Louisiana Administrative Code › Title 37 - INSURANCE › Part III - Patient's Compensation Fund Oversight Board › Chapter 1 - General Provisions › Section III-109 - General Definitions

Current through Register Vol. 50, No. 6, June 20, 2024
A. As
				used in these rules, the following terms shall have the meanings specified:
1. Terminology Definitions
Act
- the Louisiana Medical Malpractice Act,
				  Act 1975, Number 817, as amended,
				  R.S.
				  40:1299.41-1299.48.
Board
-the Louisiana Patients' Compensation
				  Fund Oversight Board established pursuant to
				  R.S.
				  40:1299.44.D.
Executive Director
- the Executive Director
				  of the Louisiana Patients' Compensation Fund Oversight Board, as designated,
				  appointed, and delegated authority pursuant to §303
2. Coverage Definitions
Claims-Made Coverage
- a form of professional
				  liability coverage which provides coverage for a claim arising from an incident
				  which both occurred and was reported during the effective period of
				  qualification with the fund. Provider must meet all requirements for continued
				  qualification.
Extended Reporting Endorsement
- tail
				  coverage.
Occurrence Coverage
- a form of professional
				  liability coverage which provides coverage for a claim arising from an incident
				  which occurred during the effective period of qualification, regardless of
				  whether the provider was actively enrolled on the date on which the claim was
				  reported. Provider must meet all requirements for continued
				  qualification.
Self-Insured Coverage
- a form of
				  professional liability coverage which provides coverage for a claim arising
				  from an incident which occurred during the effective period of qualification,
				  regardless of whether the provider was actively enrolled on the date on which
				  the claim was reported. Provider must meet all requirements for continued
				  qualification.
Tail Coverage
- an endorsement which, when
				  purchased by a provider at the end of his claims-made coverage period, provides
				  coverage for a claim arising from an incident which occurred during the
				  effective period of enrollment but was reported following the termination of
				  active enrollment. Provider must meet all requirements for continued
				  qualification.
3. Provider
				Definitions
Enrolled Provider
- an enrolled provider is
				  one who has met the requirements for qualification in the Louisiana Patient's
				  Compensation Fund (including the financial responsibility requirements of
				  R.S.
				  40:1299.42) who also:
i. is currently actively involved in medical
				practice and/or providing medical services in Louisiana; and
ii. has paid the appropriate surcharge for
				such practice to the fund for their current policy year.
Qualified Provider
- any provider who has
				  met the statutory requirements for malpractice coverage with the Louisiana
				  Patient's Compensation Fund. As long as the financial responsibility
				  requirements for continued qualification in the form prescribed by §505-509 of
				  these rules, as applicable, are met, a provider need not be currently enrolled
				  in the PCF.
4.
				General Definitions
Accept
or
Collect
- with
				  reference to the acceptance or collection of payments of applicable surcharges
				  for enrollment with the fund, such surcharges will be deemed to have been
accepted
or
collected
by the commercial
				  professional health care liability insurance companies and approved
				  self-insurance trust funds when the first agent, employee, representative, or
				  other person acting or purporting to act on behalf of the insurer or the trust
				  fund who has the responsibility to process such surcharges accepts delivery of
				  same.
Disability
- for purposes of determining
				  eligibility for the provisions of §715. D of these rules, the inability to
				  continue the practice of medicine due to a permanent illness, injury, or
				  physical impairment. However, for purposes of consideration for a waiver under
				  the provisions of §715. C.3 of these rules,
disability
may
				  also include any permanent illness, injury, or physical impairment which
				  prevents a provider from continuing the practice of his existing medical
				  specialty, surgical class, or risk rating classification as provided in
				  §705 of these rules, whether or not such
				  disability prevents the provider from engaging in the active practice of
				  medicine.