You must download our forms and fill them in so they are processed quickly. You can also electronically sign some of our forms. We have help available if you use assistive technology.
Download and complete the Medical indemnity request to aggregate payments for the same claim form.
This is in accordance with Section 31 (High Cost Claim Indemnity Scheme), Section 34ZE (Run-off Cover Indemnity Scheme) or Section 34ZZC (Allied Health High Cost Claim Indemnity Scheme) of the Medical Indemnity Act 2002.
An authorised representative of the MII must complete and sign this form and provide it to the MDO. The MDO must provide this supporting document when submitting an application through MIOC for aggregated payments.