Quote Request Form
 

Pricing Indication for Professional Indemnity Insurance

Please review the Risk Category Guide and Product Disclosure Statement to identify your scope of practice and follow the below recommendations for next steps.

Career stage Indicative Pricing Next Step
Medical Student/Graduate/Intern Complimentary APPLY HERE
Post Graduate Year: 2-5 Ranges from $50 - $100* APPLY HERE
Doctor in Specialist training Set rates available based on your eligibility APPLY HERE
Working within an Employer Indemnified role with no current or previous Private Billings Set rates available based on your eligibility APPLY HERE
Working in a combination of Public and Private or in a Private scope Prices vary based on the particulars of your individual practice

For a personalised, no-obligation offer of insurance based on the particulars of your individual scope of practice,

APPLY HERE

Or alternatively if you would prefer a quote (indicative price only), please complete the form below.

If you require assistance with either your application or quote request, you can call our Member Services team on 1800 011 255 
For Practice Indemnity Policies

Prices vary based on the scope of your practice

Complete an application form for Practice Indemnity

APPLY HERE

Prices vary based on the size and number of doctors of your practice.

For more information, read the Practice Indemnity Policy Practice Indemnity Policy - Combined Financial Services Guide, Important Information and Policy Wording V.8

*Prices may vary based on information provided through the application process.

Personal Details

Do you have a previous Member Number?
Title
*
Please enter a value for Title
First Name
*
Please enter a value for First Name
Surname
*
Please enter a value for Surname
Gender
*
Please select a value for Gender
Date of Birth
*
Please select a value for Date of Birth

Please ensure you have provided at least one of the following:

1 - Mobile number 2 - International Phone Number

Australian Mobile Number
*
Please enter a mobile number
Checking Australian Mobile Number
Invalid Australian Mobile Number.
International Phone
Invalid International Phone number
Email
*
Invalid Email address
Address
*
Please enter a value for Correspondence Address
Country
Address line 1
*
Please enter a value for Address line 1
Address line 2
Address line 3
Suburb
*
Please enter a value for Suburb
State
*
Please enter a value for State
Postcode
*
Please enter a value for Postcode
According to our records, you are already a Member of MDA National and therefore you are unable to proceed with this online quotation request. Please refer to our Member Online Services to request a policy amendment, download a Certificate of Currency or view your policy history.For more information please contact our Member Services team on 1800 011 255 or email peaceofmind@mdanational.com.au

Practice Details

When would you like your policy to start?
*
Please select a valid Policy Start Date
Please note MDA National's policies run from 01 July to 30 June. As such, please select either today's date or a future date as your policy start date. You are able to include cover for any practice prior to this date by completing the retroactive cover section below.
Primary Practice State
*
Please select a valid Primary Practice State
Primary Specialty
Please refer to our Risk Category Guide
*
Please select a valid Primary Specialty
Practice Type
*
Please select a valid Practice Type
Gross Annual Billings (not your income or salary) for current financial year
*
Please enter a valid Gross Annual Billings
Gross Annual Billings should be greater than zero

What to include :

Gross Annual Billings are the total billings generated by you from all areas of your practice for which you require indemnity from us within the financial year. This is whether the funds are retained by you or not, and before any apportionment or deduction of expenses and/or tax. This includes work performed in your name or work for which you are personally liable, including but not limited to:

  • Medicare benefits
  • Payments by individuals
  • Payments by the Commonwealth Department of Veterans' Affairs, workers' compensation schemes and third party and/or vehicle insurers
  • Income received from other healthcare services provided by you such as professional fees, writing articles, incentive payments and overseas work for which we have agreed to extend indemnity under the Policy.

What not to include :

You do not need to include any billings or income from non clinical work or healthcare services that you provide for which you have access to indemnity from a public hospital's indemnity scheme or your employer.

Do you undertake any Locum work or work in a public hospital where you do not have access to state indemnity? *
Please select yes or no
Have you received a fellowship recognised by the Australian Medical Council (AMC) ? *
Please select a value
If yes, please confirm which fellowship
*
Please select a valid Fellowship
Date fellowship received
*
Date fellowship received
Are you currently enrolled in an accredited training program recognised by AMC? *
Please select a valid College Training Program
Which college training program are you or will you be enrolled in?
*
Please select a valid Training Program
Expected date of fellowship
*
Please select a valid Expected Date of Fellowship
AHPRA Registration Number
*
To search for your registration number, please click here
Please enter AHPRA number
Your Previous Practice
The quote we provide you will include cover for your previous practice
When did you or when will you first commence medical practice in Australia?
*
Please select a date
Has your practice (specialty, type and billings) changed in the last 5 years? *
Please select yes or no
Please provide information about your previous practice using the table below
Policy Period Type Of Practice Primary Speciality Previous Gross Annual Billings
2024/2025 * * *
2023/2024
2022/2023
2021/2022
2020/2021

What to include :

Gross Annual Billings are the total billings generated by you from all areas of your practice for which you require indemnity from us within the financial year. This is whether the funds are retained by you or not, and before any apportionment or deduction of expenses and/or tax. This includes work performed in your name or work for which you are personally liable, including but not limited to:

  • Medicare benefits
  • Payments by individuals
  • Payments by the Commonwealth Department of Veterans' Affairs, workers' compensation schemes and third party and/or vehicle insurers
  • Income received from other healthcare services provided by you such as professional fees, writing articles, incentive payments and overseas work for which we have agreed to extend indemnity under the Policy.

What not to include :

You do not need to include any billings or income from non clinical work or healthcare services that you provide for which you have access to indemnity from a public hospital's indemnity scheme or your employer.

Have you ever been the subject of a claim, investigation, or complaint? *
Please select yes or no

Qualification Details

Country of initial medical degree
*
Required
Medical School/University
*
Required
Initial Qualification awarded (example: MBBS or MD)
*
Required
Year Awarded
*
Required

Comments

The space below is provided for you to enter any additional information that will assist us with issuing you with the most accurate quote. In some cases we may need to contact you to discuss your indemnity requirements and if this is the case, we will do so with the contact details you provide above.

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