N.Y. Comp. Codes R. & Regs. tit. 11 § 152.12

Current through Register Vol. 46, No. 36, September 4, 2024

Section 152.12 - Records maintenance, audits and reporting requirements

(a) Every insurer that offers a risk management premium credit shall maintain loss and expense statistics separately for those insureds receiving and not receiving the credit, and such statistics shall be made available to the superintendent upon request.

(b) At least once every two years, an insurer shall conduct a risk management audit of all insured physicians participating in its excess medical malpractice risk management programs pursuant to this Part. Such audit may be in the form of a self-review survey completed by each insured physician.

(c) An insurer that utilizes a self-review survey in lieu of a physical audit shall develop self- review procedures specific to the type of practice, varying by specialty type and size of the practice engaged in by the insured, and any other criteria it determines appropriate to evaluating the effectiveness of the Excess Medical Malpractice Risk Management Program.

(d) The self-review procedures shall be designed to provide information to the insurer to determine that participants are properly following the procedures and principles presented in the course, to assist the insurer in developing revisions and improvements to its excess medical malpractice risk management programs and to provide for the establishment of best practices in risk management methods.

(e) An insurer offering a risk management premium credit or an insurer offering a risk management program for the purpose of eligibility in the Excess Medical Malpractice Insurance Program shall annually, no later than March 1st, submit to the superintendent a report indicating, by territory and medical specialty:

(1) total number of insureds;

(2) number of insureds receiving the premium credit; and

(3) number of insureds participating in risk management programs qualifying for excess medical malpractice insurance coverage.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 152.12