Medical Indemnity Protection Society Limited

Delegation of Authority

From time to time, you may require a third party to access your membership details. MIPS is bound by the Privacy Act, and can't provide your membership details to a third party without your written authority.

Complete this form to allow MIPS to provide your membership details to your practice manager, hospital, spouse, employer, or another nominated person.

Please note: The nominated person/s will have authority to obtain your membership details, until MIPS is advised otherwise. This authority does not apply to any non-membership information, such as claims data.

Delegation of Authority Form (32.9KB)

Medical Indemnity Protection Society Ltd (MIPS) is an Australian Financial Services Licensee (AFS Lic. 301912). MIPS Insurance Pty Ltd (MIPS Insurance) is a wholly owned subsidiary of MIPS and holds an authority issued by APRA to conduct general Insurance business and is an Australian Financial Services Licensee (AFS Lic. 247301). MIPS has a binding authority from MIPS Insurance to issue the MIPS Insurance medical indemnity policy. Any financial product advice is of a general nature and not personal or specific.