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Indiana Department of Insurance

IDOI > Medical Malpractice > Calculation Sheets & Certificate of Insurance Calculation Sheets & Certificate of Insurance

IDOI provides you with the right forms and information so that your Patient's Compensation Fund filings are organized and processed correctly.

Patient's Compensation Fund Nursing Home Calculation Sheet Effective 6/28/12
Patient's Compensation Fund Hospital Calculation Sheet Effective 3/1/12
Patient's Compensation Fund Nursing Home Calculation Sheet Effective 3/1/12
Patient's Compensation Fund Hospital Calculation Sheet Effective 3/1/11
Patient's Compensation Fund Nursing Home Calculation Sheet Effective 3/1/10
Instructions for Self-Insured Hospital Filings
Locum Tenen Calculation Sheet

Certificate of Insurance

A Certificate of Insurance certifies limits of liability on behalf of the referenced health care provider.

Download the Certificate of Insurance.

Reporting Endorsement Factors.

PCF Frequently Asked Questions

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