Tenn. Comp. R. & Regs. 0780-01-84-.04

Current through December 10, 2024

Section 0780-01-84-.04 - DEFINITIONS

As used in this Chapter, unless the context otherwise requires:

(1) "Claim" means:

(a) A demand for monetary damages for injury or death caused by medical malpractice; or

(b) A voluntary indemnity payment for injury or death caused by medical malpractice.

(2) "Claimant" means a person, including a decedent's estate, who is seeking or has sought monetary damages for injury or death caused by medical malpractice.

(3) "Closed claim" means a claim that has been settled or otherwise disposed of by the insuring entity, self-insurer, facility or provider. A claim may be closed with or without an indemnity payment to a claimant.

(4) "Commissioner" means the commissioner of commerce and insurance.

(5) "Companion claims" means separate claims involving the same incident of medical malpractice made against other providers or facilities.

(6) "Department" means the Tennessee Department of Commerce and Insurance.

(7) "Economic damages" means objectively verifiable monetary losses, including medical expenses, loss of earnings, burial costs, loss of use of property, cost of replacement or repair, cost of obtaining substitute domestic services, and loss of business or employment opportunities.

(8) "Health care facility" or "facility" means an entity licensed under Title 68, including a clinic, diagnostic center, hospital, laboratory, mental health center, nursing home, office, surgical facility, treatment facility, or similar place where a health care provider provides health care to patients.

(9) "Health care provider" or "provider" means:

(a) A person licensed in either title 63, except chapter 12, or 68 to provide health care or related services including, but not limited to, an acupuncturist, a physician, a surgeon, an osteopathic physician, a dentist, a nurse, an optometrist, a podiatrist, a chiropractor, a physical therapist, a psychologist, a pharmacist, an optician, a physician assistant, a certified professional midwife, an orthopedic physician assistant, or a nurse practitioner. If the person is deceased, this includes his or her estate or personal representative; or

(b) An employee or agent of a person described in subparagraph (a) of this Paragraph, acting in the course and scope of his or her employment. If the employee or agent is deceased, this includes his or her estate or personal representative.

(10) "Insurance entity" or "insuring entity" means:

(a) An authorized insurer;

(b) A captive insurer;

(c) A joint underwriting association;

(d) A patient compensation fund;

(e) A risk retention group; or

(f) An unauthorized insurer that provides surplus lines coverage.

(11) "Medical malpractice" means an actual or alleged negligent act, error, or omission in providing or failing to provide health care services.

(12) "Noneconomic damages" means subjective, nonmonetary losses, including pain, suffering, inconvenience, mental anguish, disability, or disfigurement incurred by the injured party, emotional distress, loss of society and companionship, loss of consortium, humiliation and injury to reputation, and destruction of the parent-child relationship.

(13) "Pending Claims" means claims that have not been paid pursuant to a settlement or judgment but have been made known to the reporting entity either by a lawsuit or some other manner.

(14) "Person" means an individual or business entity.

(15) "Reporting entity" means the following:

(a) Every insurance entity providing medical malpractice insurance or professional liability insurance to a Tennessee health care institution licensed under Title 68;

(b) Every insurance entity providing medical malpractice insurance or professional liability insurance to any health care provider or health care facility;

(c) Every health care institution licensed pursuant to Title 68 or professional listed in this Rule, except the state and those employed by the state, who does not maintain professional liability insurance; or

(d) Counsel for claimants who are required to submit information as required by T.C.A. § 56-54-101 and 2008 Tenn. Public Chapter 1009, for the purposes of levying civil penalties pursuant to Rule 0780-01-84-.06.

(16) "Self-insurer" means any health care provider, facility, or other individual or entity that assumes operational or financial risk for claims of medical malpractice.

Tenn. Comp. R. & Regs. 0780-01-84-.04

Original rule filed August 11, 2005; effective October 25, 2005. Amendment filed January 16, 2007; effective April, 2007. Amendment filed February 3, 2009; effective April 19, 2009.

Authority: 2008 Tenn. Pub. Act Ch. 1009, T.C.A. §§ 56-2-301, 56-54-101, et seq., and 56-54-110.