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<section article="gin" article_name="Insurance" number="4-405" title_number="4" title_name="General Requirements for Insurers" subtitle_number="4" subtitle_name="Disclosure Requirements for Insurers">
  <level label="a">
    <level label="1">
      <text>Each insurer providing professional liability insurance to a health care provider in the State shall submit to the Commissioner information on:</text>
      <level label="i">
        <text>the nature and cost of reinsurance;</text>
      </level>
      <level label="ii">
        <text>the claims experience, by category, of health care providers;</text>
      </level>
      <level label="iii">
        <text>the amount of claim settlements and claim awards;</text>
      </level>
      <level label="iv">
        <text>the amount of reserves for claims incurred and incurred but unreported claims;</text>
      </level>
      <level label="v">
        <text>the number of structured settlements used in payment of claims; and</text>
      </level>
      <level label="vi">
        <text>any other information relating to health care malpractice claims prescribed by the Commissioner in regulation.</text>
      </level>
    </level>
    <level label="2">
      <level label="i">
        <text>An insurer subject to the reporting requirement under paragraph (1) of this subsection shall notify the Commissioner of any information that the insurer considers proprietary.</text>
      </level>
      <level label="ii">
        <text>In accordance with § 4–335 of the General Provisions Article, the Commissioner shall deny inspection of any part of a report submitted under paragraph (1) of this subsection that the Commissioner determines contains confidential commercial information or confidential financial information.</text>
      </level>
    </level>
  </level>
  <level label="b">
    <text>In addition to the information required under subsection (a) of this section, for each claim filed with the Director of the Health Care Alternative Dispute Resolution Office under § 3–2A–04 of the Courts Article, each insurer providing professional liability insurance to a health care provider in the State shall submit to the Commissioner the following information:</text>
    <level label="1">
      <level label="i">
        <text>name of insurer;</text>
      </level>
      <level label="ii">
        <text>name of insurer group;</text>
      </level>
      <level label="iii">
        <text>claim file identification;</text>
      </level>
      <level label="iv">
        <text>name of person completing form;</text>
      </level>
      <level label="v">
        <text>telephone number (area code); and</text>
      </level>
      <level label="vi">
        <text>date form completed;</text>
      </level>
    </level>
    <level label="2">
      <level label="i">
        <text>date of injury;</text>
      </level>
      <level label="ii">
        <text>date injury reported to insurer; and</text>
      </level>
      <level label="iii">
        <text>date claim closed;</text>
      </level>
    </level>
    <level label="3">
      <text>age and gender of insured person at time of injury;</text>
    </level>
    <level label="4">
      <level label="i">
        <text>type of injury;</text>
      </level>
      <level label="ii">
        <text>description of injury; and</text>
      </level>
      <level label="iii">
        <text>if the claim is against a health care provider covered under a policy issued or delivered by the insurer completing this form, the name of the health facility where the injury occurred;</text>
      </level>
    </level>
    <level label="5">
      <level label="i">
        <text>type of medical professional liability policy;</text>
      </level>
      <level label="ii">
        <text>if known, whether the patient was:</text>
        <level label="1">
          <text>an inpatient;</text>
        </level>
        <level label="2">
          <text>an emergency room outpatient; or</text>
        </level>
        <level label="3">
          <text>other outpatient;</text>
        </level>
      </level>
      <level label="iii">
        <text>physician ISO classification, or equivalent classification;</text>
      </level>
      <level label="iv">
        <text>health care provider name and license number; and</text>
      </level>
      <level label="v">
        <text>policy limits for:</text>
        <level label="1">
          <text>each claim or medical incident; and</text>
        </level>
        <level label="2">
          <text>annual aggregate;</text>
        </level>
      </level>
    </level>
    <level label="6">
      <level label="i">
        <text>if known, the facility, office, or county where injury occurred; and</text>
      </level>
      <level label="ii">
        <text>the case number and the name and location of the court where the suit was filed and the case was tried;</text>
      </level>
    </level>
    <level label="7">
      <level label="i">
        <text>whether settlement was reached or award was made at one of the following stages:</text>
        <level label="1">
          <text>arbitration;</text>
        </level>
        <level label="2">
          <text>mediation;</text>
        </level>
        <level label="3">
          <text>before suit was filed;</text>
        </level>
        <level label="4">
          <text>after suit was filed, but before trial;</text>
        </level>
        <level label="5">
          <text>during trial, but before court verdict;</text>
        </level>
        <level label="6">
          <text>court verdict;</text>
        </level>
        <level label="7">
          <text>after verdict; or</text>
        </level>
        <level label="8">
          <text>after appeal was filed;</text>
        </level>
      </level>
      <level label="ii">
        <text>if settlement was reached or award was made by court verdict, whether the result was:</text>
        <level label="1">
          <text>directed verdict for plaintiff;</text>
        </level>
        <level label="2">
          <text>directed verdict for defendant;</text>
        </level>
        <level label="3">
          <text>judgment notwithstanding the verdict for the plaintiff;</text>
        </level>
        <level label="4">
          <text>judgment notwithstanding the verdict for the defendant;</text>
        </level>
        <level label="5">
          <text>judgment for the plaintiff;</text>
        </level>
        <level label="6">
          <text>judgment for the defendant;</text>
        </level>
        <level label="7">
          <text>for plaintiff, after appeal;</text>
        </level>
        <level label="8">
          <text>for defendant, after appeal; or</text>
        </level>
        <level label="9">
          <text>any other;</text>
        </level>
      </level>
      <level label="iii">
        <text>if there was no final judgment or settlement, the date and reason for the final disposition; and</text>
      </level>
      <level label="iv">
        <text>if the case did go to trial, whether the case was tried by a jury;</text>
      </level>
    </level>
    <level label="8">
      <text>with respect to the total amount paid to the claimant:</text>
      <level label="i">
        <text>the amount paid by the insurer;</text>
      </level>
      <level label="ii">
        <text>the amount paid by the insured due to retention or deductible;</text>
      </level>
      <level label="iii">
        <text>if known, the amount paid by an excess carrier;</text>
      </level>
      <level label="iv">
        <text>if known, the amount paid by the insured due to settlement or award in excess of policy limits;</text>
      </level>
      <level label="v">
        <text>if known, the amount paid by other defendants or contributors; and</text>
      </level>
      <level label="vi">
        <text>the total amount of settlement or award;</text>
      </level>
    </level>
    <level label="9">
      <text>a summary of the occurrence from which the claim or action arose, including:</text>
      <level label="i">
        <text>a description of the misdiagnosis or alleged misdiagnosis made, if any, of the patient’s actual condition;</text>
      </level>
      <level label="ii">
        <text>a description of the procedure giving rise to the claim; and</text>
      </level>
      <level label="iii">
        <text>a description of the principal injury giving rise to the claim;</text>
      </level>
    </level>
    <level label="10">
      <level label="i">
        <text>whether a structured settlement or periodic payment was used in closing this claim; and</text>
      </level>
      <level label="ii">
        <text>if a structured settlement or periodic payment was used:</text>
        <level label="1">
          <text>the amount of immediate payment;</text>
        </level>
        <level label="2">
          <text>the present value of the projected total future payout (price of annuity if purchased); and</text>
        </level>
        <level label="3">
          <text>the projected total future payout;</text>
        </level>
      </level>
    </level>
    <level label="11">
      <text>if a neutral expert witness is employed under § 3–2A–09(d)(2) of the Courts Article, the findings of a neutral expert witness as to a plaintiff’s future medical expenses or future loss of earnings;</text>
    </level>
    <level label="12">
      <text>if the case was tried to verdict, the amount of noneconomic damages; and</text>
    </level>
    <level label="13">
      <level label="i">
        <text>the total allocated loss adjustment expense by fees and expenses paid to defense counsel; and</text>
      </level>
      <level label="ii">
        <text>the total allocated loss adjustment expense.</text>
      </level>
    </level>
  </level>
  <level label="c">
    <text>The Commissioner:</text>
    <level label="1">
      <text>shall adopt regulations on the submission of information described in this section; and</text>
    </level>
    <level label="2">
      <text>may adopt regulations that require insurers of other lines of liability insurance to submit reports containing information that is substantially similar to the information described in subsection (a) of this section.</text>
    </level>
  </level>
  <level label="d">
    <text>Failure to report in accordance with this section may result in the imposition by the Commissioner of a civil penalty of up to $5,000.</text>
  </level>
  <level label="e">
    <text>The Commissioner shall report, in accordance with § 2-1257 of the State Government Article, the Commissioner’s findings as to the impact of Chapter 5 of the Acts of the 2004 Special Session of the General Assembly and Chapter 477 of the Acts of the General Assembly of 1994 on the availability of health care malpractice and other liability insurance in the State to the Legislative Policy Committee on or before September 1 of each year.</text>
  </level>
</section>
