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Request a Certificate of Insurance or a Claims History

To Request a Certificate of Insurance

  • Complete the form found here (Request for Certificate of Insurance 10-2017.pdf) and email it to Risk-Requests@rush.edu with the subject line stating "Certificate of Insurance Request"
  • The request must be written by someone in authority within that employee/student's department. Some examples of individuals in authority are: Department Chair, Department Director, MSP Administrator or Residency Program Director. If the resident or attending is leaving Rush and is applying for employment elsewhere, they can forward their own request. The doctor should print and sign his/her name on the request.

Please allow up to ten (10) business days to receive a completed Certificate of Insurance.

To Request a Claims History

Complete the form found here (Request for Claims History 10-2017.pdf) and email it to Risk-Requests@rush.edu with the subject line stating "Claims History request".

The request must be written by someone in authority within that employee/student's department. Some examples of individuals in authority are: Department Chair, Department Director, MSP Administrator or Residency Program Director. If the resident or attending is leaving Rush and is applying for employment elsewhere, they can forward their own request. The doctor should print and sign his/her name on the request.

Please note:

  • The form must be signed by the physician/provider who is the subject of the Claims History request.
  • The full name of the facility/company with complete address and fax number to which the report is to be sent must be included.
  • The Original Claims history letter will be sent to the addressee unless otherwise indicated.
  • Please allow up to ten (10) business days to receive a completed Claims History.