Last Updated: October 3, 2023
Purpose:
The filing of a certificate of insurance (certifying primary insurance coverage) triggers Injured Patients and Families Compensation Fund (Fund) enrollment and Fund coverage for the health care provider. The information provided in the certificate is used by the Fund to classify and bill the provider.
Requirement:
Sections
655.23 (3) (b)
and
(c)
, Wis. Stat., state that authorized insurance companies and qualified self-insurers providing coverage for Fund participants must file certificates of insurance with the Fund in a form prescribed by the commissioner. More information can be found in ch. 655, Wis Stat.
Coverage requirements are described in
Coverage.
Process:
The submission must follow the electronic data format prescribed by the Commissioner of Insurance (see
Data Layout). Authorized carriers and qualified self-insurers may file certificates by registering with the Office of the Commissioner of Insurance to obtain direct access to the Fund system. Access to the Fund system allows insurers to upload files directly, review accepted and rejected certificates, and search for individual provider coverage records. To obtain a log-on ID for direct access, contact Rebecca Kamenick, Regulatory Specialist, at 608-707-5478 or rebecca.kamenick@wisconsin.gov.
Timeline:
Certificates should be filed as close to the effective date of the policy as possible, but no later than the 15th day of the month following the start date of the policy. For certificates filed late, the insurer may be subject to a late filing fee.
Links that may be of assistance in filing certificates: