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Home My WebLink AboutStanford Health Care - Insurance Certificate (2019)CERTIFICATE OF LIABILITY COVERAGE Issue Date 8/2712018 ADMINISTRATOR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Aon Insurance Managers CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE P.O. BOX HM 2450 DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE Hamilton HM JX Bermuda, COVERAGE DOUMENTS BELOW. COVERAGE PROVIDER COVERED PARTY SUMIT INSURANCE COMPANY LTD. (SUMIT) Stanford Health Care Lucile Packard Children's Hospital Stanford Stanford Health Care - Valle ,,are 1510 Page Mill Road, First Floor, Risk Mgt MC5713 Palo Alto CA 94304 THE POLICIES LISTED BELOW HAVE BEEN ISSUED TO THE ENTITY NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS AND CONDITIONS OF SUCH COVERAGE POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF COVERAGE POLICY NUMBER EFFECTIVE EXPIRATION COVERAGE LIMITS LIABILITY COVERAGES GENERAL LIABILITY [ I GENERAL LIABILITY [ ] Claims Made Each Occurrence $ [ ] Occurrence General Aggregate $ [ ] PROFESSIONAL LIABILITY I✓I PROFESSIONAL LIABILITY IV] Claims Made 1 -M01 01 -00-2018 9/1 /2018 9/1 /2019 Each Occurrence S 1,000,000 [ I Occurrence Aggregate $ 3,000,000 [l OTHER COVERAGES DESCRIPTION OF OPERATIONS I LOCATIONS I RESTRICTIONS / SPECIAL PROVISIONS: `'William Mulkerin, MD CERTIFICATE HOLDER Emergency Medicine William Mulkerin, MD c/o Stanford Health Care 300 Pasteur Drive Stanford CA 94305 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE THE EXPIRATION DATE THEREOF.SUMIT WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THIS ENTITY, ITS AGENTS OR REPRESENTATIVES. AUTH(2MM REPRESENTATIVE Aon Insurance Managers (Bermuda) Ltd. Aon Insurance Manaaers 430S6641 11B-19 Stanford Only 1 Janet Soncenbaugh 1 8/27/2018 1:06t30 Px (PDT) , Pago 1 o; 2 CERTIFICATE OF UAEILITY COVERAGE Issue Date 8/27/2018 ADMINISTRATOR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Aon Insurance Managers P.O. Box HM 2450 Hamilton HM JX Bermuda, CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE COVERAGE DOUMENTS BELOW. COVERAGE PROVIDER SUMIT INSURANCE COMPANY LTD. ( SUMIT) COVERED PARTY Stanford Health Care Lucile Packard Children's Hospital Stanford Stanford Health Care - Valle Care 1510 Page Mill Road, First Floor, Risk Mgt MC5713 Palo Alto CA 94304 THE POLICIES LISTED BELOW HAVE BEEN ISSUED TO THE ENTITY NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS AND CONDITIONS OF SUCH COVERAGE POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF COVERAGE POLICY NUMBER EFFECTIVE EXPIRATION COVERAGE LIMITS LIABILITY COVERAGES GENERAL LIABILITY Each Occurrence $ I 1 GENERAL LIABILITY [ ] Claims Made [ ] Occurrence I 1 General Aggregate $ I✓1 PROFESSIONAL LIABILITY [y/I Claims Made 1- M0101 -00 -2018 9/1/2018 9/1/2019 PROFESSIONAL LIABILITY Each Occurrence S 1,000,000 I 1 Occurrence I1 Aggregate S 3,000,000 OTHER COVERAGES DESCRIPTION OF OPERATIONS ! LOCATIONS / RESTRICTIONS t SPECIAL PROVISIONS: 'William Mulkerin, MD CERTIFICATE HOLDER CANCELLATION Emergency Medicine SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELED BEFORE THE EXPIRATION DATE THEREOF, SUMIT WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN William Mulkerin, MD c/o Stanford Health Care NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THIS ENTITY, ITS AGENTS 300 Pasteur Drive Stanford CA 94305 OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Aon Insurance Managers (Bermuda) Ltd. Aon Insurance Managers 43856641 1 18 -19 Stanford Only I Janet Sencenbaugh 1 8/27/2018 1:08:30 PM (PDT) Page 1 of 2 IMPORTANT If the certificate holder is an ADDITIONAL COVERED PERSON, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER This certificate does not constitute a contract between SUMIT and the Certificate Holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the coverage documents listed theron. c .MI 11N0.Nn1 43856641 1 18 -19 Stanford only I Janet Sencenbaugh 1 8/27/2018 1:08:30 PM (PDT) I Page 2 of 2