§ 315 — Professional malpractice or misconduct; reporting requirements

New York § 315

• Jurisdiction: New York
• Law ISC: Insurance
• Art. 3: Administrative and Procedural Provisions

Text

§ 315. Professional malpractice or misconduct; reporting requirements.\n(a) Every organization or person authorized to issue professional\nliability insurance policies in this state shall report any disposition,\nwhether by judgment or settlement, of any claim made against an\nindividual licensed pursuant to the provisions of title eight of the\neducation law where the claim was based upon fraud, incompetence or\nnegligence except that reports for physicians, physician's assistants\nand specialist's assistants shall be reported pursuant to the provisions\nof subsection (b) hereof.\n (b) (1) Each insurance company engaged in issuing professional medical\nmalpractice insurance in this state the medical malpractice insurance\nassociation shall file with the superintendent and with the commissioner\nof health quarterly reports on all claims for medical malpractice made\nagainst any of its insureds and received by it during the preceding\nthree month period, a report of any surcharge or merit-rating adjustment\nmade on an insured's premium and the reason for the surcharge or\nmerit-rating adjustment and a report of any cancellation, including\nvoluntary cancellation by the insured and the reason for the\ncancellation, of its insureds professional medical liability insurance\nfor reasons other than non-payment of premiums during the preceding\nthree month period.\n (2) Each hospital, as defined in article twenty-eight of the public\nhealth law, which, and each health care practitioner licensed, certified\nor registered pursuant to the provisions of title eight of the education\nlaw who, is self-insured for professional medical malpractice or is\ninsured for professional medical malpractice with an insurance company\nnot licensed to do business in this state shall also file quarterly\nreports with the superintendent and the commissioner of health on all\nclaims for medical malpractice made against him, her, or it during the\npreceding three month period. For purposes of this section, a hospital\nwhich, or individual who, is self-insured for professional medical\nmalpractice shall mean a hospital which, or individual who, is not\ninsured for professional medical malpractice with either an insurance\ncompany engaged in issuing professional medical malpractice insurance in\nthis state or the medical malpractice insurance association or an\ninsurance company not licensed to do business in this state.\n (c) Reports required by this section shall contain the following\ninformation:\n (1) the name and address of the professional licensee against whom\nsuch claim is made, including the name and address of the hospital,\nother person or institution if the report is made pursuant to subsection\n(b) hereof;\n (2) the name, address and age of the claimant or plaintiff;\n (3) the nature and substance of the claim;\n (4) the date and place in which the claim arose;\n (5) within three months after final disposition of the claim, the\namounts paid, if any, and the date and manner of disposition (by\njudgment, settlement or otherwise);\n (6) the reasons for the cancellation of professional liability\ninsurance for reasons other than non-payment of premiums; and\n (7) such additional information as the superintendent or the\ncommissioner of education shall require for reports required by\nsubsection (a) hereof and as the superintendent and commissioner of\nhealth shall require for reports required by subsection (b) hereof.\n (d)(1) Reports required by subsection (a) hereof shall be in writing\non a form prescribed by the superintendent and commissioner of education\nand shall be submitted to the department of education within sixty days\nof the date of any settlement or judgment.\n (2) Reports required by subsection (b) hereof shall be in writing on a\nform prescribed by the superintendent and commissioner of health and\nshall be submitted to them not less than quarterly on dates jointly\ndetermined by them and shall contain information received during the\npreceding three month period concerning claims received, additional\nrequired data not previously reported and disposition of claims.\n (e) Written reports and other documentation compiled pursuant to\nsubsection (a) hereof shall be admissible in evidence in any\nadministrative or judicial action or proceeding.\n (f) Any report or information furnished or compiled pursuant to this\nsection shall be deemed to be a confidential communication. Reports\nrequired by subsection (a) hereof shall not be subject to inspection or\ndisclosure in any manner except upon written request by a duly\nauthorized public agency or pursuant to a judicial subpoena issued in a\npending action or proceeding. Reports required by subsection (b) hereof\nshall not be open for review or be subject to subpoena except by a\npublic agency or authority of this state.\n (g) Malpractice insurance compliance reporting requirements. The\nfailure to make any report required by this section shall constitute a\nmisdemeanor. The department of health shall oversee the enforcement of\nthis subdivision, and on or before June thirtieth of each calendar year\nprovide a report to the governor and the legislature regarding industry\ncompliance. Such report shall include a recommendation from the\ndepartment regarding changes in the applicable penalties for\nnoncompliance, which are necessary to ensure the integrity of the\nreporting system. The department shall further study the necessity of\nassessing penalties for false reporting by physicians, hospitals, or\nhealth care plans for purposes of collecting and disseminating data\nrequired to be disclosed pursuant to title one of article twenty-nine-d\nof the public health law.\n