Services Australia flags unusual Medicare item numbers and starts a Professional Services Review. You must supply records, answer questions and engage advisers to manage the audit while still seeing patients day to day.

Malpractice protection insurance can help with costs for Medicare or Services Australia billing reviews, subject to limits.

After treatment, a patient complains to AHPRA or a state health complaints body. You need legal help to respond, prepare clinical notes, attend interviews and protect your registration, even if no lawsuit is filed.

Medical indemnity insurance may include costs for an AHPRA or health complaints inquiry, even if no civil claim follows.

A practice nurse administers the wrong dose after a chart is entered incorrectly. The patient is hospitalised and alleges the clinic is responsible. Their family seeks compensation for the injury and the extra treatment they needed.

Medical liability insurance is designed to cover claims from work done by you or your team, including contractors, plus defence costs.

A patient presents with chest pain. You note it as reflux and send them home. They later suffer a heart attack and claim your advice delayed treatment. A solicitor demands compensation for injury, lost income and ongoing care.

Medical malpractice insurance can respond to civil liability from a negligent act in healthcare services, plus defence costs.

After an audit, a regulator issues a civil penalty for a breach of legislation, or a court awards exemplary damages. You ask the insurer to pay the fine or non compensatory amount, plus your costs, as part of the claim.

Fines, penalties and punitive or exemplary damages are usually excluded, unless a specific statutory liability extension applies.

You sign a hospital services contract that promises you will pay any costs arising from patient complaints, even where you were not negligent. A dispute arises and the hospital demands payment under that contract.

Policies usually cover liability you’d have at law. Extra liability you assume in a contract is excluded unless it would exist anyway.

A practitioner knowingly bills a Medicare item that wasn’t provided, or a staff member alters notes to hide what happened. When a complaint and investigation follow, you try to claim for the consequences under your policy.

Deliberate, dishonest, fraudulent or criminal acts are generally excluded. Some wordings may still cover defence costs until proven.

Before renewing, you receive a letter from a patient’s lawyer about a procedure last month. You don’t notify the insurer. After cover starts, the patient files a claim and you try to lodge it under the new policy.

Claims linked to facts you knew about, or should reasonably have known, before the policy start or continuity date are usually excluded.