Commonwealth Consolidated Acts Commonwealth Consolidated ActsCriteria for certification--Level 1
(1) The Chief Executive Medicare may issue a certificate stating that a claim is a Level 1 qualifying claim if the Chief Executive Medicare is satisfied that:
(a) the claim meets the common requirements set out in subsection (3); and
(b) a person has applied for a Level 1 qualifying claim certificate in relation to the claim in accordance with section 12.
Criteria for certification--Level 2
(2) The Chief Executive Medicare may issue a certificate stating that a claim is a Level 2 qualifying claim if the Chief Executive Medicare is satisfied that:
(a) the claim meets the common requirements set out in subsection (3); and
(b) the claim meets the additional Level 2 requirements set out in subsection (4); and
(c) a person has applied for a Level 2 qualifying claim certificate in relation to the claim in accordance with section 12.
Common requirements for both Level 1 and Level 2 qualifying claim certificates
(3) A claim in relation to which an application for a Level 1 or Level 2 qualifying claim certificate has been made meets the common requirements set out in this subsection if:
(a) the claim is or was made against a person (the midwife ); and
(b) the claim relates to an incident that occurs or occurred in the course of, or in connection with, the midwife's practice as an eligible midwife; and
(c) there is a contract of insurance entered into by an eligible insurer that provides midwife professional indemnity cover in relation to the claim; and
(d) except in the circumstances specified in Rules made for the purposes of this paragraph, the incident occurs or occurred in Australia or an external Territory; and
(e) the claim does not relate to an incident that occurs or occurred in the course of, or in connection with, the provision of treatment of a public patient of a hospital; and
(f) the claim does not relate to an incident that occurs or occurred in the course of, or in connection with, practice of a kind for which:
(i) the Commonwealth, a State or a Territory; or
(ii) a local governing body; or
(iii) an authority established under a law of the Commonwealth, a State or a Territory;
indemnifies eligible midwives from liability relating to compensation; and
(h) if the application is for a Level 1 qualifying claim certificate, the incident occurs or occurred:
(i) on or after 1 July 2010; and
(ii) on or before the Level 1 termination date (if any); and
(i) if the application is for a Level 2 qualifying claim certificate the incident occurs or occurred:
(i) on or after 1 July 2010; and
(ii) on or before the Level 2 termination date (if any); and
(j) the claim is not in substance an aggregation of two or more separate claims against the midwife; and
(k) the claim is not a claim included in a class specified in Rules made for the purposes of this paragraph; and
(l) the claim does not relate to an incident of a kind specified in Rules made for the purposes of this paragraph; and
(m) the claim does not relate to a type of midwifery practice specified in Rules made for the purposes of this paragraph.
Additional requirements for Level 2 qualifying claim certificates
(4) A claim in relation to which an application for a Level 2 qualifying claim certificate has been made meets the additional Level 2 requirements set out in this subsection if:
(a) there is a contract of insurance entered into by an eligible insurer in relation to which the following requirements are satisfied:
(i) the contract provides midwife professional indemnity cover for the eligible midwife in relation to the claim, or would, but for the limit of the eligible insurer's liability under the contract in relation to a particular claim against the eligible midwife, provide such cover for the midwife in relation to the claim;
(ii) the limit of the eligible insurer's liability under the contract, in relation to each claim against the midwife, equals or exceeds the Level 2 claim threshold;
(iii) the eligible insurer is a general insurer, within the meaning of the Insurance Act 1973 ;
(iv) the eligible insurer entered into the contract in the ordinary course of the eligible insurer's business; and
(b) the contract of insurance is not a contract included in a class specified in Rules made for the purposes of this paragraph.
When a certificate is in force
(5) The certificate comes into force when it is issued and remains in force until it is revoked.
Matters to be identified or specified in certificate
(6) The certificate must:
(a) identify:
(i) the midwife; and
(ii) the claim; and
(iii) if the certificate is a Level 2 qualifying claim certificate--the contract of insurance that provides midwife professional indemnity cover for the midwife; and
(b) specify the Level 1 claim threshold or the Level 2 claim threshold, as the case requires.
The certificate may also contain other material.
ART review of decision to refuse
(7) An application may be made to the Administrative Review Tribunal for review of a decision of the Chief Executive Medicare to refuse to issue a qualifying claim certificate.
Note: Section 266 of the Administrative Review Tribunal Act 2024 requires notification of a decision that is reviewable.
Chief Executive Medicare to give applicant copy of certificate
(8) If the Chief Executive Medicare decides to issue a qualifying claim certificate, the Chief Executive Medicare must, within 28 days of making his or her decision, unless it is not reasonably practicable to do so, give the applicant a copy of the certificate. However, a failure to comply does not affect the validity of the decision.
(9) A qualifying claim certificate is not a legislative instrument.