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.

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 Statutory declaration ROCS - Deceased midwife form.

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.

Page last updated: 17 November 2022.
QC 21506