Allied Health Insurance

About This Policy

This policy is a contract of insurance between you, the allied health practitioner named in the schedule, and us, the insurer named in the schedule. In return for your payment of the premium, we agree to insure you on the terms set out in this document, the schedule and any endorsements we issue to you. Read the three documents together: they form one contract.

The policy has two operative sections, and both are written on a claims-made and notified basis:

• Section A: Professional Indemnity covers your civil liability for malpractice and for certain related civil liabilities arising from your professional services, together with extensions that respond to the realities of allied health practice in Australia: regulatory inquiries, Ahpra and National Board proceedings, coronial inquests, Medicare and NDIS audits, data breaches and more.
• Section B: Public Liability covers your civil liability for bodily injury and property damage arising from the conduct of your practice, for example a client who slips in your waiting room. Products liability, your civil liability arising from goods you supply in connection with your professional services, is provided by the Products Liability extension, so one set of terms and one policy period governs everything.

Because the whole policy is claims-made, it covers only claims first made against you and notified to us during the policy period. When the policy period ends, so does your right to notify, subject to s.40(3) of the Insurance Contracts Act 1984 (Cth) and the continuous cover, run-off and extended reporting provisions of this policy. Before you enter into this contract, your insurer or its distributor must give you written notice of the effect of s.40(3), as s.40(1) of that Act requires. The Notification of Circumstances section explains how notifying a circumstance protects you.

This policy is designed to align with the professional indemnity insurance registration standards issued by the National Boards under the Health Practitioner Regulation National Law. It gives retroactive cover back to the start of your continuous series of cover (see the definition of Retroactive Date), one automatic reinstatement (see the Automatic Reinstatement provision), and run-off cover when you cease practice (see the Run-off Cover on Retirement or Cessation of Practice extension). It covers the professional services described in your schedule, within the scope of practice of your registration or association membership. A National Board's standard may require more than the defaults in this policy, for example a longer run-off period, which Endorsement E06 provides. [WP REVIEW: check each National Board's current professional indemnity registration standard against the retroactive cover, run-off period and reinstatement in this policy, and against the Sexual Misconduct, Intoxicants and Obstetrics exclusions; verify the National Law section references for the insurance requirement.] It is written for individual allied health practitioners: practitioners registered under any National Board other than the Medical Board of Australia, and practitioners in self-regulated disciplines (such as counsellors, social workers, dietitians and exercise physiologists) who hold the accreditation or membership their recognised professional association requires. It does not cover medical practitioners for their own clinical practice, because their cover is separately mandated under the Commonwealth medical indemnity framework. Privately practising midwives participating in the Commonwealth contribution scheme for midwife professional indemnity are not insured under this product. This product is written to be an eligible insurance contract for the purposes of the Allied Health High Cost Claims Indemnity Scheme established under the Medical Indemnity Act 2002 (Cth).

This wording is written for businesses and professionals. Some buyers, such as small businesses, may be retail clients under the Corporations Act 2001 (Cth). Where a buyer is a retail client, the issuer must give a Product Disclosure Statement and make a Target Market Determination available. This wording is not itself a Product Disclosure Statement. [WP REVIEW: confirm the retail-client posture for sole practitioners buying professional indemnity cover (s761G and reg 7.1.12).]

We have written this policy in plain English. Words with special meanings are listed in the Definitions section. Where this policy refers to legislation, the reference includes that legislation as amended, replaced or re-enacted from time to time, together with its regulations and any corresponding law of a State or Territory. If anything in this document is unclear, contact us before you rely on it.

Version and Document History

This document is version-controlled. The version and date shown on the cover page and in the footer of each page govern this text. The version stated in your schedule as current at inception applies for the life of your policy period, unless your schedule or an endorsement states otherwise.

Schedule

(Completed separately for each policy. It contains your specific details.)

The schedule shows:

• The insured, their health discipline and National Board registration or professional association membership, and any practice entity named under Endorsement E03
• The professional services covered
• The policy period, start and end dates
• The retroactive date
• The limit of liability, and whether Section A and Section B have separate limits
• Sub-limits that differ from the defaults in the Sub-limits provision
• The excess
• The declared gross fee income used to rate the policy
• The premium, including stamp duty and GST
• The state or territory whose law governs this policy (see the Governing Law condition)
• The claims and complaints contact details of the insurer
• The endorsements that apply, by code, with their variables

Definitions

These words have the meanings below wherever they appear in this policy, the schedule or an endorsement. The singular includes the plural and the plural includes the singular.

Section A: Professional Indemnity

Professional Indemnity Cover

We will pay your civil liability for any claim first made against you and notified to us during the policy period, arising from:

• (a) malpractice, that is any breach of your professional duty of care in the provision of your professional services; or
• (b) any of the following, committed unintentionally (except where stated) in connection with your professional services:
• (i) defamation, being libel or slander;
• (ii) breach of privacy or breach of a duty of confidentiality, including a breach of the Privacy Act 1988 (Cth), the My Health Records Act 2012 (Cth), the Health Records and Information Privacy Act 2002 (NSW), the Health Records Act 2001 (Vic), the Health Records (Privacy and Access) Act 1997 (ACT), or corresponding State or Territory law;
• (iii) breach of the Australian Consumer Law (Schedule 2 to the Competition and Consumer Act 2010 (Cth)) or similar consumer protection legislation of the Commonwealth or of a State or Territory, including breach of the consumer guarantees of due care and skill and fitness for purpose as they apply to your professional services;
• (iv) infringement of intellectual property rights, including copyright, trade marks and moral rights, but not patents; and
• (v) unlawful discrimination, harassment or vilification under Commonwealth, State or Territory anti-discrimination legislation, other than in your capacity as an employer.

We will also pay your defence costs for a claim covered by this clause. This clause and every extension are subject to the retroactive date, to the What Is Not Covered section, to the How Much We Will Pay section, and to your obligations in the Your Obligations section and the How to Make a Claim section.

How the Extensions Apply

Each extension below is part of Section A: Professional Indemnity. Unless an extension says otherwise: each extension is subject to all the terms, conditions and exclusions of this policy; any sub-limit stated is part of, and not in addition to, the limit of liability and is the most we will pay under that extension in the aggregate for the policy period; and the excess applies. Where an extension covers costs rather than civil liability, no excess applies unless the schedule states one.

Data Breach Notification Costs

We will pay the reasonable costs you incur, with our prior written consent, to comply with an NDB Notification obligation arising from an eligible data breach (or suspected eligible data breach) of personal information, including health information, held by your practice and first discovered by you during the policy period. Covered costs include the costs of: conducting the assessment required by s.26WH of the Privacy Act 1988 (Cth) within the 30-day statutory assessment period; forensic IT investigation; preparing and delivering the statement to the Office of the Australian Information Commissioner; notifying affected individuals; and providing affected individuals with credit or identity monitoring for up to 12 months where reasonably required.

You must:

• (a) notify us as soon as practicable after discovering the breach or suspected breach, and in any event in time for the statutory 30-day assessment to be completed (nothing in this policy prevents or delays your compliance with the Privacy Act); and
• (b) at the time of the breach, have maintained back-up copies of your electronic records made no less frequently than daily and stored separately from the primary system.

If you do not comply with these obligations, we may reduce the amount we pay by the amount that fairly represents the prejudice we suffer, in accordance with s.54 of the Insurance Contracts Act 1984 (Cth).

The most we will pay under this extension is the sub-limit shown in the Sub-limits provision, unless the schedule states a different amount.

Data Breach Fines and Penalties

To the extent the law allows it to be insured, we will pay civil penalties imposed on you under the Privacy Act 1988 (Cth) or a State or Territory health records law, arising from a breach of privacy or data protection obligations first notified to us during the policy period, provided the breach was not intentional, reckless (except as covered by the Serious Invasion of Privacy extension), or the result of your deliberate disregard of a known obligation. The most we will pay under this extension is the sub-limit shown in the Sub-limits provision. Where the same breach triggers both this extension and the Data Breach Notification Costs extension, the two share one sub-limit.

We do not pay any fine or penalty that the law does not allow to be insured, and we do not pay a criminal fine.

[WP REVIEW: confirm whether a civil penalty under the Privacy Act 1988 (Cth) or a State or Territory health records law can lawfully be insured; the position is unsettled.]

Medicare, NDIS and PBS Audits and Employee Fraud

We will pay:

• (a) the reasonable legal costs and expenses you incur, with our prior written consent, in responding to an audit, compliance review or investigation of your billing, claiming or record-keeping first made against you, as the definition of Inquiry provides, and notified to us during the policy period, by Services Australia, the Chief Executive Medicare, the Department of Health, the Professional Services Review, the National Disability Insurance Agency or the NDIS Quality and Safeguards Commission, in connection with Medicare benefits, the Pharmaceutical Benefits Scheme, the Child Dental Benefits Schedule or NDIS funding; and
• (b) your civil liability to repay amounts, and associated defence costs, where the liability arises from the fraudulent or dishonest billing or claiming conduct of an employee committed without your knowledge, consent, connivance or reckless disregard.

This extension does not cover: repayment of amounts to which you were never entitled by your own act or omission (a trading debt, not an insured loss); any fine or penalty except as provided by the Statutory Liability extension; or any matter in which your own fraud or dishonesty is finally established. Cover under paragraph (a) forms part of the sub-limit for the Inquiry Costs extension.

Good Samaritan Acts

We will pay your civil liability for any claim first made against you and notified to us during the policy period arising from a Good Samaritan Act performed by you anywhere in the world. This extension operates in addition to any protection you have under civil liability legislation for good faith assistance at emergencies. The USA and Canada exclusion continues to apply to claims made or determined in the United States of America or Canada.

Inquiry Costs

We will pay the reasonable legal costs and expenses you incur, with our prior written consent, to be represented at, respond to, or prepare for an inquiry, where the inquiry is first made against you during the policy period, as the definition of Inquiry provides, and you notify us of it during the policy period. This includes, without limitation:

• (a) investigations, performance assessments, health assessments, immediate-action proceedings, panel hearings and tribunal proceedings by or on behalf of Ahpra or a National Board under the National Law;
• (b) investigations and proceedings by the Health Ombudsman (Queensland), the Health Care Complaints Commission (New South Wales) or any other state or territory healthcare complaints entity;
• (c) coronial investigations and inquests;
• (d) investigations and proceedings by the NDIS Quality and Safeguards Commission;
• (e) the Medicare, PBS and related audits and investigations described in paragraph (a) of the Medicare, NDIS and PBS Audits and Employee Fraud extension;
• (f) Royal Commissions, boards of inquiry and parliamentary inquiries; and
• (g) formal disciplinary proceedings of your professional association.

The most we will pay under this extension, together with paragraph (a) of the Medicare, NDIS and PBS Audits and Employee Fraud extension and the Mandatory Reporting Costs extension, which share this sub-limit, is the inquiry costs sub-limit shown in the Sub-limits provision, unless the schedule states a different amount. This extension covers costs only: it does not cover any fine, penalty, order for the repayment of fees or benefits, registration fee, or costs order made against you in favour of an inquiring body, except as expressly provided elsewhere in this policy.

Mandatory Reporting Costs

We will pay the reasonable legal costs and expenses you incur, with our prior written consent, in obtaining advice about, making, or responding to a mandatory notification under the mandatory notification provisions of the National Law (including a notification you are legally required to make about another registered health practitioner, and a notification made about you), where the date you first become aware of the facts that require you to make the notification, or first receive notice of a notification made about you, falls in the policy period and you notify us during the policy period. That date is treated as the date an inquiry is first made against you, for the purposes of the definition of Inquiry. [WP REVIEW: add the National Law section references for mandatory notifications; the previous draft cited ss.140 to 143, which have not been verified.] Costs under this extension form part of the sub-limit for the Inquiry Costs extension. Nothing in this policy prevents, delays or penalises your compliance with a mandatory notification obligation under the National Law: see the No Admissions Without Our Consent obligation.

Loss of Documents

If, during the policy period, you first discover that documents belonging to you, or for which you are legally responsible, have been destroyed, damaged, lost or mislaid in the course of your practice and cannot be found after diligent search, we will pay the reasonable costs of replacing or restoring them (including re-creating electronic records from back-ups and source material), and your civil liability to third parties arising directly from the loss.

You must:

• (a) notify us as soon as practicable, and in any event within 30 days after discovery;
• (b) for electronic documents, at the time of loss have maintained back-up copies made no less frequently than daily and stored separately from the primary system; and
• (c) support the amount claimed by bills and accounts approved by a competent person we nominate with your agreement.

If you do not comply with obligation (a) or (b), we may reduce the amount we pay by the amount that fairly represents the prejudice we suffer, in accordance with s.54 of the Insurance Contracts Act 1984 (Cth).

The most we will pay under this extension is the sub-limit shown in the Sub-limits provision. No excess applies. This extension does not cover loss caused by wear, tear, vermin, gradual deterioration, or the failure of electronic media where no back-up existed.

Public Relations and Crisis Expenses

If a claim or inquiry covered by this policy, or an event reasonably likely to give rise to one, attracts or is reasonably likely to attract adverse publicity that could materially damage the reputation of you or your practice, we will pay the reasonable fees of a public relations consultant engaged with our prior written consent to mitigate that damage, provided the consultant is engaged within 30 days after the event, claim or inquiry first becomes known to you. The most we will pay under this extension is the sub-limit shown in the Sub-limits provision. No excess applies.

Court Attendance Costs

If, during the policy period, a person described below is legally required to attend court, a tribunal or an inquiry as a witness in connection with a claim or inquiry covered by this policy, we will pay:

• (a) $500 for each day, or part of a day, of attendance by the person named in the schedule, a principal or a partner; and
• (b) $250 for each day, or part of a day, of attendance by an employee.

The most we will pay under this extension is the sub-limit shown in the Sub-limits provision. No excess applies. This extension does not apply to attendance by a person as a claimant or complainant.

Continuous Cover

If you first became aware of a circumstance during a period in which you were continuously insured by us under an allied health professional indemnity policy, and you did not notify us of it under the policy in force at that time, we will cover the resulting claim under this policy, even though the Prior Known Circumstances and Prior Notifications exclusion would otherwise apply, provided that:

• (a) you have been continuously insured by us for this class of risk from the date you first became aware of the circumstance until the date the claim is first made and notified;
• (b) the failure to notify was not fraudulent; and
• (c) cover under this extension is provided on the terms, conditions, exclusions and limits of the policy in force when you first became aware of the circumstance, or of this policy, whichever are more favourable to us, and we may reduce the amount we pay by the amount that fairly represents any prejudice we suffer from the late notification.

Run-off Cover on Retirement or Cessation of Practice

If, during the policy period, you permanently retire from practice, permanently cease to provide professional services, die, or become permanently disabled such that you cannot practise, this policy is automatically extended, at no additional premium, to cover claims first made against you and notified to us during the period of 72 months after the date you ceased practice, provided the claim arises from professional services provided before that date and after the retroactive date. This run-off cover:

• (a) ends immediately if you resume practice;
• (b) does not increase the limit of liability, which continues to apply as a single aggregate amount across the policy period and the run-off period combined;
• (c) extends to your estate, heirs, legal representatives and personal insolvency administrators as described in the Spouses, Estates and Legal Representatives extension; and
• (d) is provided to assist you to meet the run-off requirements of the professional indemnity insurance registration standards under the National Law. The default period is 72 months. If your National Board's registration standard requires a longer period, Endorsement E06 provides it, and this extension alone may not meet that standard.

If another insurer also covers the same run-off exposure, we may seek contribution from that insurer as the law allows.

[WP REVIEW: check each National Board's registration standard for the required run-off period, and whether a single aggregate limit shared across the policy period and the run-off period is permitted.]

Extended Reporting Period

If we cancel or refuse to renew this policy for any reason other than your non-payment of premium or fraud, or you do not renew it, you may purchase an extended reporting period of 12 months, beginning on the day the policy period ends, during which you may notify us of claims first made against you in that 12-month period arising from professional services provided before the end of the policy period and after the retroactive date. The premium for the extended reporting period is 100% of the last annual premium, is payable within 30 days after the policy period ends, and is not refundable. The extended reporting period does not increase the limit of liability.

Therapy Animals

We will pay your civil liability for any claim first made against you and notified to us during the policy period for physical injury to any person caused by a therapy animal while you are providing professional services. This extension does not cover injury caused by an animal that is not a therapy animal, injury occurring outside the provision of professional services, or liability arising from the breeding, sale or boarding of animals.

Therapy and Counselling for You After an Inquiry

If you attend an inquiry covered by the Inquiry Costs extension, we will reimburse the reasonable cost of psychological therapy or counselling services you obtain for yourself from a registered psychologist, psychiatrist, accredited mental health social worker or accredited counsellor in connection with the stress of that inquiry, up to the sub-limit shown in the Sub-limits provision. No excess applies.

Trauma Counselling Following Violence

If, in the course of performing a Good Samaritan Act covered by the Good Samaritan Acts extension, you are the victim of, or witness to, an act of physical violence, we will reimburse the reasonable cost of trauma counselling you obtain for yourself from a registered psychologist, psychiatrist, accredited mental health social worker or accredited counsellor, up to the sub-limit shown in the Sub-limits provision. No excess applies.

Teaching, Publications and Expert Reports

We will pay your civil liability for any claim first made against you and notified to us during the policy period arising from: your teaching, training, lecturing, mentoring or examining in your professional discipline; material you author, publish or present in your professional discipline; or reports, opinions or evidence you provide as an expert in your professional discipline. This extension does not cover a guarantee of educational or commercial outcomes, or liability of an educational institution itself.

Students and Work-experience Placements

We will pay the civil liability of any student or person on a work-experience or vocational placement with your practice, for any claim first made and notified to us during the policy period arising from professional services performed under your direct supervision, as though they were you. This extension does not cover services a student performs outside your supervision or outside your practice.

Locum Tenens

We will pay:

• (a) the civil liability of a locum engaged by your practice, for any claim first made and notified to us during the policy period arising from professional services provided for and on behalf of your practice during the engagement, as though the locum were you; and
• (b) your civil liability for any claim first made and notified to us during the policy period arising from professional services you provide while working as a locum for another practitioner or practice, within the scope of your professional services.

Paragraph (a) does not cover a locum for services provided otherwise than for your practice, and does not relieve the locum's own insurer of any obligation.

Volunteers

We will pay the civil liability of any volunteer assisting your practice, for any claim first made and notified to us during the policy period arising from acts performed under your direct supervision and in accordance with your documented risk-management framework, as though they were you.

Spouses, Estates and Legal Representatives

If you die, become legally incapacitated, or become bankrupt or insolvent, we will treat your estate, heirs, executors, administrators, legal personal representatives and personal insolvency administrators as you under this policy, for claims arising from your professional services. We will also pay the civil liability of your spouse or domestic partner for a claim arising solely from their status as your spouse or partner (for example, a claim against jointly owned property), provided the claim arises from your professional services and not from any act, error or omission of the spouse or partner. This extension does not extend the scope of cover beyond your own conduct.

Telehealth and Remote Care

For the avoidance of doubt, professional services include services you provide by telehealth, videoconference, telephone, secure messaging, remote monitoring or other remote means, to patients or clients located anywhere in Australia, provided you hold the registration or accreditation required where the patient or client is located and comply with your National Board's or professional association's telehealth guidelines. Cover for telehealth to patients located outside Australia is available under Endorsement E09. The USA and Canada exclusion always applies.

Statutory Liability

We will pay:

• (a) your defence costs for a prosecution or civil penalty proceeding first brought against you and notified to us during the policy period under an Act of the Commonwealth or of a State or Territory, including WHS Law, arising from the conduct of your practice; and
• (b) to the extent permitted by law in the relevant jurisdiction, any statutory penalty imposed in that proceeding, other than a criminal fine,

provided the act, error or omission giving rise to the proceeding was not intentional, deliberate or committed with reckless disregard for the relevant law. The most we will pay under this extension is the sub-limit shown in the Sub-limits provision.

We do not pay any fine or penalty that the law does not allow to be insured. In particular, we do not pay a penalty imposed under work health and safety law in a State or Territory whose law prohibits insurance of it (including New South Wales, Victoria and Queensland), and we do not pay a criminal fine.

[WP REVIEW: confirm the list of jurisdictions that prohibit insurance of WHS penalties; library sources differ on WA and Victoria.]

Advance Claim Protection

If you notify us of a claim or circumstance and we have not yet confirmed whether this policy covers it, we will appoint and pay a lawyer from our panel to protect your position, including preserving evidence, meeting court and regulatory deadlines, and advising you on immediate steps, until we confirm or decline cover. If we later decline cover, we will not seek to recover from you the panel-lawyer costs incurred before the date we notified you of our decision, unless you obtained the benefit of this extension through fraud.

Serious Invasion of Privacy

We will pay civil liability for any claim first made against you and notified to us during the policy period under the statutory cause of action for serious invasion of privacy in Schedule 2 to the Privacy Act 1988 (Cth) (as inserted by the Privacy and Other Legislation Amendment Act 2024 (Cth)), arising in connection with your professional services, as follows:

• (a) we will cover the person or entity named in the schedule as the insured, including for vicarious liability arising from the conduct of any other insured person;
• (b) we will cover any other insured person, but only where the invasion is alleged to have been reckless rather than intentional; and
• (c) we do not cover any person who is found by a court or tribunal, or who admits, to have intentionally committed a serious invasion of privacy, and if we have advanced defence costs to that person, they must repay them.

The most we will pay under this extension is the sub-limit shown in the Sub-limits provision. Exemplary damages remain excluded under the Fines, Penalties and Punitive Damages exclusion.

Section B: Public Liability

Public Liability Cover

We will pay your civil liability for any claim first made against you and notified to us during the policy period for:

• (a) bodily injury to any person other than an employee; or
• (b) property damage to the property of any person,

arising from the conduct of your practice, including the occupation of premises used for your practice. We will also pay your defence costs for a claim covered by this clause.

Like Section A: Professional Indemnity, this section is written on a claims-made and notified basis: it covers only claims first made against you and notified to us during the policy period, arising from bodily injury or property damage occurring after the retroactive date.

Relationship Between Section A and Section B

Section B: Public Liability covers premises liability and bodily injury or property damage that does not arise from a failure in your professional services, for example a visitor who trips on loose carpet in your waiting room. Section A: Professional Indemnity covers liability arising from your professional services, for example an injury caused by treatment.

Where a single claim arises from both a failure in professional services and a premises or occupier's failure, Section A applies to the professional element and Section B applies to the occupier or premises element. Where it is genuinely doubtful which section applies to a claim or an element of a claim, the section providing the greater cover for that claim or element applies. In no case will the same loss or the same defence costs be paid under both sections, and in no case will more than the limit of liability be payable for one claim.

How the Section B Extensions Apply

Each extension below is part of Section B: Public Liability and is subject to the same framework described in the How the Extensions Apply clause.

Products Liability

We will pay your civil liability for any claim first made against you and notified to us during the policy period for bodily injury or property damage occurring after the retroactive date and caused by products, that is goods sold, supplied, dispensed, fitted, repaired, serviced or installed by you or on your behalf in connection with your professional services. Examples include orthoses, prostheses, mobility and daily-living aids, compression garments, mouthguards, dentures and dental appliances, spectacles and contact lenses, hearing devices, dressings, and medicines lawfully dispensed or supplied within your scope of practice.

This extension does not cover: the cost of repairing, replacing, recalling or refunding the products themselves; liability arising from goods you sell or supply otherwise than in connection with your professional services (see the Goods Sold or Supplied Outside Professional Services exclusion); or liability arising from the manufacture of goods, other than the fitting, adjustment, compounding, assembly or customisation of goods as a normal part of your professional services.

Tenant's Legal Liability

The Property in Your Care, Custody or Control exclusion does not apply to your civil liability for property damage to premises (including their landlord's fixtures and fittings) that you occupy as a tenant or licensee for your practice, where the damage arises from the conduct of your practice. This extension does not cover liability you assume under a lease or licence beyond the liability you would have at law, or damage that the lease requires the landlord to insure.

Non-owned and Hired Plant and Equipment

The Property in Your Care, Custody or Control exclusion does not apply to your civil liability for property damage to plant, equipment or devices (other than motor vehicles, watercraft or aircraft) that you hire, borrow or lease for your practice, where the damage arises from the conduct of your practice. The most we will pay under this extension is the sub-limit shown in the Sub-limits provision.

Advertising Liability

We will pay your civil liability for any claim first made against you and notified to us during the policy period arising from unintentional defamation, unintentional infringement of copyright, title or slogan, or unintentional misappropriation of advertising ideas, committed in advertising your practice. This extension does not cover: statements you knew to be false or misleading; failure of goods or services to conform with advertised quality or performance; an incorrect description of the price of goods or services; or claims covered by Section A: Professional Indemnity.

Notification of Circumstances

Your Right to Notify Circumstances

If, during the policy period, you become aware of a circumstance, you may (and, under the Notify Us as Soon as Practicable obligation, you must) give us written notice of it as soon as reasonably practicable, and in any event before the policy period ends. Your notice should include the identity of the potential claimant (if known), the professional services and dates involved, a description of what happened, and the reasons you consider a claim might result.

Effect of Notification

If you give us written notice of a circumstance during the policy period, then under s.40(3) of the Insurance Contracts Act 1984 (Cth) we are not relieved of liability by reason only that the resulting claim is made against you after the policy period ends. Any claim that later arises from a notified circumstance is treated as a claim first made against you and notified to us on the date we received your notice of the circumstance, and is covered on the terms, limit of liability and excess of this policy.

What Counts as One Notification

A circumstance notified to us, and every claim and inquiry arising from it, are treated as a single claim under the Multiple Claims Aggregation condition, including as to the date on which it is first made. For this purpose a circumstance is notified on the date we receive your notice of it.

Notifying Possible Inquiries

The same regime applies to inquiries: if you receive a complaint, notification or other communication during the policy period indicating that an inquiry might follow, notify us during the policy period and any resulting inquiry will be treated as first made against you, and notified to us, when we received your notice.

What Is Not Covered

The following exclusions apply to every section and extension of this policy unless an exclusion states, or an extension expressly provides, otherwise. We will not cover any claim, inquiry, loss, defence costs or other amounts:

Medical Practitioners

arising from any act, error or omission by a person registered in the medical profession under the National Law, in that person's practice of medicine. This exclusion applies to the clinical practice of medical practitioners because their professional indemnity cover is separately mandated under the Commonwealth medical indemnity framework, including the Medical Indemnity Act 2002 (Cth) and the Medical Indemnity (Prudential Supervision and Product Standards) Act 2003 (Cth).

This exclusion does not apply to you, and does not reduce your cover, merely because you work alongside, share premises with, receive referrals from, refer patients to, act on the orders or prescriptions of, or otherwise collaborate with a medical practitioner. Your own liability for your own professional services remains covered even where a medical practitioner is involved in the same episode of care, and even where you are alleged to be vicariously or concurrently liable with a medical practitioner, in which case we cover only your own liability, not the medical practitioner's.

Unregistered or Unaccredited Practice

arising from professional services provided at a time when you did not satisfy whichever of the following applies to your discipline:

• (a) where registration under the National Law is required for your discipline, you did not hold current registration in the relevant profession (or held registration subject to a condition, undertaking or suspension that prohibited the service in question); or
• (b) where registration under the National Law is not required or not available for your discipline, you did not hold the current membership, accreditation or certification of your professional association required for practising members.

This exclusion does not apply to an employee, student or volunteer performing tasks lawfully open to unregistered persons under your direct supervision, and does not apply where your registration or accreditation lapsed solely through administrative error and was restored with continuous effect.

Obstetrics and Intrapartum Homebirth

arising from the provision of obstetric care during active labour, delivery, or the 24-hour post-partum period, in any setting other than a licensed healthcare facility. Midwives may apply for Endorsement E01, which extends this policy to cover facility-based intrapartum care; intrapartum care at a homebirth or in any other non-facility setting remains excluded in all cases and cannot be endorsed under this product. This exclusion does not apply to: antenatal or postnatal care outside the periods described above; emergency care you provide as a Good Samaritan Act where no alternative care is available; or care you provide in the course of transferring a patient to a licensed healthcare facility.

Prescription-only Medicines Outside Authority

arising from your prescription, supply or administration of a medicine included in schedule 4 or schedule 8 of the Poisons Standard, unless the medicine was:

• (a) prescribed by a medical practitioner, or by another person authorised by law to prescribe it; or
• (b) prescribed, supplied or administered by you under, and within, an authority you hold by law, including a scheduled medicines endorsement, a nurse practitioner or endorsed midwife authority, or the prescribing and dispensing authority of your registration (for example, as a dentist, optometrist, podiatrist or pharmacist), and in accordance with the drugs, poisons and controlled substances legislation of the relevant State or Territory.

Clinical Trials and Experimental Procedures

arising from your conduct of, or participation as an investigator in, a clinical trial, or from any procedure, therapy or treatment that is experimental, or that has not been approved (where approval is required) by the Therapeutic Goods Administration or a properly constituted human research ethics committee, unless Endorsement E02 applies. This exclusion does not apply to the routine off-label use of an approved therapy where that use is accepted practice in your profession and within your scope of practice.

Sexual Misconduct

arising from any actual or alleged sexual assault, sexual misconduct, molestation, grooming, or sexual relationship with a patient or client, committed or alleged to have been committed by you. However:

• (a) Defence costs. We will pay the reasonable defence costs of the accused insured person in defending a claim or inquiry alleging conduct described in this exclusion, up to the sexual misconduct defence costs sub-limit shown in the Sub-limits provision, provided the insured person denies the allegation. If the conduct is subsequently admitted by the insured person, or established by a final adjudication of a court, tribunal or inquiring body, the insured person must repay to us all amounts we paid under this paragraph; and
• (b) Innocent insureds. This exclusion does not apply to an insured person who did not commit, participate in, acquiesce in, or fail to report in breach of a legal duty, the alleged conduct, including a practice principal alleged to be vicariously liable for the conduct of another person, and the Severability and Non-imputation condition applies.

Intoxicants

arising from professional services provided by an insured person while under the influence of alcohol or of a drug (other than a drug taken as prescribed or directed by a treating practitioner and not impairing the insured person's capacity to practise safely). This exclusion applies only to the insured person who was under the influence; the Severability and Non-imputation condition protects the others.

Deliberate, Dishonest, Fraudulent or Criminal Acts

arising from any deliberate, dishonest, fraudulent, criminal or malicious act or omission by you, or any wilful breach of duty, statute or contract by you. This exclusion applies only where the relevant conduct is admitted by the insured person concerned or established by a final adjudication; until then we will advance defence costs subject to repayment under the Repayment Where Cover Is Not Established condition. This exclusion does not apply to an insured person who did not commit, participate in, or acquiesce in the conduct, and the Severability and Non-imputation condition applies. Nothing in this exclusion overrides paragraph (b) of the Medicare, NDIS and PBS Audits and Employee Fraud extension.

Employer's Liability and Workers Compensation

for bodily injury to an employee arising out of or in the course of their employment or engagement, or any liability for which you are or would be entitled to indemnity under a policy of compulsory workers compensation insurance, or which is imposed by workers compensation, accident compensation or industrial legislation.

Employment Practices

arising from your acts or omissions as an employer or prospective employer, including unfair or unlawful dismissal, denial of natural justice in employment, employment-related discrimination, harassment or bullying of an employee or job applicant, or breach of an employment contract or industrial instrument.

Directors' and Officers' Liability

arising from your acts or omissions in the capacity of a director, officer, secretary or trustee of any company, association or trust, as distinct from your capacity as an allied health practitioner.

Uninsurable Penalties

for any WHS or other monetary penalty to the extent the law of the relevant jurisdiction prohibits insurance or indemnity for it, and for any criminal fine. Defence costs for WHS and other statutory proceedings remain covered under the Statutory Liability extension, and penalties are covered under that extension only to the extent permitted by law.

Prior Known Circumstances and Prior Notifications

arising from: any circumstance of which you were aware before the policy period began (except as provided by the Continuous Cover extension); any claim first made, or inquiry first commenced, before the policy period began; anything notified, or that ought to have been notified, under any policy of insurance in force before this policy began; or any act, error, omission or conduct occurring before the retroactive date.

Assumed Contractual Liability

arising from a warranty, guarantee, indemnity or contractual term you have given, to the extent it imposes on you a liability greater than the liability you would have at law in the absence of that term. This exclusion does not apply merely because you have agreed in a contract that the proportionate liability legislation of a State or Territory is excluded or modified, where that agreement is itself permitted by the relevant legislation; in that case we cover the liability you would have had if liability had been apportioned without regard to the proportionate liability legislation.

Trading Debts, Fees and Billing Disputes

for any trading debt of your practice; the refund, reduction, waiver or set-off of professional fees or charges; or any dispute about the amount, reasonableness or recovery of your fees or billing, except as expressly provided by the Medicare, NDIS and PBS Audits and Employee Fraud extension.

Goods Sold or Supplied Outside Professional Services

arising from goods manufactured, sold or supplied by you otherwise than in connection with your professional services, for example general retail sales unconnected with treatment. Goods supplied as part of, or in connection with, your professional treatment or advice are covered under the Products Liability extension.

Related Parties

made against you by, or on behalf of: any insured person; your parent, subsidiary or related entity; or any person or entity in which you (or your spouse, domestic partner or immediate family member) hold, directly or indirectly, an interest of 15% or more, or which holds such an interest in your practice. This exclusion does not apply to a claim brought by such a person or entity for their own bodily injury, or to a claim that originates from, and is genuinely pressed on behalf of, an independent third party without solicitation, collusion or assistance by an insured person.

Fines, Penalties and Punitive Damages

for fines, penalties, or punitive, exemplary, aggravated, liquidated or multiplied damages, or civil penalties, except to the extent expressly covered by the Data Breach Fines and Penalties extension or the Statutory Liability extension, and in either case only to the extent permitted by law and never for a criminal fine.

Nuclear

directly or indirectly caused by or arising from ionising radiation or contamination by radioactivity from any nuclear fuel, nuclear waste, or the combustion of nuclear fuel, or from the hazardous properties of any nuclear installation, reactor, weapon or component. This exclusion does not apply to radioisotopes, radium or radium compounds used, stored or transported exclusively for diagnostic or therapeutic purposes within your professional services (including medical radiation practice and nuclear medicine imaging within your scope of practice).

Asbestos

directly or indirectly caused by or arising from the existence, mining, handling, processing, manufacture, sale, distribution, storage, use, removal of, or exposure to, asbestos or materials containing asbestos. This exclusion does not apply to a claim arising from your assessment, diagnosis, treatment or care of a person suffering from, or believed to be suffering from, an asbestos-related condition.

Terrorism and War

directly or indirectly caused by or arising from war, invasion, acts of foreign enemies, hostilities (whether war is declared or not), civil war, rebellion, revolution, insurrection, military or usurped power, or any act of terrorism, or any action taken in controlling, preventing or suppressing any of these. This exclusion does not apply to a claim arising from your provision of professional services in assessing, treating or caring for victims of any of these events.

USA and Canada

made, brought, continued or determined in the United States of America or Canada (or their territories or protectorates), or arising from professional services provided in, or products supplied in or to, the United States of America or Canada, or in respect of the enforcement of any judgment, order or award obtained there. This exclusion is absolute and applies to both sections and every extension.

Pollution and Contamination

directly or indirectly caused by or arising from the discharge, dispersal, release, seepage, migration or escape of pollutants or contaminants into or upon land, the atmosphere or any watercourse or body of water, or the cost of testing for, monitoring, removing, containing, treating, detoxifying, neutralising or cleaning up pollutants or contaminants. Under Section B: Public Liability only, this exclusion does not apply to bodily injury or property damage caused by a sudden, identifiable, unintended and unexpected discharge, dispersal, release or escape that takes place in its entirety at a specific time and place in the conduct of your practice.

Property in Your Care, Custody or Control

under Section B: Public Liability only, for property damage to property owned by you, or in your physical or legal care, custody or control, except as provided by the Tenant's Legal Liability extension and the Non-owned and Hired Plant and Equipment extension, and except for the personal effects (including mobility aids, clothing and devices) of patients, clients and visitors while at your practice, which remain covered.

Aircraft, Watercraft and Vehicles

under Section B: Public Liability only, arising from your ownership, operation or maintenance of any aircraft, aerial device, watercraft exceeding 8 metres, or motor vehicle for which compulsory third-party or statutory motor insurance is required. This exclusion does not apply to the loading or unloading of, or treatment of a patient in, a vehicle, ambulance or aircraft where the liability is not covered by compulsory statutory insurance.

Communicable Disease: Deliberate Breach

arising from your deliberate or reckless breach of a public health order, direction or infection-control standard applying to your practice. Claims arising from the transmission of disease in the course of professional services otherwise remain covered under Section A: Professional Indemnity.

How Much We Will Pay

Limit of Liability

The most we will pay under this policy for all claims, inquiries, losses, defence costs and other amounts combined, across all sections and extensions, is the limit of liability shown in the schedule, which applies in the aggregate for the policy period. If the schedule shows separate limits for Section A and Section B, each stated limit applies in the aggregate to its section, and no amount is payable under one section's limit for a liability covered by the other.

Automatic Reinstatement

If the limit of liability for Section A: Professional Indemnity is reduced or exhausted by payment of claims in the policy period, we reinstate it once, in full, for claims that are wholly unrelated to the claims that reduced it and are first made and notified later in the same policy period. A reinstated limit never applies to a claim that reduced or exhausted the limit, or to any claim treated as one with it under the Multiple Claims Aggregation condition, and sub-limits are not reinstated. This provision meets the automatic reinstatement requirement of the National Boards' professional indemnity insurance registration standards. Endorsement E12 is not needed for this reinstatement.

Defence Costs Are Inclusive

Unless the schedule states that defence costs are payable in addition to the limit of liability, defence costs form part of, and are not payable in addition to, the limit of liability and any applicable sub-limit.

Sub-limits

Every sub-limit stated in an extension or the schedule is part of, and not in addition to, the limit of liability, and is the most we will pay under that extension in the aggregate for the policy period, regardless of the number of claims, inquiries or insured persons. Unless the schedule states a different amount, the sub-limits are:

Excess

You must bear the excess shown in the schedule for each claim before we pay anything. The excess applies inclusive of defence costs unless the schedule states otherwise. Where an extension states that no excess applies, none does. If we pay the excess or any part of it on your behalf, you must reimburse us on demand.

One Claim

All claims and inquiries are treated as one claim as the Multiple Claims Aggregation condition states, including the date on which that one claim is first made. One limit of liability and one excess apply to that one claim.

Other Insurance

If a loss covered by this policy is also covered by another insurance policy, we will not refuse or reduce our payment because of that other insurance. We may seek contribution from the other insurer as the law allows. This does not apply where the schedule or an endorsement states that this policy is excess of a specified underlying policy, in which case this policy pays only after the limit of that specified policy is exhausted.

Tell us about any other insurance, indemnity arrangement or statutory scheme that covers, or might cover, a claim when you notify it (see the Tell Us About Other Recoveries obligation).

Allied Health High Cost Claims Indemnity Scheme

This policy is written to be an eligible insurance contract for the purposes of the Allied Health High Cost Claims Indemnity Scheme under Part 2, Division 2C of the Medical Indemnity Act 2002 (Cth), under which the Commonwealth reimburses eligible insurers 50% of the amount by which an eligible claim against an eligible privately practising allied health professional exceeds the scheme threshold. Any reimbursement we receive under that scheme is for our account, does not reduce your cover, does not increase the limit of liability, and imposes no obligation on you other than reasonable cooperation with any information requirements of the scheme. [WP REVIEW: confirm the scheme's current Part and Division references and the insurer eligibility conditions.]

GST and the Limits

The limit of liability, sub-limits and excess are inclusive of GST. The GST and Input Tax Credits condition deals with your input tax credit entitlement.

Your Obligations

The obligations in this section, and the obligations stated in individual extensions and endorsements, are contractual obligations, not conditions precedent to our liability. If you do not comply with an obligation, we will not refuse a claim outright on that ground alone: consistent with s.54 of the Insurance Contracts Act 1984 (Cth), we may reduce the amount we pay by the amount that fairly represents the prejudice we suffer because of your non-compliance, and we may refuse the claim only where the Act permits, for example where your act or omission caused the loss, or where the claim is fraudulent.

Notify Us as Soon as Practicable

You must give us written notice, as soon as reasonably practicable and during the policy period, of: any claim first made against you; any notice of an inquiry; and any circumstance of which you become aware. The Notification of Circumstances section explains the effect of notifying a circumstance. Send notices as described in the How to Make a Claim section.

No Admissions Without Our Consent

You must not admit liability for, settle, or make or promise any payment in respect of any claim or circumstance, or incur any defence costs, without our prior written consent, which we will not unreasonably withhold or delay. However, nothing in this policy prevents, and you do not breach this obligation by, any of the following, and none of the following is treated by us as an admission of liability:

• (a) expressing regret, saying sorry, or making an apology or expression of sympathy that is protected by, or consistent with, the civil liability legislation of the relevant State or Territory (for example, Part 2C of the Civil Liability Act 2002 (NSW) and its counterparts);
• (b) participating in Open Disclosure, including providing a factual explanation of what happened;
• (c) making a mandatory notification you are legally required to make under the mandatory notification provisions of the National Law, or complying with any registration, reporting or disclosure obligation under the National Law;
• (d) making a reportable incident notification you are legally required to make to the NDIS Quality and Safeguards Commission;
• (e) making, or contributing to, a report of a reportable incident under the Serious Incident Response Scheme, or making any other report or notification required by the Aged Care Act;
• (f) conducting an assessment of, or making a notification about, an eligible data breach as required by Part IIIC of the Privacy Act 1988 (Cth) or a corresponding health records law; and
• (g) making any other disclosure, notification or report you are required by law to make.

We ask that you tell us about any of these steps as soon as practicable, so we can support you, but taking a legally required step before telling us is never, by itself, a breach of this policy.

[WP REVIEW: add the National Law section references for mandatory notifications and registration reporting; the previous draft cited s.130 and ss.140 to 143, which have not been verified.]

Cooperate With Us

You must, at your own cost (except where this policy expressly pays, such as under the Court Attendance Costs extension): give us and our appointed lawyers, investigators and experts all information, documents and assistance we reasonably request; be truthful and frank in everything you tell us; attend interviews, conferences, mediations, hearings and trials as reasonably required; and do nothing that prejudices our position or our rights of recovery. Nothing in this obligation requires you to waive legal professional privilege otherwise than to us, or to breach any law, including privacy law.

Mitigate

You must take all reasonable steps to prevent or minimise any loss, including acting on reasonable risk-management directions we give you after a claim or circumstance is notified.

Tell Us About Material Changes

You must tell us in writing as soon as reasonably practicable if, during the policy period: your registration or accreditation is suspended, cancelled, surrendered or made subject to conditions or undertakings; you materially change the nature or scope of your professional services; you begin practising a discipline not described in the schedule; you merge your practice with, or sell it to, another person or entity; or you become bankrupt or enter an insolvency administration. We may then adjust the terms or premium prospectively; no adjustment affects cover for professional services already provided.

Tell Us About Other Recoveries

You must not seek, accept or agree to indemnity, contribution or compensation for a claim or amount covered by this policy from any other insurer, indemnifier, employer or scheme without disclosing that fact to us. If you receive any such amount, you must account for it to us to the extent we have paid, or would otherwise pay, the same amount under this policy.

Pay the Premium

You must pay the premium (including all government charges) by the due date shown in the schedule or invoice. If the premium is unpaid, we may cancel this policy in accordance with ss.59 to 63 of the Insurance Contracts Act 1984 (Cth), after giving the notice the Act requires.

General Conditions

Insurance Contracts Act

Nothing in this policy excludes, restricts or modifies the operation of the Insurance Contracts Act 1984 (Cth). Where this policy is inconsistent with the Act, the Act prevails.

If this policy would otherwise let us refuse to pay a claim, in whole or in part, because of something you did or did not do after this policy was entered into, section 54 of the Act applies. We may not refuse to pay the claim only because of that act or omission. Our liability is reduced by the amount that fairly represents the extent to which our interests were prejudiced. Where the act or omission could reasonably be regarded as capable of causing or contributing to the loss, we may refuse to pay only the part of the claim that the act or omission caused or contributed to. We may not refuse any part that you prove the act or omission did not cause. This applies to every condition, exclusion, limit and obligation in this policy, not only to the claims conditions.

Your Duty of Disclosure

Before you entered into this policy, renewed, varied, extended or reinstated it, you had a duty under s.21 of the Insurance Contracts Act 1984 (Cth) to disclose to us every matter you knew, or a reasonable person in the circumstances could be expected to know, to be relevant to our decision whether to accept the risk and on what terms. You did not need to tell us about anything that diminishes the risk, is of common knowledge, we know or should know as an insurer, or we told you we did not need to know.

If you failed to comply with the duty, our remedies are those set out in Division 3 of Part IV of the Act: we may reduce our liability to the amount that would place us in the position we would have been in had the duty been complied with and, if the non-disclosure was fraudulent, we may avoid the policy from its beginning. For the duty of disclosure, only facts known to the person named in the schedule as the insured (or to the person completing the application) are relevant.

Cancellation

You may cancel this policy at any time by telling us. We refund the premium for the unexpired period of insurance on a pro-rata basis, less any non-refundable government charges.

We may cancel this policy only as the Insurance Contracts Act 1984 (Cth) allows, by giving you written notice as that Act requires. We refund the premium for the unexpired period on a pro-rata basis.

Cancellation never affects cover for claims and circumstances already notified.

Governing Law

This policy is governed by the law of the state or territory of Australia shown in the schedule for this purpose. If none is shown, it is governed by the law of the state or territory in which your principal place of business was located at the start of the policy period.

Jurisdiction

You and we submit to the non-exclusive jurisdiction of the courts of the state or territory whose law governs this policy under the Governing Law condition, the courts of the Commonwealth of Australia, and the courts that hear appeals from those courts.

Disputes and Complaints

If you are dissatisfied with any decision or service of ours, you may use our internal complaints process at no cost, using the complaints contact details shown in the schedule. We will acknowledge your complaint within 1 business day, keep you informed, and give you our final response within 30 calendar days.

If your complaint is not resolved to your satisfaction, or we take longer than 30 days, you may refer it to the Australian Financial Complaints Authority (AFCA): www.afca.org.au, info@afca.org.au, 1800 931 678, GPO Box 3, Melbourne VIC 3001. AFCA's determinations bind us but not you. Time limits apply. We subscribe to the General Insurance Code of Practice.

Conduct of the Defence and Conflicts of Interest

We are entitled to take over and conduct, in your name, the investigation, defence and settlement of any claim, and your representation at any inquiry we cover, and to appoint lawyers of our choosing for those purposes. We will: keep you informed of all material developments; consult you on strategy and on any proposed settlement; not settle any claim in a way that includes an admission of professional misconduct by you without your consent; and instruct the appointed lawyers that, in any matter bearing on your registration, reputation or clinical record, their professional duty is owed to you.

If a conflict of interest arises between you and us, or between insured persons, we will tell you promptly, and we will pay for separate representation for you by an independent lawyer agreed between us or, failing agreement, nominated under the Senior Counsel Clause condition.

Senior Counsel Clause

We will not require you to contest any claim, or appeal any judgment, unless Senior Counsel (agreed between you and us or, failing agreement within 21 days, nominated by the President of the Law Society or Bar Association of the State or Territory whose law governs this policy) advises that the claim or appeal should be contested, taking into account the prospects of success, the likely costs, and the interests of both you and us, including your reputational and registration interests. The costs of obtaining that advice are defence costs.

Settlement Opportunities

If we recommend a settlement of a claim that is acceptable to the claimant, and you do not consent to it, our liability for that claim will not exceed: the amount for which the claim could have been settled; plus defence costs incurred up to the date your consent was requested; less the excess. You then conduct the further defence at your own risk and expense as to the difference.

Allocation

If a claim includes both matters covered by this policy and matters not covered, or is made against both persons insured under this policy and persons not insured, you and we will use our best endeavours to agree a fair and proper allocation of loss and defence costs between covered and uncovered matters and persons, taking into account the relative legal and financial exposures. If we cannot agree within 30 days, the allocation will be determined by Senior Counsel appointed under the mechanism in the Senior Counsel Clause condition, whose determination is binding on you and us, and whose costs we will pay. Pending agreement or determination, we will advance defence costs on the allocation we reasonably consider fair.

Subrogation

If we pay anything under this policy, we are subrogated to all your rights of recovery, contribution and indemnity in respect of that payment, and we may pursue those rights in your name. You must not do anything to prejudice those rights, and you must give us reasonable assistance in pursuing them at our expense. We will not exercise rights of subrogation against: an employee, student, volunteer or locum (unless their conduct was serious or wilful misconduct, or dishonest, fraudulent or criminal); or any person against whom s.65 or s.66 of the Insurance Contracts Act 1984 (Cth) prevents recovery. Any recovery is applied first to our outlay and costs of recovery, and any balance to you.

Severability and Non-imputation

Cover applies to each insured person as if a separate policy had been issued to each of them. In deciding whether an exclusion applies, or whether an obligation has been breached: the conduct, state of mind and knowledge of one insured person is not imputed to any other insured person; and only the individual's own conduct, state of mind and knowledge count against them. The Your Duty of Disclosure condition states whose knowledge is relevant to disclosure. For a practice entity named under Endorsement E03, the knowledge and conduct of the entity are only those of a member of its control group, and the knowledge or conduct of any other insured person is not imputed to the entity. Nothing in this condition increases the limit of liability.

GST and Input Tax Credits

If you are entitled to an input tax credit for the premium, you must tell us the extent of that entitlement at or before the time you make a claim. Where we pay an amount under this policy, we may reduce the payment by the amount of any input tax credit or decreasing adjustment to which you are, or would be, entitled in respect of the acquisition to which the payment relates. Amounts we pay are otherwise inclusive of GST, up to the limit of liability.

Multiple Claims Aggregation

All claims and inquiries arising out of, based upon, or attributable to the same act, error, omission or event, or to a series of acts, errors, omissions or events that are similar or related, or interrelated by reason of a common cause, transaction, patient episode, course of conduct or originating source, are together treated as a single claim for all purposes of this policy, including the limit of liability, sub-limits and excess. That single claim is treated as first made when the earliest of them was first made against you or first notified to us, whichever is earlier, and falls in the policy period in which it is treated as first made.

Australian Currency

All premiums, limits, sub-limits, excesses and payments under this policy are in Australian dollars. Where a loss is incurred in another currency, it is converted at the market rate of exchange published by the Reserve Bank of Australia on the date the payment obligation is finally determined.

Assignment

You may not assign this policy or any right under it without our prior written consent, except that the Spouses, Estates and Legal Representatives extension operates automatically on death, incapacity or insolvency.

Repayment Where Cover Is Not Established

If we advance defence costs or other amounts, and it is later admitted by the relevant insured person or established by a final adjudication that the claim or inquiry falls within the Sexual Misconduct exclusion or the Deliberate, Dishonest, Fraudulent or Criminal Acts exclusion, or is otherwise not covered by this policy, that insured person must repay those amounts to us on demand. The Severability and Non-imputation condition protects innocent insured persons from repayment obligations arising from another person's conduct.

Utmost Good Faith

You and we each owe the other a duty of utmost good faith in all dealings under this policy, as implied by s.13 of the Insurance Contracts Act 1984 (Cth). We will handle every claim honestly, fairly, transparently and in a timely way.

Sanctions

We do not provide cover, pay any claim or provide any benefit under this policy to the extent that doing so would expose us to any sanction, prohibition or restriction under:

• the Autonomous Sanctions Act 2011 (Cth), the Charter of the United Nations Act 1945 (Cth), or regulations made under either Act; or
• the trade or economic sanctions laws of the United Kingdom, the United States of America or the European Union, to the extent they apply to us.

[WP REVIEW: confirm that naming the UK, US and EU regimes is appropriate for Australian capacity; this is a deliberate library-wide scope choice.]

Notices

Notices to you are effective when sent to the postal or email address last notified to us. Notices to us are effective when received at the claims or complaints contact details shown in the schedule.

Privacy

We collect personal information, including health information where necessary to assess and manage claims, in accordance with the Privacy Act 1988 (Cth). We collect it to assess your application, issue and administer your policy, handle claims, and comply with law. We may disclose it to our reinsurers, service providers, legal and claims professionals, and regulators, some of whom may be overseas. You can ask for access to or correction of your personal information, or make a privacy complaint, using the contact details in the schedule.

How to Make a Claim

Contact us. Notify every claim, inquiry and circumstance in writing to the claims contact shown in the schedule, quoting your policy number. If a matter is urgent, for example you have been served with proceedings, received an immediate-action notice from a National Board, or discovered a data breach, telephone first, then confirm in writing.

What to send us. As soon as reasonably practicable, send us: every demand, claim form, originating process, complaint, notice or correspondence you have received (unanswered); your factual account of the relevant professional services, with dates; the relevant clinical records (subject to privacy law: we will guide you on lawful disclosure); the identity of any other practitioners, practices or insurers involved; and details of any other insurance or indemnity that may respond (see the Other Insurance provision and the Tell Us About Other Recoveries obligation).

What we will do. We will: acknowledge your notification within 5 business days; tell you what further information we need; confirm or explain our position on cover as soon as we reasonably can, and meanwhile protect your position under the Advance Claim Protection extension; appoint and pay lawyers experienced in health-practitioner matters where representation is needed; conduct the matter in consultation with you under the Conduct of the Defence and Conflicts of Interest condition; and keep you informed at every material step. We will comply with the claims-handling standards of the General Insurance Code of Practice.

What you must not do. Do not: admit liability, settle, or offer payment without our written consent (remembering the protected steps in the No Admissions Without Our Consent obligation, which you may always take); appoint your own lawyers at our cost without our written consent (except under the Advance Claim Protection extension or where we have agreed separate representation under the Conduct of the Defence and Conflicts of Interest condition); or destroy, alter or withhold any relevant record. Altering a clinical record after a complaint is both a policy breach and a serious disciplinary matter: if a record needs correction, make a dated supplementary note and tell us.

Endorsement Library

An endorsement applies only if its code is shown in the schedule. Each endorsement changes this policy only as it states, and is read together with the variables (sub-limits, excesses, conditions and additional premium) shown for it in the schedule. Except as an endorsement expressly varies them, all terms of this policy continue to apply to cover provided under an endorsement.

E01 Facility-based Intrapartum Midwifery Care

Available to registered midwives. The Obstetrics and Intrapartum Homebirth exclusion does not apply to intrapartum care (active labour, delivery, and the 24-hour post-partum period) provided by the insured midwife within a licensed healthcare facility, within the midwife's scope of practice and any collaborative arrangements required by law. Intrapartum care at homebirths and in all other non-facility settings remains excluded and cannot be endorsed under this product.

The midwife must hold the current endorsement or credentialing required by the facility. Privately practising midwives requiring intrapartum homebirth cover should seek cover under the Commonwealth-supported midwife professional indemnity arrangements.

Schedule variables: facilities; special excess (optional); sub-limit (optional).

E02 Clinical Trials and Approved Research

The Clinical Trials and Experimental Procedures exclusion does not apply to the insured's participation as an investigator or study clinician in a clinical trial or research project named in the schedule, provided the trial or project has current approval from a human research ethics committee constituted under NHMRC guidelines and, where required, complies with the Therapeutic Goods Administration's CTN or CTA scheme. Cover applies in excess of the indemnity given by the trial sponsor that is stated in the schedule.

Schedule variables: trials or projects named; sponsor indemnity; sub-limit (optional).

E03 Practice Entity as Named Insured

The definition of you, your and insured person is extended to include the company, partnership or trust named in the schedule through which the insured conducts the practice, but only for civil liability arising from professional services provided by insured persons and covered by this policy, and never for the entity's trading debts, employment practices, or directors' and officers' liability. The knowledge and conduct of the entity are those of its control group, as the Severability and Non-imputation condition provides. The limit of liability is not increased.

Schedule variables: practice entity name and ABN.

E04 Increased Inquiry Costs Sub-limit

The sub-limit for the Inquiry Costs extension is increased to the amount stated in the schedule. The sub-limit remains part of, and not in addition to, the limit of liability.

Schedule variables: inquiry costs sub-limit.

E05 Extended Reporting Period

Records the purchase of the 12-month extended reporting period described in the Extended Reporting Period extension, with the start and end dates stated in the schedule.

Schedule variables: extended reporting period start and end dates.

E06 Extended Run-off Cover

The 72-month automatic run-off period in the Run-off Cover on Retirement or Cessation of Practice extension is extended to the longer period stated in the schedule (including an unlimited run-off period where stated), to meet the run-off requirements of the insured's National Board registration standard or professional association. The other terms of that extension continue to apply.

Schedule variables: run-off period.

E07 Cosmetic and Aesthetic Procedures

Professional services are extended to include the non-surgical cosmetic or aesthetic procedures described in the schedule (for example, cosmetic injectables administered by a dentist for an aesthetic purpose), provided each procedure is within the insured's scope of practice, is performed in accordance with the relevant National Board's guidelines on cosmetic procedures, and, where a prescription-only substance is used, the Prescription-only Medicines Outside Authority exclusion is satisfied.

Schedule variables: procedures named; special excess (optional); sub-limit (optional).

E08 Worldwide Territorial Extension

Cover is extended to professional services provided temporarily outside Australia, for the destinations, purposes and maximum duration stated in the schedule (for example, humanitarian placements, sports-team travel, or conference demonstrations). The USA and Canada exclusion continues to apply absolutely, and claims must be brought and determined in a jurisdiction other than the USA or Canada.

Schedule variables: destinations; purposes; maximum duration.

E09 Telehealth to Overseas Patients

The Telehealth and Remote Care extension is extended to professional services provided by telehealth from Australia to patients or clients located in the countries stated in the schedule, provided the insured complies with the registration, licensing and privacy laws of both Australia and the patient's location. The USA and Canada exclusion continues to apply absolutely.

Schedule variables: countries.

E10 Animal-assisted Therapy Program

The Therapy Animals extension is extended to the structured animal-assisted therapy program described in the schedule, including the additional therapy animals, handlers and program locations named there. The insured must hold current veterinary health certification and a temperament assessment for each therapy animal, and maintain a documented animal-welfare and infection-control protocol.

Schedule variables: program description; animals, handlers and locations; sub-limit (optional).

E11 First Aid and Event Medical Services

Professional services are extended to include first aid, event health services and sideline coverage the insured provides at the sporting, community or mass-gathering events described in the schedule, whether paid or voluntary, within the insured's scope of practice and any event-medical guidelines of the insured's National Board or professional association.

Schedule variables: events.

E12 Second Reinstatement of the Limit

In addition to the Automatic Reinstatement provision, the limit of liability for Section A: Professional Indemnity is reinstated a second time, in full, for claims wholly unrelated to the claims that exhausted it and first made and notified later in the same policy period. The reinstated limit never applies to a claim that exhausted an earlier limit, or to any claim treated as one with it under the Multiple Claims Aggregation condition, and sub-limits are not reinstated.

Schedule variables: none.

E13 Physiotherapy

This endorsement applies where the insured is a physiotherapist registered with the Physiotherapy Board of Australia, or a practice whose professional services described in the schedule are wholly or predominantly physiotherapy services.

Covered techniques. Professional services include the following techniques and modalities when performed by an allied health practitioner registered in the profession of physiotherapy, within the scope of practice recognised by the Physiotherapy Board of Australia:

• (a) spinal manipulation and mobilisation, including high-velocity, low-amplitude thrust techniques applied to the spine and peripheral joints;
• (b) dry needling, being the insertion of fine filiform needles into myofascial trigger points, muscles or connective tissue for the management of pain and movement dysfunction; and
• (c) exercise prescription, including the assessment, prescription, progression and supervision of therapeutic exercise programs directed at rehabilitation, injury prevention, pain management or the restoration or maintenance of physical function.

No separate endorsement is required for dry needling.

Additional obligations. These are added to the Your Obligations section and operate on the same basis:

• (a) Continuing professional development. You must complete, and keep records evidencing, the continuing professional development required by the Physiotherapy Board of Australia's registration standard for continuing professional development as in force from time to time. Where you perform dry needling, your continuing professional development must include, or you must otherwise hold and maintain, training specific to dry needling covering safe needling technique, relevant anatomy, infection control, and the recognition and management of adverse events (including pneumothorax).
• (b) Scope of practice. Every treatment and technique you provide must be within the physiotherapy scope of practice described in the Physiotherapy Board of Australia's practice standards (or any registration standard, code or guideline that replaces them), and within any conditions, undertakings or notations recorded on your registration.

Additional exclusions. These are added to the What Is Not Covered section. We will not cover any claim, inquiry, loss, defence costs or other amounts arising from:

• (a) Podiatric surgery: the performance of podiatric surgery or any other procedure reserved to podiatrists or podiatric surgeons registered with the Podiatry Board of Australia. This exclusion is stated for certainty; such work is outside the physiotherapy scope of practice.
• (b) Cosmetic and aesthetic physiotherapy: any treatment or procedure performed wholly or predominantly for aesthetic or cosmetic purposes and not directed at physical rehabilitation, the treatment of illness or injury, or the management of pain, including facial physiotherapy, cosmetic needling, or muscle-stimulation treatments provided for purely cosmetic purposes without a clinical indication. This exclusion does not apply to scar management directed at the functional or symptomatic management of scar tissue, or to post-surgical rehabilitation (including after reconstructive or cosmetic surgery) directed at restoring movement, strength, function or lymphatic drainage, or at managing pain, swelling or scarring.

Gym, fitness and personal training. Professional services do not include gym instruction, group fitness classes or personal training services conducted under a separate business structure (including a separate company, partnership, trust or registered business name) that is not the practice described in the schedule. Exercise prescription and supervised therapeutic exercise delivered as part of your physiotherapy practice, including sessions delivered in a gym or fitness setting, remain covered.

Schedule variables: none.

E14 Psychology and Counselling

This endorsement applies where the insured is a psychologist (including a provisionally registered psychologist) registered with the Psychology Board of Australia, or a counsellor or psychotherapist who is a full member of the Australian Counselling Association (ACA) or the Psychotherapy and Counselling Federation of Australia (PACFA) and holds a current practising certificate or equivalent credential issued by that association, or a practice whose professional services described in the schedule are wholly or predominantly psychology, counselling or psychotherapy services.

Counsellors. For the purposes of this endorsement, an allied health practitioner includes a person who, at the time of the relevant act, error or omission, holds either:

• (a) registration as a psychologist with the Psychology Board of Australia (including provisional registration, where the person practises under supervision arrangements that comply with the Board's requirements); or
• (b) full membership of the Australian Counselling Association or the Psychotherapy and Counselling Federation of Australia, as the person's professional association, together with the current practising certificate or equivalent credential that association requires for practising members.

Increased sexual misconduct defence costs sub-limit. The sexual misconduct defence costs sub-limit under the Sexual Misconduct exclusion is increased from $500,000 to $750,000 in the aggregate for the policy period. All other terms of that exclusion, including the repayment obligation where the conduct is admitted or established and the protection of innocent insured persons, continue to apply.

False and recovered memory claims. The Professional Indemnity Cover clause extends to your civil liability for any claim first made against you and notified to us during the policy period alleging that a therapeutic process you conducted, including hypnotherapy, regression techniques or other memory-related therapeutic techniques, caused the claimant or a patient to form false memories, including false memories of abuse. The most we will pay for these claims is $500,000 in the aggregate for the policy period, as part of and not in addition to the limit of liability.

Third-party psychological harm. The Professional Indemnity Cover clause extends to your civil liability for any claim first made against you and notified to us during the policy period by a person who was not your patient or client, for psychological harm suffered by that person as a result of your negligent advice to your patient or client in the course of your professional services. The most we will pay for these claims is $250,000 for any one claim and $500,000 in the aggregate for the policy period, as part of and not in addition to the limit of liability. This does not extend cover to claims otherwise excluded, including under the Related Parties exclusion.

Mandatory child protection reporting. Making a report or notification you are required or permitted by law to make under child protection legislation, including the Children and Young Persons (Care and Protection) Act 1998 (NSW), the Children, Youth and Families Act 2005 (Vic), the Child Protection Act 1999 (Qld) and the corresponding legislation of every other State and Territory, or under any mandatory reporting scheme applying to your profession, is added to the protected steps in the No Admissions Without Our Consent obligation. It is never treated by us as an admission of liability and never of itself prejudices your cover.

Group therapy and telepsychology. Professional services include group therapy, group counselling and group programs you facilitate. Claims by more than one participant arising from the same act, error, omission or event are one claim under the Multiple Claims Aggregation condition. Consistent with the Telehealth and Remote Care extension, professional services include telepsychology and remote counselling delivered in compliance with the Australian Psychological Society's ethical guidelines for psychological services via telehealth or, for a counsellor, the telehealth guidance of their professional association.

Scope limit. A provisionally registered psychologist is an insured person only for professional services provided under supervision arrangements that comply with the Psychology Board of Australia's provisional registration requirements. This is a limit on who is covered, not an obligation, and the Your Obligations section does not apply to it.

Additional obligations. These are added to the Your Obligations section and operate on the same basis:

• (a) A counsellor must maintain the membership, practising certificate, supervision and continuing professional development requirements of the ACA or PACFA throughout the policy period.
• (b) You must keep contemporaneous clinical records of all consultations, including telehealth consultations, in accordance with your Board's or professional association's record-keeping standards.

Additional exclusions. We will not cover any claim, inquiry, loss, defence costs or other amounts arising from:

• (a) the prescription of a medicine by you (psychologists and counsellors hold no prescribing authority); this does not apply to advice about, or care coordination involving, a medicine lawfully prescribed by another authorised prescriber; or
• (b) the provision of change or suppression (conversion) practices prohibited under the legislation of any State or Territory.

Schedule variables: none.

E15 Dental and Oral Health

This endorsement applies where the insured is a dental practitioner (a dentist, dental specialist, dental hygienist, dental therapist, oral health therapist or dental prosthetist) registered with the Dental Board of Australia, or a practice whose professional services described in the schedule are wholly or predominantly dental or oral health services.

Dental practitioners are covered. A dental practitioner registered with the Dental Board of Australia is an allied health practitioner and is not a medical practitioner for the purposes of this policy. The Medical Practitioners exclusion does not apply to, and does not reduce cover for, any dental practitioner.

Covered dental procedures. Professional services include, without limitation, the following when performed within the insured's registration division, specialty and scope of practice under the Dental Board of Australia's scope of practice registration standard:

• (a) oral surgery, including simple and surgical tooth extractions;
• (b) the placement and restoration of dental implants;
• (c) orthodontics;
• (d) endodontics;
• (e) periodontics;
• (f) prosthodontics, including the design, fitting and adjustment of dentures and other dental prostheses (which are also products for the purposes of the Products Liability extension); and
• (g) oral pathology, including the examination, diagnosis and referral of oral mucosal disease.

Dental sedation and general anaesthesia. The Professional Indemnity Cover clause extends to your civil liability arising from the administration of conscious sedation (including inhalational, oral and intravenous sedation) in connection with your professional services. At the time of the treatment:

• (a) the sedation must be administered in compliance with the Dental Board of Australia's registration standard and guidelines for conscious sedation (and, where applicable, an endorsement for conscious sedation on the insured's registration);
• (b) the premises must comply with any applicable State or Territory hospital, day-procedure or health-facility licensing requirements for the level of sedation administered; and
• (c) the person administering the sedation must hold current sedation-specific training and continuing professional development certification.

If (a) to (c) are not met, we may reduce the amount we pay by the amount that fairly represents the prejudice we suffer, consistent with s.54 of the Insurance Contracts Act 1984 (Cth).

Additional obligations. These are added to the Your Obligations section and operate on the same basis:

• (a) Radiation safety. Where you take, or cause to be taken, dental radiographs (including intraoral radiography, orthopantomography and cone-beam computed tomography), you must hold and comply with the radiation licence, registration or accreditation required by the radiation safety legislation of the relevant State or Territory, and provide evidence of it to us on request.
• (b) Infection control. You must comply with the Dental Board of Australia's guidelines on infection control and the current Australian Dental Association infection control guidelines applicable to your practice.

Additional exclusions. We will not cover any claim, inquiry, loss, defence costs or other amounts arising from:

• (a) Cosmetic facial injectables: the administration of botulinum toxin, dermal fillers or other cosmetic facial injectables for purely aesthetic purposes (that is, otherwise than for the treatment of temporomandibular disorders, bruxism, hyperhidrosis, dental or facial pain, or another clinical indication within the insured's scope of practice), unless the insured has declared that activity to us and Endorsement E07 applies. Where a facial injectable is administered for a clinical indication, the Prescription-only Medicines Outside Authority exclusion continues to apply to the prescribing and supply of the substance.
• (b) Specialist oral and maxillofacial surgery: any surgical procedure that requires specialist registration as an oral and maxillofacial surgeon, unless the insured holds that specialist registration and it is noted in the schedule. Surgical procedures within the general dental scope of practice, including surgical extractions, remain covered.
• (c) General anaesthesia elsewhere: dental treatment performed under general anaesthesia, unless the general anaesthesia was administered in an accredited day surgery or hospital facility by a person lawfully authorised to administer it. This is an exclusion of a kind of risk, not an obligation. Treatment under general anaesthesia administered in such a facility by such a person is covered.

Schedule variables: specialist registration (where held).

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Designed for the Australian market. Assumes application of the Insurance Contracts Act 1984 (Cth). Users are responsible for their own legal review, regulatory compliance, and reinsurance alignment.