Use this form to declare for the Midwife Professional Indemnity Run-Off Cover Scheme (MPIROCS) that an eligible midwife is deceased and a valid death certificate isn’t available.
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 or need an interpreter.
Download and complete the Statutory declaration ROCS - Deceased midwife form.
The MPIROCS only applies to claims or incidents first notified on or after 1 July 2010.
This information was printed 20 February 2025 from https://www.servicesaustralia.gov.au/mo040. It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.servicesaustralia.gov.au/site-notices when using this material.