PA 07-25—sSB 249

Insurance and Real Estate Committee

Appropriations Committee

AN ACT CONCERNING MEDICAL MALPRACTICE DATA REGARDING MEDICAL PROFESSIONALS

SUMMARY: This act extends to insurers of any “medical professional,” instead of just insurers of physicians, advanced practice registered nurses, or physician assistants, the requirement to provide to the insurance commissioner a closed claim report. A “closed claim” is one that has been settled, or otherwise disposed of, and for which the insurer has paid all claims. By law, the insurer must submit the report on a form the commissioner prescribes within 10 days after the last day of the calendar quarter in which a claim is closed. The report includes information only about claims settled under Connecticut law.

The act defines “medical professional” as any person licensed or certified to provide health care services to individuals, including chiropractors, clinical dietitians, clinical psychologists, dentists, nurses, occupational speech and physical therapists, optometrists, pharmacists, physicians, podiatrists, and psychiatric social workers. By law, a closed claim report contains details about the insured and the insurer, the injury or loss, the claims process, and the amount paid on each claim.

EFFECTIVE DATE: October 1, 2007

BACKGROUND

Closed Claim Reports

By law, the insurance commissioner must aggregate the individual closed claim report data into a summary and annual report. The summary must include (1) an analysis of the trend of direct losses, incurred losses, earned premiums, and investment income as compared to prior years and (2) base premiums medical malpractice insurers charge for each specialty and the number of providers insured by specialty for each insurer. By law, the commissioner must annually submit the report to the Insurance and Real Estate Committee. He must also (1) make the report available to the public, (2) post it on the department's Internet site, and (3) provide public access to the electronic database after establishing that individually identifiable information about claimants and practitioners has been removed.

Claims Process

The report must contain details about the claims process including:

1. whether a lawsuit was filed and, if so, in which court;

2. its outcome;

3. the number of other defendants, if any;

4. the stage in the process when the claim was closed;

5. the trial dates;

6. the date of any judgment or settlement;

7. whether an appeal was filed and, if so, the date filed;

8. the resolution of the appeal and the date it was decided;

9. the date the claim was closed; and

10. the initial and final indemnity and expense reserve for the claim.

Amount Paid on the Claim

The report must include:

1. the total amount of the initial judgment rendered by a jury or awarded by the court;

2. the total amount of the settlement if no judgment was rendered or awarded or the claim was settled after judgment was rendered or awarded;

3. the amount of economic and noneconomic damages, or the insurer's estimate of these amounts in a settlement;

4. the amount of any interest awarded due to failure to accept an offer of compromise;

5. the amount of any reduction or addition and the amount of final judgment after such reductions or additions;

6. the amount the insurer paid;

7. the amount the defendant paid due to a deductible or a judgment or settlement in excess of policy limits;

8. the amount other insurers or defendants paid;

9. whether a structured settlement was used;

10. the expense assigned to and recorded with the claim, including defense and investigation costs but not including the actual claim payment; and

11. any other information the commissioner determines necessary to regulate the medical malpractice insurance industry, ensure its solvency, and ensure that such liability insurance is available and affordable.

OLR Tracking: GC: SS: JL: ts