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LOUISIANA PATIENT S COMPENSATION FUND MD and ADVANCED PRACTICE RN S APPLICATION - doa la

LOUISIANA PATIENT S COMPENSATION FUND MD and ADVANCED PRACTICE RN S APPLICATION - doa la 2025

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The document is an application form for the Louisiana Patient's Compensation Fund, intended for healthcare providers with primary insurance. It requires detailed information about the provider, their insurance coverage, and professional specialties. The form outlines eligibility criteria, coverage limits, and conditions under which claims may be denied. It emphasizes the importance of compliance with reporting requirements and provides instructions for submission.

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Click ‘Get Form’ to open it in the editor.
Begin with the 'Provider Details' section. Fill in your complete name, mailing address, license number, date of birth, and professional specialty. Ensure all required fields are completed.
Proceed to the 'Primary Coverage' section. Here, you must provide details about your insurance policy including the insuring company, policy number, effective dates, and whether it is a claims made or occurrence policy.
In the next section, indicate if you are employed as a Medical Director and specify any medical/surgical procedures you engage in by checking the appropriate boxes.
Review all entries for accuracy. Once completed, print and sign the form before mailing or faxing it to the Louisiana Patient's Compensation Fund at the provided address.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the PCF limit in Louisiana?

These rate estimates are for informational purposes only and are based on the LA standard limits of $100,000 each claim / $300,000 aggregate per year in coverage. The Louisiana Patients Compensation Fund (PCH) surcharge is in addition to these estimates.

What is Louisiana patients compensation fund?

The Patients Compensation Fund provides protection for the healthcare system, keeping costs down, and providing a guaranteed pool of funds to pay those citizens injured from medical malpractice of private health care providers.

What is the patient compensation fund?

Patient compensation funds are state-operated programs that afford excess insurance coverage for healthcare providers, including doctors, hospitals, dentists, and some allied healthcare professionals.

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