Statutory declaration ROCS - deceased midwife form (MO040)

Use this form if at the time a claim is made, an eligible midwife is deceased and a valid death certificate is not available to support eligibility under the ROCS provisions of the Midwife Professional Indemnity (Commonwealth Contribution) Scheme Act 2010.

Midwife Professional Indemnity Run-off Cover only applies to a claim or incident first notified on or after 1 July 2010.

A claim is taken to be made, on the date on which the midwife’s insurer was first notified 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.

ROCS is the Run-off Cover Indemnity Scheme.

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Page last updated: 10 April 2019