Legislation
SECTION 3436
Medical malpractice insurance; type of coverage
Insurance (ISC) CHAPTER 28, ARTICLE 34
* § 3436. Medical malpractice insurance; type of coverage. (a) Every
insurer which issues or renews policies for primary levels of medical
malpractice insurance covering physicians licensed to practice in this
state shall issue such policies on a claims-made or occurrence basis, as
prescribed by the superintendent by regulation; provided, further, that
nothing in this section shall preclude any insurer from applying
otherwise applicable underwriting standards in determining whether to
issue or renew such policies.
(b) A claims-made policy shall contain the following provisions:
(1) if the insured has purchased a claims-made policy from an admitted
insurer for a period of five or more consecutive years and the insured,
after attaining the age of sixty-five or older, retires permanently and
totally from the practice of medicine or if the insured has purchased
such a policy for a period of ten or more consecutive years, and the
insured, after attaining the age of fifty-five or older, retires
permanently and totally from the practice of medicine, the insurer
shall, without charging an additional premium therefor at the time of,
or subsequent to, such retirement, also cover all occurrences between
the inception date of the first such consecutive policy from such
insurer and such retirement date which, subsequent to the termination
date, are reported in accordance with statutory and policy requirements;
(2) if the insured dies or becomes permanently disabled and unable to
practice medicine while covered by such a policy, the insurer shall,
without charging an additional premium therefor at the time of, or
subsequent to, such event, also cover all occurrences between the
inception date of the first such consecutive policy from such insurer
and the death or disability of the insured; and
(3) the insurer shall make available and shall advise the insured of
the availability and cost of coverage for occurrences between the
inception date of the first such consecutive policy from such insurer
and the termination of such policy which, subsequent to the termination
date, are reported in accordance with statutory and policy requirements,
pursuant to such terms and conditions as may be specified by the
superintendent by regulation. The insured shall have the option of
purchasing such coverage either in a single payment, or in three annual
installments with an additional finance charge.
(c) Such regulation shall also provide that if the coverage of an
insured who continues to practice in this state is transferred from an
admitted insurer or the medical malpractice insurance association to
another admitted insurer or the medical malpractice insurance
association without any gap in coverage, the former entity shall pay
over to the successor an actuarially appropriate dollar amount to
provide for the requirements of subsection (b) of this section, and the
insured shall be entitled to the benefits of such subsection as if such
insured had been continuously covered by the successor entity during the
entire period of consecutive years of coverage.
(d) Such regulation shall also provide that if the coverage of an
insured is transferred from an insurer in liquidation to another insurer
not in liquidation without any gap in coverage, then the successor
entity shall accept the amounts payable from the property-casualty
insurance security fund as provided in subparagraph (G) of paragraph one
of subsection (a) of section seven thousand six hundred three of this
chapter, to provide for the requirements of subsections (b) and (c) of
this section, and the insured shall be entitled to the benefits of such
subsections as if such insured had been continuously covered by the
successor entity during the entire period of consecutive years of
coverage.
(e) An insurer may issue a claims-made policy with more liberal policy
provisions than are required in this section, subject to the approval of
the superintendent. Such liberal policy provisions may include but not
be limited to a provision which, for all of the policyholders of the
insurer, grants credit toward the cost of the coverage provided in
subsection (b) of this section in proportion to the number of years the
insured has purchased a claims-made policy.
* NB There are 2 § 3436's
insurer which issues or renews policies for primary levels of medical
malpractice insurance covering physicians licensed to practice in this
state shall issue such policies on a claims-made or occurrence basis, as
prescribed by the superintendent by regulation; provided, further, that
nothing in this section shall preclude any insurer from applying
otherwise applicable underwriting standards in determining whether to
issue or renew such policies.
(b) A claims-made policy shall contain the following provisions:
(1) if the insured has purchased a claims-made policy from an admitted
insurer for a period of five or more consecutive years and the insured,
after attaining the age of sixty-five or older, retires permanently and
totally from the practice of medicine or if the insured has purchased
such a policy for a period of ten or more consecutive years, and the
insured, after attaining the age of fifty-five or older, retires
permanently and totally from the practice of medicine, the insurer
shall, without charging an additional premium therefor at the time of,
or subsequent to, such retirement, also cover all occurrences between
the inception date of the first such consecutive policy from such
insurer and such retirement date which, subsequent to the termination
date, are reported in accordance with statutory and policy requirements;
(2) if the insured dies or becomes permanently disabled and unable to
practice medicine while covered by such a policy, the insurer shall,
without charging an additional premium therefor at the time of, or
subsequent to, such event, also cover all occurrences between the
inception date of the first such consecutive policy from such insurer
and the death or disability of the insured; and
(3) the insurer shall make available and shall advise the insured of
the availability and cost of coverage for occurrences between the
inception date of the first such consecutive policy from such insurer
and the termination of such policy which, subsequent to the termination
date, are reported in accordance with statutory and policy requirements,
pursuant to such terms and conditions as may be specified by the
superintendent by regulation. The insured shall have the option of
purchasing such coverage either in a single payment, or in three annual
installments with an additional finance charge.
(c) Such regulation shall also provide that if the coverage of an
insured who continues to practice in this state is transferred from an
admitted insurer or the medical malpractice insurance association to
another admitted insurer or the medical malpractice insurance
association without any gap in coverage, the former entity shall pay
over to the successor an actuarially appropriate dollar amount to
provide for the requirements of subsection (b) of this section, and the
insured shall be entitled to the benefits of such subsection as if such
insured had been continuously covered by the successor entity during the
entire period of consecutive years of coverage.
(d) Such regulation shall also provide that if the coverage of an
insured is transferred from an insurer in liquidation to another insurer
not in liquidation without any gap in coverage, then the successor
entity shall accept the amounts payable from the property-casualty
insurance security fund as provided in subparagraph (G) of paragraph one
of subsection (a) of section seven thousand six hundred three of this
chapter, to provide for the requirements of subsections (b) and (c) of
this section, and the insured shall be entitled to the benefits of such
subsections as if such insured had been continuously covered by the
successor entity during the entire period of consecutive years of
coverage.
(e) An insurer may issue a claims-made policy with more liberal policy
provisions than are required in this section, subject to the approval of
the superintendent. Such liberal policy provisions may include but not
be limited to a provision which, for all of the policyholders of the
insurer, grants credit toward the cost of the coverage provided in
subsection (b) of this section in proportion to the number of years the
insured has purchased a claims-made policy.
* NB There are 2 § 3436's