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This entry was published on 2014-09-22
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SECTION 315
Professional malpractice or misconduct; reporting requirements
Insurance (ISC) CHAPTER 28, ARTICLE 3
§ 315. Professional malpractice or misconduct; reporting requirements.
(a) Every organization or person authorized to issue professional
liability insurance policies in this state shall report any disposition,
whether by judgment or settlement, of any claim made against an
individual licensed pursuant to the provisions of title eight of the
education law where the claim was based upon fraud, incompetence or
negligence except that reports for physicians, physician's assistants
and specialist's assistants shall be reported pursuant to the provisions
of subsection (b) hereof.

(b) (1) Each insurance company engaged in issuing professional medical
malpractice insurance in this state the medical malpractice insurance
association shall file with the superintendent and with the commissioner
of health quarterly reports on all claims for medical malpractice made
against any of its insureds and received by it during the preceding
three month period, a report of any surcharge or merit-rating adjustment
made on an insured's premium and the reason for the surcharge or
merit-rating adjustment and a report of any cancellation, including
voluntary cancellation by the insured and the reason for the
cancellation, of its insureds professional medical liability insurance
for reasons other than non-payment of premiums during the preceding
three month period.

(2) Each hospital, as defined in article twenty-eight of the public
health law, which, and each health care practitioner licensed, certified
or registered pursuant to the provisions of title eight of the education
law who, is self-insured for professional medical malpractice or is
insured for professional medical malpractice with an insurance company
not licensed to do business in this state shall also file quarterly
reports with the superintendent and the commissioner of health on all
claims for medical malpractice made against him, her, or it during the
preceding three month period. For purposes of this section, a hospital
which, or individual who, is self-insured for professional medical
malpractice shall mean a hospital which, or individual who, is not
insured for professional medical malpractice with either an insurance
company engaged in issuing professional medical malpractice insurance in
this state or the medical malpractice insurance association or an
insurance company not licensed to do business in this state.

(c) Reports required by this section shall contain the following
information:

(1) the name and address of the professional licensee against whom
such claim is made, including the name and address of the hospital,
other person or institution if the report is made pursuant to subsection
(b) hereof;

(2) the name, address and age of the claimant or plaintiff;

(3) the nature and substance of the claim;

(4) the date and place in which the claim arose;

(5) within three months after final disposition of the claim, the
amounts paid, if any, and the date and manner of disposition (by
judgment, settlement or otherwise);

(6) the reasons for the cancellation of professional liability
insurance for reasons other than non-payment of premiums; and

(7) such additional information as the superintendent or the
commissioner of education shall require for reports required by
subsection (a) hereof and as the superintendent and commissioner of
health shall require for reports required by subsection (b) hereof.

(d)(1) Reports required by subsection (a) hereof shall be in writing
on a form prescribed by the superintendent and commissioner of education
and shall be submitted to the department of education within sixty days
of the date of any settlement or judgment.

(2) Reports required by subsection (b) hereof shall be in writing on a
form prescribed by the superintendent and commissioner of health and
shall be submitted to them not less than quarterly on dates jointly
determined by them and shall contain information received during the
preceding three month period concerning claims received, additional
required data not previously reported and disposition of claims.

(e) Written reports and other documentation compiled pursuant to
subsection (a) hereof shall be admissible in evidence in any
administrative or judicial action or proceeding.

(f) Any report or information furnished or compiled pursuant to this
section shall be deemed to be a confidential communication. Reports
required by subsection (a) hereof shall not be subject to inspection or
disclosure in any manner except upon written request by a duly
authorized public agency or pursuant to a judicial subpoena issued in a
pending action or proceeding. Reports required by subsection (b) hereof
shall not be open for review or be subject to subpoena except by a
public agency or authority of this state.

(g) Malpractice insurance compliance reporting requirements. The
failure to make any report required by this section shall constitute a
misdemeanor. The department of health shall oversee the enforcement of
this subdivision, and on or before June thirtieth of each calendar year
provide a report to the governor and the legislature regarding industry
compliance. Such report shall include a recommendation from the
department regarding changes in the applicable penalties for
noncompliance, which are necessary to ensure the integrity of the
reporting system. The department shall further study the necessity of
assessing penalties for false reporting by physicians, hospitals, or
health care plans for purposes of collecting and disseminating data
required to be disclosed pursuant to title one of article twenty-nine-d
of the public health law.