Certificate of Insurance and Proof of Coverage Requests

Departments engaged in activities involving outside parties may receive requests for the University's certificate of insurance or proof of coverage from these outside parties. The following will provide departments helpful information in managing these requests and instructions on how to request the certificate.

Assistance in acquiring proof of medical malpractice coverage for individuals employed by the University (not Medical Center) may also be requested using the same form listed below, or by sending the request received to the Office Property & Liability of Risk Management. Medical Center requests should be sent to both Piedmont Liability Trust (434-296-2100), Box 800767, 1020 Ednam Ctr., Ste 100, Charlottesville VA 22903 and Cheryl Skinner at UVa Medical Center Risk Management (434-924-5595), P.O. Box 800503 Charlottesville, VA 22908.

The University, its officers, employees and agents are provided with liability insurance protection through the Commonwealth's self-insurance program. (Insurance Coverage FIN 006) provides additional information about this and other University coverages.

As a public agency, the University is not permitted to add other entities as additional insureds to the Commonwealth's self-insurance comprehensive liability program, nor can we provide contractual liability coverage that would assume contractual indemnification or hold harmless provisions.

To request a certificate of coverage the department should complete and submit a Request for Certificate of Insurance form. Accompanying the request for a certificate of insurance should be a signed copy of any contract or agreement between the outside organization and the University of Virginia. All contracts or agreements must go through the proper University contract review process as explained in ( Policy FIN-036 University Contracts ) before submitting a request for a certificate of insurance.

If possible, the request and contract/agreement should be submitted to the Office of Property & Liability Risk Management at least one week prior to the date we are to provide the certificate.

Requests must be submitted by University employees only. In order to ensure that departments remain in control of their relationships and activities, we will refer outside parties submitting requests back to the department engaged in the activity prompting the request.

If you have any questions regarding completion of the request form, contact Miranda Bransom at (434) 924-3055 for assistance. For other assistance contact