N.Y. Insurance Law § 315: Professional malpractice or misconduct; reporting requirements

§ 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.