Section 2343. Medical malpractice insurance rates; special additional provisions regarding such rates  


Latest version.
  • (a) Whereas the provisions of a chapter  of the laws of nineteen hundred eighty-five regarding medical and dental
      malpractice will have both a prospective and retrospective  effect  upon
      the  loss  experience of physicians, dentists and hospitals professional
      liability  insurers,  including  the   medical   malpractice   insurance
      association,  the  superintendent  is directed forthwith to review rates
      previously in effect for the  period  commencing  July  first,  nineteen
      hundred   eighty-four   and  ending  June  thirtieth,  nineteen  hundred
      eighty-five, and, where appropriate, require modification of such  rates
      for such period.
        (b)  Any  such  modified  rate shall remain in effect as a provisional
      rate for the period commencing July first, nineteen hundred  eighty-five
      and  ending  on  November  thirtieth,  nineteen hundred eighty-five. The
      superintendent,  subsequent  to   December   first,   nineteen   hundred
      eighty-five,  shall  approve  final rates for the period commencing July
      first, nineteen hundred eighty-five and ending June thirtieth,  nineteen
      hundred  eighty-six.  No  insurer  shall have the duty to file for final
      rates for the period commencing July first, nineteen hundred eighty-five
      prior to December first, nineteen hundred eighty-five.
        (c)  Notwithstanding  any  other  provision  of   this   chapter,   no
      application  for an order of rehabilitation or liquidation of a domestic
      insurer whose primary liability arises  from  the  business  of  medical
      malpractice  insurance,  as  that  term  is defined in subsection (b) of
      section five thousand five hundred one of this chapter, shall be made on
      the grounds specified in subsection (a) or (c) of section seven thousand
      four hundred two of this chapter at any time prior  to  June  thirtieth,
      two thousand eleven.
        (d)  The  superintendent  shall  promulgate a regulation, which may be
      amended from  time  to  time,  establishing  a  physicians  professional
      liability  insurance merit rating plan applicable to medical malpractice
      insurance coverage whether written as an individual policy or through  a
      voluntary   attending   physician   ("channeling")   program  previously
      permitted by the superintendent which reflects an individual physician's
      or surgeon's experience with respect  to  incidents  or  occurrences  of
      alleged  medical  malpractice.  The regulation shall establish standards
      and  limitations  intended  to  insure  that  merit  rating  plans   are
      reasonable  and  are not unfairly discriminatory, inequitable, violative
      of public policy or otherwise contrary to  the  best  interests  of  the
      people of this state. Such regulation shall include:
        (1)  reasonable  standards to be applied in arriving at premium rates,
      surcharges and discounts based on an evaluation of the  hazards  of  the
      insured,   geographical   area,   specialties   of  practice,  past  and
      prospective  loss  and  expense  experience  for   medical   malpractice
      insurance  written  and  to  be  written  in  this  state, trends in the
      frequency and severity of losses, and the limited nature, if any, of the
      practice of the insured;
        (2) rules for recognizing experience of individual risks;
        (3) any other factors deemed relevant in a system of merit rating  for
      the purpose of establishing equitable merit rates.
        The   superintendent   shall   also  consider,  in  establishing  such
      regulation, whether premium rates unfairly  burden  physicians  who  are
      initiating  their practice, those who are transitioning to retirement or
      those who practice part-time or hold academic positions.
        Insurers shall review merit rating plans which were  approved  by  the
      superintendent  prior  to the promulgation of the regulation required by
      this subsection  and  shall,  before  January  first,  nineteen  hundred
      eighty-six,  file  with  the  superintendent statements that their merit
    
      rating plans conform with the regulation, or file an appropriate plan or
      amendments to their existing plans which will bring them into compliance
      with the standards of the regulation. Any such amendments  shall  become
      effective upon approval by the superintendent.
        (e)  The  superintendent  may approve an appropriate premium reduction
      for an insured physician who successfully completes  a  risk  management
      course,  which  must  be  approved by the superintendent subject to such
      standards  as  the  superintendent  may  prescribe  by  regulation.   In
      prescribing  such  regulation  the  superintendent  may consult with the
      commissioner of health.