High Cost Claim Indemnity Scheme medical indemnity payment application form (MO012)
Use this form to apply for payments made under the High Cost Claim Indemnity Scheme (HCCS) if you're a Medical Defence Organisation or a Medical Indemnity Insurer.
Before you start, read more about HCCS.
If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.
Page last updated: 13 November 2018