2023 New York Laws › ISC - Insurance › Article 3 - Administrative and Procedural Provisions › 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.