available to you including insurance covers.
Ceasing practice in Australia 32 You are not entitled to the benefits of membership,
including cover under the Indemnity Insurance
Student 33 Policy, for the provision of healthcare outside your
membership classification or where you do not
Healthcare student 33
hold appropriate recognised qualifications,
International practitioner awaiting 34 training and experience.
registration
The benefits of MIPS membership apply
Medical 35 throughout all Australian states and territories.
Your practice location should reflect where you
Non specialists (eg Medical officer) 35 generate the majority of your non-employer
General practitioner 35 indemnified (private) practice gross billings in
a membership period or where you undertake
Other medical specialist 38 the majority of your practice (hours) if you are
employer indemnified. If you undertake work
Dental 42 (eg locums) in multiple locations you should
Other healthcare 42 provide the capital city in the state where you
intend to undertake the majority of your work
Nuclear medicine technologist 42 in a membership period.
You may submit all queries about your
membership classification to info@mips.com.au

26
Financial Services Guide

General requirements Some types of practice may be excluded when


Members must practice within the constraints of undertaken in a non-employer indemnified
any restrictions or practice conditions imposed by (private) setting. Categories may contain
AHPRA or its healthcare practitioner boards and exclusion/s and you should check these carefully.
comply with guidelines and/or requirements
issued by their registration body and colleges. Your practice basis
You will be required to provide information
There is a general requirement that every regarding the level and type of practice you
member has the appropriate training, undertake in order to determine an appropriate
qualifications and experience for the healthcare practice basis.
services they provide including appropriate
supervision if required. This applies even if such The type of information we require to determine
services are normally provided by the majority your practice basis includes but is not limited to
of practitioners in the category. your level of training, the amount you bill annually
for non-employer indemnified (private) services,
Members are expected to undertake the the type of non-employer indemnified (private)
provision of healthcare services in a facility services you undertake or if you are fully
that holds appropriate accreditation and have employer indemnified for all your practice.
available appropriate resources for the range
of services that will be provided. Basis: Clinical training/study applies if you are a
Healthcare Student or you are an international
Your category healthcare practitioner undertaking ‘pre-registration’
Your category should reflect your AHPRA activities before obtaining your AHPRA registration.
registration details or the specialty in which you
are undertaking an accredited training program Basis: New graduate applies if you have graduated
(or unaccredited registrar position). Members who within the current membership period (ie financial
hold multiple healthcare registrations or specialties year) and you have not yet commenced a training
must nominate the category that appropriately program. Cover and benefits will be limited for
reflects the healthcare they provide. Where more medical practitioners to practise only as allowed
than one category may be appropriate, the under their Provisional Registration. International
category selected should reflect the highest risk graduates should not declare as their year of
membership category as defined by MIPS. graduation the year they were awarded their
Some categories will need to be selected by the AMC certificate, but rather the year they first
description of the level of practice within your obtained their equivalent Australian healthcare
specialty in a non-employer indemnified (private) qualification (eg MBBS, BDSc etc).
setting, for example procedural or non-procedural.
Where a category includes a list of treatments
and procedures these are not intended to be
exhaustive and may vary from year to year
dependent upon our claims experience, treatment
developments and innovations, views of colleges,
professional associations and AHPRA, claims
expectations and views of insurers and reinsurers.

27
Membership Benefits Handbook

Basis: Recent graduate applies if you have Basis: Dentist in training applies if you are a
graduated within 5 years of the current membership general dentist and you have commenced a
period and you have not yet commenced a specialist dental qualification. Cover is provided
registrar or dental specialist training program. for additional non-employer indemnified (private)
Non-employer indemnified (private) practice may practice outside of your training program as long
be included; however, it is expected you have the as that practice does not constitute more than
appropriate recognised qualifications, training, 50% of your hours worked per week (annualised)
experience and supervision arrangements for and is commensurate with your training,
these healthcare services. All supervisors must qualifications and experience.
have the recognised qualifications, training and
Members who already hold an Australian
experience. They must also maintain an
specialist dental qualification are not eligible for
appropriate level of indemnity cover for the
the ‘Dentist in training’ basis.
supervision they provide.
Basis: Gross private billings/salary applies
Basis: Registrar applies if you are undertaking an
if you undertake non-employer indemnified
accredited registrar training program or practice
(private) practice and your type of practice means
in a non-accredited registrar position. Cover is
you are ineligible for another basis. Members are
provided for additional non-employer indemnified
required to provide an estimated gross billings
(private) practice outside of your training program
amount and a billing band which will be
as long as that practice does not constitute more
appended to your basis.
than 50% of your hours worked per week
(annualised) and is commensurate with your training, Refer to ‘Private practice billings and salary’
qualifications and experience with appropriate for further information.
supervision arrangements in place (if applicable).
Cover is excluded for any of the following Basis: Hours per week applies if you are a dental
practice when undertaken in a non-employer hygienist, prosthetist or therapist or oral health
indemnified (private) setting: obstetric services therapist and you undertake non-employer
(other than ‘shared care’ antenatal consulting), indemnified (private) practice. You are required to
bariatric surgery, spinal surgery and neurosurgery. provide an estimate of weekly hours for all of your
practice and then nominate the percentage of
Members who already hold an Australian hours that relate to non-employer indemnified
specialist qualification are not eligible for the (private) practice.
‘Registrar’ basis.
Basis: Non-operating surgeon applies if you are
Basis: Employer indemnified only applies if you a surgeon who has ceased operating but
are fully indemnified by your employer for all your continues to consult patients in non-employer
healthcare practice regardless of whether you are indemnified (private) practice, for example
in a public or private setting. This basis will not clinico-legal assessments including examinations
provide indemnity for civil claims arising from for the purposes of assessment and seeing
salaried work. patients for second opinions. You may also
Refer ‘Employer indemnified practice’ for further undertake surgical assisting in this basis. If you
information. undertake any procedures in your consultations
you should refer these for assessment by MIPS.

28
Membership classificationSection
guide

Basis: Non practising applies if you have ceased Your endorsements


all healthcare practice in Australia and your Some types of practice you undertake may
membership provides run-off cover for previous require an ‘endorsement’ to extend or restrict
practice. The type of run-off cover you are eligible your coverage.
for will be appended to this basis.
Minor cosmetics extension endorsement
Refer to ‘Ceasing practice in Australia’ for further is required if you undertake specified minimally
information. invasive office-based cosmetic procedures and the
billings relating to those services do not exceed
Basis: Prescribing/referral only applies if you are 50% of your annual total gross private billings.
no longer undertaking any healthcare practice in
Australia, however you continue to hold your Minor cosmetic procedures include:
AHPRA registration and undertake prescribing • Botulinum toxin (Botox) injections
and referral services on a gratuitous basis only. • injections of non-permanent dermal fillers
Please note this basis does not provide any cover (including collagen, fat)
for employer indemnified practice. • superficial chemical peels
• superficial dermal resurfacing, including laser
Basis: Reciprocal applies if you are practising in
procedures.
Australia under the MPS/MIPS reciprocal
arrangement and you are fully employer All other procedures should be referred for
indemnified for all your healthcare practice approval under this endorsement.
regardless of whether you are in a public or Refer ‘Cosmetic procedures’ for further
private setting. Refer ‘Employer indemnified information.
practice’ for further information.
Spinal surgery extension endorsement is
Basis: Surgical assisting only applies if you are a required if you are an orthopaedic surgeon and
specialist (excluding general practitioners) and you undertake spinal surgery in a non-employer
your only non-employer indemnified (private) indemnified (private) setting.
practice is surgical assisting. Non specialist undertaking procedural GP
activities endorsement is required if you hold
general registration only (not a specialist or
undertaking specialist training) and you
undertake unsupervised procedural GP activities
in a non-employer indemnified (private) setting.
Refer ‘GP Procedural’ for further information.

29
Membership Benefits Handbook

Specified dental procedures extension Employer indemnified outside of Australia


endorsement is required if you are a general endorsement is required if you have been
dentist and you undertake the following approved for an extension of cover for practice
‘specified dental procedures’ in a non-employer outside of Australia to undertake an employer
indemnified (private) setting: indemnified placement.
• surgical placement of dental implants Gratuitous services outside of Australia
• bridgework in excess of four units per endorsement is required if you have been
treatment plan approved for an extension of cover for practice
• conscious sedation outside of Australia to provide gratuitous aid
• veneers in excess of four units per treatment plan work services to disadvantaged locals.
• Botulinum toxin (Botox) and non-permanent Sporting & cultural outside of Australia
dermal fillers for appropriate dental treatment endorsement is required if you have been
purposes as permitted by the Dental Board approved for an extension of cover for practice
of Australia outside of Australia to accompany an Australian
• maxillo-facial or dento-alveolar surgery by sporting or cultural group. Cover will only apply
non-specialists in high risk situations (high-risk when treating Australian nationals.
situations include severe tooth impaction and
where teeth are in close approximation to critical Employer indemnified practice
structures such as nerve supply and sinuses).
Employers have obligations (such as vicarious
If you undertake botulinum toxin (Botox) or liability) for any acts and omissions of their
non-permanent dermal fillers for cosmetic employees in carrying out their duties. In general
purposes refer to the ‘Minor cosmetic extension’ terms, the MIPS benefits to members in this
endorsement. situation exclude protection for the employee
Bariatric surgery extension endorsement is for matters that are the proper responsibility of
required if you are a general surgeon and you the employer. This means for example, that the
undertake bariatric surgery in a non-employer indemnity insurance does not extend to healthcare
indemnified (private) setting. This endorsement practice for which your employer (eg public hospital)
is also required if you are undertaking locums or would normally be exposed, for example civil
volunteering to cover for colleagues where you claims arising from that healthcare.
may have to manage postoperative care of If your employer has agreed to indemnify you for
bariatric surgery patients. your practice you should obtain written confirmation
Volunteer services within Australia endorsement as MIPS cannot provide that confirmation.
is required if you are a fully employer indemnified As a member (unless you are in a non-practising
practitioner for all your healthcare practice and membership classification) you may receive cover
you undertake volunteer services in Australia. and assistance for a range of matters that may
Gratuitous prescribing/referring in Australia not be covered by your employer regardless of
endorsement is required if you are fully employer whether it is in a public or private setting.
indemnified for all your healthcare practice and
you undertake prescribing and/ or referral
services on a gratuitous basis.

30
Membership classification guide

Examples include: If you undertake non-employer indemnified


• professional disputes with your employer (private) practice, you are required to provide an
(eg hospital) estimate of your ‘annualised’ gross private billings
• registration boards’ complaints to determine the level of risk for all your non-
employer indemnified (private) practice for which
• coroner’s inquests
you require medical indemnity cover. Where a
• healthcare services commissioners’ matters
member does not bill any patients in their name
(eg NSW Health Care Complaints Commission,
(or billed by a third party on their behalf) they are
Victoria Healthcare services Commissioner,
requested to provide their salary to determine
Health Quality and Complaints Commission
that level of risk.
Queensland)
• investigations by state drug and poisons services Your estimated gross private billings/salary will be
annualised and applied to all periods you require
• general assistance and clinico-legal advice on
cover for non-employer indemnified (private)
issues such as informed consent, testamentary
practice and a billing band will be appended to
capacity, when to report to the coroner, release
your practice basis. We ask that members notify
of medical records etc.
MIPS as soon as they become aware they will
Members may also approach MIPS for assistance exceed that band or if their estimated gross
if they have concerns that their employer is not private billings reduces significantly. Members
meeting or is unable to meet their obligations to cannot select a billing band as these are subject
them (eg due to conflict of interest). to change each membership period and instead
Practitioners employed under contract in the are required to provide an estimated amount.
public hospital system may contact the Australian Where indemnity is provided by your employer,
Salaried Medical Officers Federation (ASMOF) for the billings and/or salary from that employment is
advice regarding the indemnity provided under not included in the above calculation.
their contract.
Cosmetic procedures
Private practice billings and salary A cosmetic/aesthetic treatment or procedure is
Gross private practice billings and/or salary are defined as a procedure which has as its primary
the total of all billings generated by you from all purpose the alteration of the non-pathological
areas of your practice for which you require external appearance of a patient.
medical indemnity cover (ie includes billings
Any additional membership fee charged reflects
charged in your name or for work for which you
the very high risk associated with cosmetic work.
are personally liable), including: Medicare
Actions are more readily defensible where a
Australia benefits, payments by individuals; and
procedure is performed by a doctor who can
payments by the Commonwealth Department of
demonstrate certified satisfactory completion
Veterans Affairs, worker compensation schemes
(preferably by formal examination) of accredited
and third party and/or vehicle insurers, whether
postgraduate training.
retained by you or otherwise, and before any
apportionment or deduction of any expenses If you undertake ‘minor cosmetic’ procedures
and/or tax. as defined by MIPS your membership must
be endorsed. Refer ‘Endorsements’ for a
list of procedures.
31
Membership Benefits Handbook

If you undertake any other cosmetic procedures Changing your practice type
(unless stated as included within your speciality)
or if your cosmetic services will exceed 50% of
or location
your annual total gross private billings you must You are required to notify MIPS of any change in
provide details to MIPS. the nature of healthcare services you provide or
practice location as soon as you become aware of
All dental practitioners (including allied dental the change to ensure you do not prejudice your
health) are required to comply with any policies membership benefits including insurance covers.
or guidelines provided by the Dental Board of
Australia. All queries regarding this should be If you expect to exceed your estimated gross
referred directly to AHPRA. Please note the billings/salary from non-employer indemnified
cosmetic definition does not apply to intra-oral (private) practice, you must advise MIPS to ensure
dental procedures such as: you are adequately covered.
• teeth whitening/bleaching Any changes to your membership details may
• crowns/veneers. result in an amendment (additional fee or refund)
to your membership fee.
Shared antenatal care You may also be required to sign a disclaimer
Shared antenatal care includes uncomplicated confirming that you have notified or otherwise
low risk pregnancies when the patient has been disclosed to MIPS all material matters when you
referred to and accepted as a patient in writing seek retroactive changes to your membership.
at an early stage of pregnancy by either:
• a hospital for obstetric management as a Ceasing practice in Australia
public patient or If you have ceased practice (temporarily or
• a GP obstetrician or specialist obstetrician for permanently) you will need to maintain run-off
obstetric management as a private patient. cover to ensure that you remain covered for
Shared care arrangements require that you emerging claims from your prior practice in
have appropriate qualifications, training and Australia. Your type of run-off cover will depend
experience and work collaboratively under on your individual circumstances.
the direction (that may include protocols and MIPS can offer you run-off cover for your past
supervision) of the practitioner or hospital practice in an extended reporting period (ERP)
responsible for the patient’s obstetric care. membership classification. The cost of ERP cover
You must not become involved, or have the is calculated on your individual risk history and
intention of becoming involved, in the induction will vary for each member. If you have been with
or management of labour or delivery. The only MIPS for five continuous years and you are
exception is for public patients in a public setting permanently retiring from all healthcare practice
where you are indemnified by the hospital. you will be eligible for ERP loyalty cover which is
offered at $50 per annum.

32
Membership classification guide

After three years of no private practice in Healthcare student


Australia, medical practitioners become
eligible for the Run-off Cover Scheme (ROCS), This category
✕ is suitable for students currently
studying a healthcare discipline (medical, dental
an Australian Government scheme that offers
science, oral health or nuclear medicine
run-off cover at no cost to eligible practitioners.
technology) at a recognised education provider in
In some circumstances, such as maternity leave Australia and students currently studying an
or retirement over the age of 65, medical 5
equivalent healthcare discipline at a recognised
practitioners may be immediately eligible for education provider outside of Australia undertaking
ROCS from the date they cease practice. 6
a temporary elective placement in Australia.
To advise MIPS of your cessation of practice in Membership benefits including insurance covers
Australia please complete the Ceasing Practice for those undertaking an elective placement
in Australia form at mips.com.au/forms (excluding US or where US law applies) is subject
to individual application and approval and will
Student extend to supervised student healthcare activities
(commensurate with their experience) as below:
A student membership category is not • observation, taking a history or performing
appropriate if you already hold an Australian the physical examination of a patient
general or specialist healthcare practitioner
• writing a patient management plan and
qualification. If you become a registered interpreting investigations
healthcare practitioner you must contact MIPS
• administration and principles of admitting and
and select a membership category that accurately
discharging patients
reflects the healthcare you provide. Failure to do
• communicating with patients, relatives and staff
so may prejudice the level of cover and assistance
MIPS can provide. • basic clinical activities (dressing wounds,
venepuncture, cannulation, suturing, assisting
Please note that the cover under the MIPS in surgery)
Members’ Practice Entity Policy does not apply • basic dental activities (scale/clean, oral health
to the Student membership categories. instruction, simple extractions, restorations)
Students are generally not covered under the
Students undertaking elective placement activities
MIPS Members’ Personal Accident Policy except
are required to be appropriately supervised for any
where stated. See the Members’ Insurance healthcare activities they undertake. The supervisor
Covers Handbook for terms and conditions. must have the appropriate registration, recognised
qualifications, training, experience and indemnity
for the healthcare services they are supervising.
Appropriate supervision includes both direct
supervision and indirect supervision where there
continues to be adequate access to communication,
oversight, interaction, direction and support from
your supervisor after initial instruction has been
provided. Where you provide healthcare in any
capacity other than as a student or other than
under the appropriate supervision, your rights to
indemnity and or assistance may be prejudiced.

33
Membership Benefits Handbook

International practitioner awaiting Practitioners undertaking pre-registration


placement activities are required to be
registration
✕ appropriately supervised for any healthcare
This category is suitable for international activities they undertake. The supervisor must
healthcare practitioners (ie trained outside of have the appropriate recognised registration
Australia) undertaking relevant Australian qualifications, training, experience and indemnity
qualifications but currently not qualified to for the healthcare services they are supervising.
5
practise in Australia. If you have obtained Appropriate supervision includes both direct
AHPRA
6 registration (or you will have obtained supervision and indirect supervision where there
it by the time you commence practice) you continues to be adequate access to
are not eligible to select this category. communication, oversight, interaction, direction
Please refer to other categories. and support from your supervisor after initial
Members in this category may undertake instruction has been provided. Where you
pre-registration activities under complete provide healthcare in any capacity or other than
supervision of an Australian registered healthcare under the appropriate supervision, your rights to
practitioner but must not provide any healthcare indemnity and or assistance may be prejudiced.
of a type required to be provided by a registered This category is also suitable for international
healthcare practitioner or be responsible in any trained practitioners undertaking a temporary
way for patient management. Membership supervised medical observership.
benefits including insurance covers for those
undertaking pre–registration placements will
extend to supervised healthcare activities
(commensurate with their experience) as below:
• observation, taking a history or performing
a physical examination of a patient
• writing a patient management plan and
interpreting investigations
• administration and principles of admitting
and discharging patients
• communicating with patients, relatives and staff
• basic clinical activities (dressing wounds,
venepuncture, cannulation, suturing, assisting
in surgery)
• basic dental activities (scale/clean, oral health
instruction, simple extractions, restorations).

34
Membership classification guide

Medical General practitioner


These categories are selected by practitioners
Non specialists that hold specialist registration, are vocationally
registered or are permitted to practise as a
These categories are suitable for medical practitioners
specialist. These categories should also be
that hold general, limited or provisional
selected if you are undertaking an accredited
registration only and have not yet commenced
registrar training program or practise in a
an Australian registrar program, specialist
non-accredited registrar position. If you do not
recognition pathway or registrar position.
meet these criteria refer to category ‘General
When selecting a category, it should reflect where practice’ ✕
under Non specialists.
you generate the majority of your non-employer
indemnified (private) practice gross billings in a GP non procedural
membership period or where you undertake the This category is suitable for General Practitioners
majority of your practice (hours) if you are who undertake treatments, procedures or
employer indemnified only. 5
practice most GPs commonly perform in their
rooms.
6 It does not include all the treatments,
Medical
✕ officer procedures or practice that GPs could perform
This category applies to practitioners who practice in their rooms.
in a hospital (or non general practice) setting.
Although such procedures or treatments are
Cover is limited to unsupervised practice listed usually carried out in a GP’s surgery/ consulting
5
under the GP non-procedural category. rooms, they may also be performed in patients’
6 endorsement is required if you are
An residences, hospitals and other healthcare facilities.
undertaking any services listed under the Procedures include:
GP procedural category and/or any ‘minor • repair of superficial lacerations of skin and
cosmetic’ services as defined by MIPS subcutaneous tissue
• removal of superficial skin lesions, tumours and
General
✕ practice
cysts
This category applies to general registration • biopsy of skin lesions (including punch biopsies)
practitioners who practice in a general practice
• removal of foreign bodies, including superficial
setting.
corneal and aural
5
Cover is limited to unsupervised practice listed • incision and drainage of superficial abscesses
under
6 the GP non-procedural category. • eyelid – excision/curettage of chalazion
An endorsement is required if you are • cautery and cryotherapy of superficial skin lesions
undertaking any services listed under the • electrocautery of nose bleeds
GP procedural category and/or any ‘minor • drainage of thrombosed external haemorrhoids
cosmetic’ services as defined by MIPS.
• reduction of simple closed joint dislocations
• treatment of simple fractures – not requiring
reduction or anaesthesia
• local anaesthesia (not including regional blocks)
• acupuncture (including laser acupuncture)
35
Membership Benefits Handbook

• aspiration of and/or intra-articular injections An endorsement is required if you undertake any


into peripheral joints (not spine) ‘minor cosmetic’ services as defined by MIPS.
• insertion of IUCDs when approved (requests to The ‘GP non procedural’ category excludes cover
be directed to info@mips.com.au) for the following practices when undertaken in a
• removal of IUCDs non-employer indemnified setting:
• avulsion of a toenail (may include wedge • obstetric services other than ‘shared antenatal
resection but excluding total removal of nail bed) care’ (see ‘Shared antenatal care’ definition)
• implanon NXT insertion and removal (provided • perinatal care
you have completed MSD training and • procedures listed under GP procedural
certificate is provided to MIPS)
• administering and monitoring sedation for
• hormonal implants (subcutaneous) procedures such as (but not limited to)
• proctoscopy/sigmoidoscopy (without biopsy) gastroscopy and colonoscopy
• syringing of the external auditory canal • anaesthesia or intravenous/intravascular
• insertion of urinary catheters sedation (other than those performed
• venepuncture and simple insertions of IV lines/ under local anaesthesia including finger
IV drug therapy and toe blocks)
• allergy testing/desensitisation • neurosurgery, bariatric surgery and spinal surgery
• arterial blood gas estimations • other procedures normally undertaken by medical
• blood transfusions specialists unless agreed in writing by MIPS.
• surgical assistance
Skin flaps and grafts
• skin flaps and grafts when approved
If you are performing small skin flaps and grafts in
• shared antenatal care in consultation with a this category, you should advise MIPS of the size,
hospital or specialist obstetrician or GP location, types of patients and purpose of the
obstetrician (see ‘shared antenatal care’ definition) flaps and grafts to ensure if this category is
• exercise ECG (with appropriate resuscitation appropriate. This is to assess the level of risk
facilities) involved. For example, small flaps on the face
• post mortems of a child are considered higher risk than larger
• lumbar puncture. flaps on the upper leg of an adult.
This list is not exhaustive. Queries should be Practitioners undertaking services in a skin
directed to info@mips.com.au cancer clinic are more likely to require the GP
Procedural category.

36
Membership classification guide

GP procedural An endorsement is required if you undertake any


‘minor cosmetic’ services as defined by MIPS.
This category is suitable for General Practitioners
who perform procedures not covered under the The ‘GP procedural’ category excludes cover
5 for the following practices when undertaken
non-procedural category definition and/or
procedures
6 usually performed under regional in a non-employer indemnified setting:
or general anaesthesia or sedation or • obstetric services other than ‘shared antenatal
neuroleptanalgesia. This category should be care’ (see ‘Shared antenatal care’ definition)
selected even if such procedures are performed • perinatal care
without anaesthesia. • sedation muscle relaxant or anaesthesia agents
Procedures include: such as Diprivan
• accident and emergency activities undertaken • neurosurgery, bariatric surgery and spinal
in rural and remote settings surgery
• arterial line insertion • other procedures normally undertaken by
• bronchoscopy medical specialists unless agreed in writing
by MIPS.
• vasectomy
• male circumcision
• colposcopy
• chest tube/drains
• sclerotherapy of varicose veins
• D&C uterus and termination of pregnancy
(up to 20 weeks)
• syringing tear ducts
• hyperbaric medicine
• regional anaesthesia excluding spinal or
epidural
• minor general surgical procedures
(eg haemorrhoids and hernia repairs)
• IV Sedation using Fentanyl / Midazolam /
Diazepam / Valium (other sedatives to be
referred to info@mips.com.au for approval).

This list is not exhaustive. Queries should be


directed to info@mips.com.au

37
Membership Benefits Handbook

GP procedural including Other medical specialist


anaesthetics and/or obstetrics These categories are suitable if you hold the
This category is suitable for GP Obstetricians recognised AHPRA specialist registration and
5 practice within the specialty. These categories
(DRANZCOG or equivalent) or GP Anaesthetists
6
(JCCA or equivalent). should also be selected if you are undertaking an
accredited registrar training program or practice
Procedures include: in a non-accredited registrar position. If you do
• regional anaesthesia (beyond digital blocks) not meet these criteria refer to category ‘Medical
• general anaesthesia officer’ under Non specialists.
• administering agents other than narcotic/ An endorsement is required if you undertake any
benzodiazepine combinations ‘minor cosmetic’ procedures as defined by MIPS
• private obstetric services beyond shared unless stated within your category that cover is
antenatal care in a healthcare facility. provided for cosmetic services.
This list is not exhaustive. Queries should be Please contact MIPS, if your specialty is not listed,
directed to info@mips.com.au you undertake
✕ cosmetic procedures or you
If you are training and undertaking unsupervised practice

in multiple specialities.
obstetrics or anaesthetic services in a non- Anaesthesia

employer indemnified (private) setting submit 5
your details for assessment to info@mips.com.au Cardiothoracic surgery
6
5
An endorsement is required if you undertake any Cosmetic proceduralist
6
5
‘minor cosmetic’ services as defined by MIPS. This category should be selected if:
6
The ‘GP procedural including anaesthetics • your minor cosmetic services exceed 50% of
and/or obstetrics’ category excludes cover for your annual total gross private billings
the following practices when undertaken in a • you are a plastic surgeon, dermatologist,
non-employer indemnified setting: ophthalmologist, otolaryngologist or
• any involvement in planned home births vascular surgeon and your approved
• neurosurgery, bariatric surgery and spinal cosmetic services exceed 50% of your
surgery annual total gross private billings
• other procedures normally undertaken by • you are any other type of practitioner and
medical specialists unless agreed in writing you undertake any cosmetic procedures
by MIPS. other than ’Minor Cosmetics‘
• you have been advised by MIPS.
See 'Cosmetic procedures' definition.

38
Membership classification guide

✕ ✕

Dermatology Gynaecology including IVF


5 5
Dermatologists may also perform cosmetic This category excludes cover for the
6 6
procedures provided those services: management or induction of labour in a
non-employer indemnified (private) setting.
• fall within the scope of your accredited training;
If you undertake these services you are required
and
to select ‘Obstetrics and gynaecology’.
• generate less than 50% of your gross
private billings. Gynaecologists who perform ultrasound
(including diagnostic O&G imaging) only,
If your cosmetic procedures exceed 50% of ✕
should select the Radiology category.
your total gross private billings or you undertake ✕
laser blepharoplasty, meloplasty and similar Intensive care medicine
procedures
✕ you will need to select the ‘Cosmetic 5 ✕
proceduralist’ category. Neurosurgery
6
✕ 5
Emergency medicine Obstetrics and gynaecology
6
5 5
This category provides cover for the management
General surgery 6
6 or induction of labour in a healthcare facility in a
5
An endorsement is required if you undertake non-employer indemnified (private) setting.
6
bariatric surgery in a non-employer indemnified
This category excludes cover for any involvement
(private) setting. Bariatric surgery, commonly ✕
in planned home births.
referred to as weight loss surgery, refers to the
various surgical procedures performed to treat Ophthalmology
obesity by modification of the gastrointestinal 5
tract to reduce nutrient intake and/or absorption. Ophthalmologists may also perform cosmetic
6
This includes surgeons undertaking locums or procedures provided those services:
volunteering to cover for colleagues where they • fall within the scope of your accredited basic
may have to surgically manage postoperative training; and
care of bariatric patients. • generate less than 50% of your gross private
billings.
If your cosmetic procedures exceed 50% of your
total gross private billings or you undertake
refractive laser therapy, outside a peer-reviewed
university department you will need to select the
‘Cosmetic proceduralist’ category.

39
Membership Benefits Handbook

✕ ✕


Oral and maxillofacial surgery Paediatric

surgery
5 5
Oral maxillofacial surgeons may also perform Pathology
6 6
cosmetic procedures provided those services: 5
Physician rehabilitation and occupational
• fall within the scope of your accredited training; 6
5
and This category is suitable for physicians who
6
undertake:
• generate less than 50% of your gross private
billings. • Occupational medicine
• Pre-employment
✕ and fitness for work medicals
If your cosmetic procedures exceed 50% of your
• Rehabilitation medicine
total gross
✕ private billings you will need to select
the ‘Cosmetic proceduralist’ category. Physician non procedural
5
Orthopaedic surgery This category is suitable for consultant physicians
6
5
who practise in the disciplines/perform minimally
An endorsement is required if you undertake invasive, lower risk procedures including:
6
spinal surgery in a non-employer indemnified
✕ • Bone marrow biopsy
(private) setting.
• Cardiology (non-interventional & non-invasive)
Otolaryngology head and neck surgery • Chemotherapy
5
Otolaryngologists may also perform cosmetic • Gastroscopy (excluding ERCP & colonoscopy)
6
procedures provided those services: • Geriatric medicine
• fall within the scope of your accredited basic • Haematology
training; and • Immunology
• generate less than 50% of your gross private • Medical oncology
billings. • Nephrology
If your cosmetic procedures exceed 50% of your • Neurology
total gross private billings you will need to select • Paediatric medicine
the ‘Cosmetic proceduralist’ category. • Proctoscopy
• Renal biopsy
• Respiratory medicine (including endobronchial
ultrasound-guided transbronchial needle
aspiration (EBUS TBNA) and transbronchial
lung biopsy)
• Sigmoidoscopy
If you are a physician who also holds a pathology
qualification you may also select this category
provided pathology reporting activities generate
less than 50% of your gross non-employer
indemnified (private) billings.

40
Membership classification guide

✕ ✕

Physician procedural Vascular surgery


5 5
This category is suitable for physicians who Vascular surgeons may also perform cosmetic
6 6
perform invasive procedures including but not procedures provided those services:
limited to: • fall within the scope of your accredited basic
• Cardiology – interventional (ie cardiac training; and
catheterisation) • generate less than 50% of your gross private
• Colonoscopy billings.
• Endoscopic retrograde cholangio If your cosmetic procedures exceed 50% of your
pancreatography (ERCP) total gross private billings you will need to select
• Endoscopic
✕ procedures the ‘Cosmetic proceduralist’ category.
• Liver biopsy
Plastic surgery
5
Plastic surgeons may also perform cosmetic
6
procedures provided those services:
• fall within the scope of your accredited basic
training; and
• generate less than 50% of your gross private
billings.
If your cosmetic procedures exceed 50% of your
total gross
✕ private billings you will need to select
the ‘Cosmetic proceduralist’ category.
Psychiatry
5
Practice in this category includes:
6
• Medico-legal
✕ reporting
• Electroconvulsive

therapy (ECT).
Radiation

oncology
5
Radiology

6
5
Sport and exercise medicine
6
5
Urology
6
5

41
Membership Benefits Handbook

Dental Oral and maxillofacial surgery

These categories are suitable if you hold the Oral and maxillofacial surgeons may also perform
5
recognised AHPRA general or specialist dental cosmetic procedures provided those services:
6
registration and practice within the speciality or • fall within the scope of your accredited training;
you are undertaking a dental specialty training and
program. • generate less than 50% of your gross private
billings.
All dental categories (excluding the Oral and
maxillofacial surgery category) require If your cosmetic procedures exceed 50% of your
endorsement if you undertake any ‘minor total gross private billings you will need to select
cosmetic’ services as defined by MIPS. the
✕ ‘Cosmetic proceduralist’ category

Please contact MIPS, if your specialty is not listed ✕ Oral medicine


or
✕ you practice in multiple specialities. ✕ Oral pathology
5
✕ Dental hygienist ✕ Oral surgery
6
5
✕ Dental therapist ✕ Orthodontics
5 6
5
6
✕ Oral health therapist ✕ Paediatric dentistry
5 6
5
6
✕ Dental prosthetist ✕ Periodontics
5 6
5
6
Dentist ✕ Prosthodontics
5 6
5
6
An endorsement is required in this category Public health dentistry (Community dentistry)
5
if you undertake ‘specified dental procedures’ 65
6 as defined by MIPS in a non-employer indemnified6
(private) setting. See the ‘Endorsements’ section at
5

6
Other healthcare

the start of this ‘Membership classification guide’
Nuclear medicine technologist
for
✕ the ‘specified dental procedures’ definition.

✕ Dento-maxillofacial radiology 5

✕ Endodontics 6
5

6
Forensic odontology
5

6
5

42
Privacy

MIPS takes your privacy seriously. MIPS uses a range of physical and electronic
security measures to protect the security of the
How we collect, use, hold and disclose
personal and sensitive information we hold.
information is governed by the Privacy Act and
For example:
the Australian Privacy Principles (APPs). MIPS is
committed to protecting the privacy of your • access to information systems is controlled
personal information. Personal information through strict identity and access management
includes any information or opinion, about an procedures;
identified individual or an individual who can be • appropriate data encryption techniques are
reasonably identified from information about applied;
them. Information or opinion is still treated as • employees are bound by internal information
personal information whether it is true or not and security policies and are required to attest to
regardless of whether we have kept a record of it. compliance with policies;
• service agreements with external service
How do we hold personal information? providers are required to meet or exceed the
Much of the information we hold will be stored minimum requirements outlined by APPs;
securely and managed by MIPS or specialist • all employees are required to complete
external service providers. Some information we training about information security; and
hold will be stored in paper files. Personal and • we regularly monitor and review our
sensitive information is currently held in a secure compliance with internal policies, regulatory
manner in Australia, Canada, France, Germany, and industry guidelines.
Gibraltar, Hong Kong, Singapore, Switzerland,
United States of America and United Kingdom. Right of access to your information
You have a right to access and correct your
personal and sensitive information. Please
contact us on 1800 061 113 to request your
information. There is no charge for the provision
of that personal information. If you request access
to sensitive information, there may be a delay
in providing this information, for example if the
information is related to a claim that is still under
consideration.
For more information, see our privacy policy at
mips.com.au/privacy

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Contact us
General and membership enquiries
1800 061 113 or
+61 3 8620 8888 outside Australia
info@mips.com.au

24-hour Clinico-Legal Support


1800 021 223 or
+61 3 8620 8829 outside Australia
claims@mips.com.au

Postal address
PO Box 25
Carlton South VIC 3053

mips.com.au

Medical Indemnity Protection Society | ABN 64 007 067 281 | AFSL 301912 PB201605-105

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