Current through Register Vol. XLI, No. 50, December 13, 2024
Section 115-6-3 - Implementation of Insurance Coverage3.1. Date coverage to be offered. Coverage may be offered pursuant to the statute, and may have an effective date retroactive to the effective date of Article 12B, Chapter 29 of the West Virginia Code.3.2. Amount of Coverage. The amount of insurance coverage available to the particular health care provider is determined by statute, and subject to the policies and procedures of the board.3.3. Premium Rates. The premium rate schedule is to be established by the board using the criteria of the statute under the board's policies and procedures.3.4. Coverage Form. Insurance issued through the "West Virginia Health Care Provider Professional Liability Insurance Availability Act" will be issued under the policies and procedures of the board with such forms and policy provisions consistent with the providing of insurance to health care providers in West Virginia under this act.3.5. Excess Coverage. The Board may, but is not required, to obtain excess verdict liability coverage for the programs described in this act.3.6. Administration. The board may establish such policies and procedures to administer the preferred medical liability program and the high risk medical liability program and exercise and perform other powers and duties and functions specified in the statute. The board may set the time and place of the meeting, may allow attendance by speaker phone, teleconferencing or other means where necessary. Three members of the five-member board shall be a quorum. The vote of the majority of the quorum present is required for a motion to be approved.3.7. Actuary. The Board may establish such policies and procedures necessary to obtain and implement (at least annually) from an independent outside source ratings to be used for premiums for the preferred medical liability program and high risk medical liability program.3.8. Underwriting Criteria. The board may prepare such policies and procedures to determine and annually review the underwriting criteria for the preferred medical liability program and high risk medical liability program.3.9. Legislative Reports. The board may implement such policies and procedures to prepare and publish separate summaries for the preferred medical liability program and the high risk medical liability program during the proceeding fiscal year before each regular session of the Legislature. 3.10. Surcharge. The board may implement such policies and procedures to determine and annually review the claims history, debit or surcharge for the high risk medical liability program.3.11. Transfer. The board may implement such policies and procedures to determine and annually review the criteria for transfer from the preferred medical liability program to the high risk medical liability program.3.12. Agents. The board may implement such policies and procedures to determine and annually review the role of agents and the amount of commission, if any, to be paid, in the preferred medical liability program and the high risk medical liability program.3.13. Legislative Recommendations. The board may implement such policies and procedures to study and annually evaluate the operation of the preferred medial liability program and the high risk medical liability program and make such recommendations to the legislature to insure its continued viability including but not limited to recommendations for civil justice reform.3.14. Five Year Plan. The Board may implement such policies and procedures to establish a five year financial plan to insure an adequate premium base to cover the long tail nature of the claims-made coverage provided by the preferred medical liability program and the high risk medical liability program. The board may approve such policies and procedures to retain the services of an impartial professional to determine that the plan may reasonably be expected to generate sufficient revenues and meet all estimated program and administrative costs: The board may implement such policies and procedures to submit its final approved five year financial plan to the Governor and the Legislature by the first day of January preceding the fiscal year; The board may implement such policies and procedures to identify factors that the board shall consider appropriate including the trends for the program in the industry and the claims history and the number and category participants in each program and the settlement claims and judicial results; The board may implement such policies and procedures to identify that the participants in the program have made a diligent search for comparable coverage in the voluntarily insurance market and have been unable to obtain the same.3.15. Meetings. The board may implement such policies and procedures for board meetings to review the implementation of its current financial plan in light of its actual experience.3.16. Reinsurance. The board may implement such policies and procedures for the purchase of reinsurance if it deems it to be appropriate.3.17. Tail Coverage Availability. The board shall implement such policies and procedures to establish an optional extended reporting coverage or tail coverage availability.3.18. Settlements. The board may implement such policies and procedures to enter into settlements or structured settlements where appropriate for claims made against the preferred medical liability program or the high risk medical liability program.3.19. Unacceptable Risk. The board may implement such policies and procedures for the refusal of the Board to provide insurance coverage for individual physicians whose prior loss experience or current professional training and capability or other issues are such that the physician represents an unacceptable risk of loss if coverage is provided.3.20. Termination. The board may implement such policies and procedures for the termination of coverage for nonpayment of premiums upon written notice of the termination forwarded to the health care provider not less than 30 days prior to the termination of coverage.3.21. Transfer of Insurance Obligations. The board may implement such policies and procedures to assign coverage or transfer all insurance obligations and/or risk of existing or in-force contracts of insurance to a third-party medical professional liability insurance carrier with the comparable coverage conditions as determined by the board. These policies and procedures shall effect a novation of the transferred contract of insurance, which such novation shall extinguish all liability of the board and the state of West Virginia.3.22. Medical Malpractice Advisory Panel. The board may implement such policies and procedures that it deems appropriate to meet and consult with the medical malpractice advisory panel.3.23. Medical Malpractice Advisory Panel Administration. The board may institute such policies and procedures as needed to consult with and/or administer the state medical malpractice advisory panel, its creation, composition, duties, and compensation; the board may implement such policies and procedures for the organization, meetings, records, and reports of the panel as it deems necessary; the board may implement such policies and procedures as it deems necessary for the establishment and maintenance of health care provider professional liability insurance programs; the board may implement such policies and procedures as it deems necessary to establish the eligibility criteria for participation in the health care provider professional liability insurance programs including the preferred medical liability program and the high risk professional liability insurance program; the board may implement such policies and procedures as necessary for the deposit, expenditure, and investment of premiums and for the payment for settlements or judgments; the board may implement such policies and procedures as necessary to maintain confidential information from disclosure; the board may implement such policies and procedures as it deems necessary for the issuance of any appeal bond, if necessary.