Policy #: RUM-1005-14
Dates: Retroactive date is December 30, 1986, expiration date is July 1, 2017
Limits: $1,000,000 each claim/$3,000,000 each occurrence/$5,000,000 annual aggregate.
Form of Insurance: Claims made
"Tail" Coverage: automatically provided
Moonlighting activities: not covered
Please note: Records prior to 1986 predate our current records system and we have no way to validate the provider. A response to that effect will be sent in lieu of a verification.
Procedure for Requesting Liability Credentialing / Malpractice Claims History / Loss-Run Report
To process this request, you must provide an authorization signed by the provider. An electronic signature or verbal authorization is not acceptable.
A generic template can be found here.
***Please do NOT include SSN or other HIPAA-protected information on this form!
The authorization should be emailed to email@example.com
As of September 30, 2013, we no longer accept faxed credentialing requests. Please ensure there is an email address on the request for us to reply to.
Procedure for Requesting a Certificate of Insurance
You may obtain a current copy of the University’s Certificate of Professional Liability Insurance at:
Pam Ubel, Assistant to Director, Risk Management and Insurance