Update on medical indemnity claims statistics – Trends and risk areas


[co-author: Danielle Webb]

On 11 July 2014, the Australian Institute of Health and Welfare released the latest in its series of reports on medical indemnity claims in the public and private sectors. The report examined claims made, current or finalised, in the 2012-13 period.

The report provides an interesting insight into claim trends which will be of interest to both underwriters and risk managers.

Compared to the previous reporting period, there has been only a minimal reduction in the number of new claims despite continuing focus on risk management, continuing education and technological improvements (from 4525 to 4225).

Errors in procedures continue to represent the highest proportion of claims (24 percent), followed by errors in diagnosis (17 percent) and errors in treatment (17 percent). In general practice, medication-related errors surprisingly represented the highest proportion of claims (47 percent) followed by errors in diagnosis (38 percent). Presumably due to ongoing education and training by medical defence organisations, consent to treatment claims have continued to decrease and made up only one percent of all claims during the reporting period. Infection control represented only 0.3 percent of claims, although it will be interesting to see whether this statistic alters in subsequent reporting periods following the recent media emphasis on hospital-borne illnesses.

General medical practice generated the highest proportion of claims during the reporting period (23 percent), followed by general surgery (eight percent) and orthopedic surgery (seven percent). While emergency medicine practitioners were involved in a higher percentage of claims that during the previous reporting period, it was the fifth highest (nearly five percent) after obstetrics and gynecology (nearly six percent). 

The data also revealed a reduction in the number of large claims. In the 2012-13 reporting period, only four percent of claims settled for over AU$500,000. The most recent data shows that nearly 44 percent of claims settled for less than AU$10,000. The percentage of claims that settled for no payment was 15.4 percent.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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