§ 36-6811. Time for filing closed claim report.

A.  An insuring entity shall file, between January 1 and March 15 of each year, a closed claim report.  These reports shall include data for all claims closed in the preceding calendar year and any adjustments to data reported in prior years.

B.  Any violation by an insurer of the Medical Professional Liability Insurance Closed Claim Reports Act shall subject the insurer to discipline including a civil penalty of not less than Five Thousand Dollars ($5,000.00).

C.  Every insuring entity or self-insurer that provides medical professional liability insurance to any facility or provider in this state shall report each medical professional liability closed claim to the Insurance Commissioner.

D.  A closed claim that is covered under a primary policy and one or more excess policies shall be reported only by the insuring entity that issued the primary policy.  The insuring entity that issued the primary policy shall report the total amount, if any, paid with respect to the closed claim, including any amount paid under an excess policy, any amount paid by the facility or provider, and any amount paid by any other person on behalf of the facility or provider.

E.  If a claim is not covered by an insuring entity or self-insurer, the facility or provider named in the claim shall report it to the Commissioner after a final claim disposition has occurred due to a court proceeding or a settlement by the parties.  Instances in which a claim may not be covered by an insuring entity or self-insurer include situations in which:

1.  The facility or provider did not buy insurance or maintained a self-insured retention that was larger than the final judgment or settlement;

2.  The claim was denied by an insuring entity or self-insurer because it did not fall within the scope of the insurance coverage agreement; or

3.  The annual aggregate coverage limits had been exhausted by other claim payments.

F.  If a claim is covered by an insuring entity or self-insurer that fails to report the claim to the Commissioner, the facility or provider named in the claim shall report it to the Commissioner after a final claim disposition has occurred due to a court proceeding or a settlement by the parties.

1.  If a facility or provider is insured by a risk retention group and the risk retention group refuses to report closed claims and asserts that the federal Liability Risk Retention Act (95 Stat. 949; 15 U.S.C. Sec. 3901 et seq.) preempts state law, the facility or provider shall report all data required by the Medical Professional Liability Insurance Closed Claim Reports Act on behalf of the risk retention group.

2.  If a facility or provider is insured by an unauthorized insurer and the unauthorized insurer refuses to report closed claims and asserts a federal exemption or other jurisdictional preemption, the facility or provider shall report all data required by the Medical Professional Liability Insurance Closed Claim Reports Act on behalf of the unauthorized insurer.

3.  If a facility or provider is insured by a captive insurer and the captive insurer refuses to report closed claims and asserts a federal exemption or other jurisdictional preemption, the facility or provider shall report all data required by the Medical Professional Liability Insurance Closed Claim Reports Act on behalf of the captive insurer.

Added by Laws 2003, c.390 , § 12, eff. July 1, 2003.  Amended by Laws 2009, c. 176, § 55, eff. Nov. 1, 2009; Laws 2010, c. 222, § 52, eff. Nov. 1, 2010; Laws 2011, c. 278, § 52, eff. Nov. 1, 2011.