Forms

Pharmaceutical injury report form

Forms must be signed personally. Therefore, they cannot be submitted electronically to the Finnish Mutual Insurance Company for Pharmaceutical Injury Indemnities.

Claim form

The claim form should be filled out and returned only after the Finnish Mutual Insurance Company for Pharmaceutical Injury Indemnities has issued a positive compensation decision.

Employer’s salary notification

Any employer, who has been asked by the Finnish Mutual Insurance Company for Pharmaceutical Injury Indemnities to provide an account of the amount of earned income lost, may submit the account by filling out the appended form.

Letter of attorney

If you wish to authorise some other person to attend to your pharmaceutical injury matter on your behalf, you may append this letter of attorney, signed, and submit it to the Finnish Mutual Insurance Company for Pharmaceutical Injury Indemnities at a later date. Any expiration of the authorisation must always be reported, in writing, to the Finnish Mutual Insurance Company for Pharmaceutical Injury Indemnities.

If the patient is deceased, the beneficiaries of the deceased’s estate may authorise one person to attend to the pharmaceutical injury matter and withdraw the indemnities.

Send the forms by mail to the address:

Finnish Mutual Insurance Company for Pharmaceutical Injury Indemnities

PB 115

00181 Helsinki