Section 3436. Medical malpractice insurance; type of coverage  


Latest version.
  • (a) Every
      insurer which issues or renews policies for primary  levels  of  medical
      malpractice  insurance  covering physicians licensed to practice in this
      state shall issue such policies on a claims-made or occurrence basis, as
      prescribed by the superintendent by regulation; provided, further,  that
      nothing  in  this  section  shall  preclude  any  insurer  from applying
      otherwise applicable underwriting standards in  determining  whether  to
      issue or renew such policies.
        (b) A claims-made policy shall contain the following provisions:
        (1) if the insured has purchased a claims-made policy from an admitted
      insurer  for a period of five or more consecutive years and the insured,
      after attaining the age of sixty-five or older, retires permanently  and
      totally  from  the  practice of medicine or if the insured has purchased
      such a policy for a period of ten or more  consecutive  years,  and  the
      insured,  after  attaining  the  age  of  fifty-five  or  older, retires
      permanently and totally from  the  practice  of  medicine,  the  insurer
      shall,  without  charging an additional premium therefor at the time of,
      or subsequent to, such retirement, also cover  all  occurrences  between
      the  inception  date  of  the  first  such  consecutive policy from such
      insurer and such retirement date which, subsequent  to  the  termination
      date, are reported in accordance with statutory and policy requirements;
        (2)  if the insured dies or becomes permanently disabled and unable to
      practice medicine while covered by such a  policy,  the  insurer  shall,
      without  charging  an  additional  premium  therefor  at the time of, or
      subsequent to, such  event,  also  cover  all  occurrences  between  the
      inception  date  of  the first such consecutive policy from such insurer
      and the death or disability of the insured; and
        (3) the insurer shall make available and shall advise the  insured  of
      the  availability  and  cost  of  coverage  for  occurrences between the
      inception date of the first such consecutive policy  from  such  insurer
      and  the termination of such policy which, subsequent to the termination
      date, are reported in accordance with statutory and policy requirements,
      pursuant to such terms  and  conditions  as  may  be  specified  by  the
      superintendent  by  regulation.  The  insured  shall  have the option of
      purchasing such coverage either in a single payment, or in three  annual
      installments with an additional finance charge.
        (c)  Such  regulation  shall  also  provide that if the coverage of an
      insured who continues to practice in this state is transferred  from  an
      admitted  insurer  or  the  medical malpractice insurance association to
      another  admitted  insurer  or   the   medical   malpractice   insurance
      association  without  any  gap  in coverage, the former entity shall pay
      over to the  successor  an  actuarially  appropriate  dollar  amount  to
      provide  for the requirements of subsection (b) of this section, and the
      insured shall be entitled to the benefits of such subsection as if  such
      insured had been continuously covered by the successor entity during the
      entire period of consecutive years of coverage.
        (d)  Such  regulation  shall  also  provide that if the coverage of an
      insured is transferred from an insurer in liquidation to another insurer
      not in liquidation without any  gap  in  coverage,  then  the  successor
      entity  shall  accept  the  amounts  payable  from the property-casualty
      insurance security fund as provided in subparagraph (G) of paragraph one
      of subsection (a) of section seven thousand six hundred  three  of  this
      chapter,  to  provide for the requirements of subsections (b) and (c) of
      this section, and the insured shall be entitled to the benefits of  such
      subsections  as  if  such  insured  had been continuously covered by the
      successor entity during  the  entire  period  of  consecutive  years  of
      coverage.
    
        (e) An insurer may issue a claims-made policy with more liberal policy
      provisions than are required in this section, subject to the approval of
      the  superintendent.  Such liberal policy provisions may include but not
      be limited to a provision which, for all of  the  policyholders  of  the
      insurer,  grants  credit  toward  the  cost  of the coverage provided in
      subsection (b) of this section in proportion to the number of years  the
      insured has purchased a claims-made policy.
        * NB There are 2 § 3436's