Statutory Declaration Run-off Cover Indemnity Scheme – Medical practitioner who has not engaged in either private or remunerated medical practice during the preceding 3 years form (MO034)

This statutory declaration must be completed by a medical practitioner who has not engaged in either private or remunerated medical practice during the 3 years preceding the notification date, on which the Medical Defence Organisation (MDO) or Medical Indemnity Insurer (MII) was first notified of a Run-off claim made against the practitioner, or an incident or series of incidents that may give rise to a Run-off claim against the practitioner. The Run-off Cover Indemnity Scheme (ROCS) only applies to claims or incidents first notified on or after 1 July 2004.

Page last updated: 8 June 2016

This information was printed Wednesday 28 September 2016 from humanservices.gov.au/health-professionals/forms/mo034 It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.