Indiana § 27-13-31-2 Liability limitations

Indiana Statutes

§ 27-13-31-2 — Liability limitations

Indiana·Title 27 INSURANCE·Art. 13 HEALTH MAINTENANCE ORGANIZATIONS·Ch. 31 Confidentiality of Medical Information and Limitation

(a)As used in this section, "in good faith and without malice" when used to describe an action taken or a decision or recommendation made means that:

(1)a reasonable effort has been taken to obtain the facts of the matter;

(2)a reasonable belief exists that the action, decision, or recommendation is warranted by the facts known; and

(3)if the action is described in IC 34-30-15-7, the action is made in compliance with IC 34-30-15-7.

(b)As used in this section, "health care review committee" means a peer review committee under IC 34-6-2.1-145 (or IC 34-4-12.6-1(c) before its repeal).

(c)In all actions to which this section applies, good faith shall be presumed and malice shall be required to be proven by the person aggrieved.

(d)A person who, in good faith and without malice:

(1)take

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(a) As used in this section, "in good faith and
without malice" when used to describe an action taken or a decision or
recommendation made means that:
(1) a reasonable effort has been taken to obtain the facts of the
matter;
(2) a reasonable belief exists that the action, decision, or
recommendation is warranted by the facts known; and
(3) if the action is described in IC 34-30-15-7, the action is made
in compliance with IC 34-30-15-7.
(b) As used in this section, "health care review committee" means
a peer review committee under IC 34-6-2.1-145 (or IC 34-4-12.6-1(c)
before its repeal).
(c) In all actions to which this section applies, good faith shall be
presumed and malice shall be required to be proven by the person
aggrieved.
(d) A person who, in good faith and without malice:
(1) takes any action or makes a decision or recommendation as a
member, an agent, or an employee of a health care review
committee; or
(2) furnishes any record, information, or assistance to a health
care review committee;
is not subject to liability for damages in any legal action in
consequence of that action.
(e) Neither:
(1) the health maintenance organization or limited service health
maintenance organization that established the health care review
committee; or
(2) the officers, directors, employees, or agents of the health
maintenance organization or limited service health maintenance
organization;
are liable for damages in any civil action for the activities of a person
who, in good faith and without malice, takes any action or makes a
decision or recommendation as a member, an agent, or an employee of
a health care review committee, or furnishes any record, information,
or assistance to a health care review committee.
(f) This section does not relieve any person of liability arising from
treatment of a patient or an enrollee, or from a determination of the
reimbursement to be provided under the terms of an insurance policy,
a health maintenance organization contract, or another benefit program
providing payment, reimbursement, or indemnification for health care
costs based on the appropriateness of health care services delivered to
an enrollee.
(g) A health care review committee shall comply with IC 34-6-2.1-145.