Statutory Declaration Run-off Cover Indemnity Scheme - Midwife who has ceased practice form (MO041)

The midwife completing this statutory declaration must have temporarily or permanently ceased midwifery practice because of maternity as at the notification date on which the insurer was firstnotified of a run-off claim made against the midwife, or an incident that may have given rise to a run-off claim against the midwife. Midwife Professional Indemnity Run-off Cover only applies to a claim or incident first notified on or after 1 July 2010. This statutory declaration should be completed by a midwife on or after the notification date.

 

Page last updated: 8 June 2016

This information was printed Sunday 25 September 2016 from humanservices.gov.au/health-professionals/forms/mo041 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.