Florida Administrative Code
69 - DEPARTMENT OF FINANCIAL SERVICES
69O - OIR - Insurance Regulation
Chapter 69O-187 - PROFESSIONAL LIABILITY SELF-INSURANCE TRUST FUNDS
Section 69O-187.010 - Bylaws, Mutual Covenants, Rules and Regulations, and Service Agent's Contract

Universal Citation: FL Admin Code R 69O-187.010

Current through Reg. 50, No. 187; September 24, 2024

As a condition of the Office's approval of the Fund, the documents filed pursuant to Rule 69O-187.004, F.A.C., shall contain all of the following provisions, but may also contain other provisions not inconsistent with these rules or with the required provisions.

(1) The bylaws of the Fund shall contain the name and location of the fund, its purposes and powers. The meeting of the members shall be specified and meet no less than annually. Members shall be advised of voting rights. Trustee number, qualifications, term of office, election process, and selection of officers shall be addressed. Duties of the Trustees, the times and places of meetings, the removal of a Trustee, the replacement of the Trustee created by the vacancy therein, and any compensation as may be determined shall be a part of this document. Alteration, amendment or repeal of any part of this document shall only be as specified therein.

(2) The mutual covenants, herein after referred to as the Agreement, shall be given to and accepted by each member of the Fund. The Agreement shall be executed by the Chairman of the Trustees, attested by its Secretary, by the Service Agent and by the member. The membership shall be defined, and the statutory authority to pool such liabilities to form the self-insurance trust fund shall be clearly stated. The initial Trustees shall be designated. The parties to this Agreement shall agree as follows:

(a) The Fund and each member will individually, severally and proportionately, but not jointly except as provided in Section 627.357, F.S., covenant and agree to pay premiums, charges and assessments based upon appropriate classifications and rates, and the Fund and its members will individually, severally and proportionately covenant to assume and discharge, by payment, any lawful awards or final judgments entered against any member of the fund, and further, the members will individually, severally and proportionately covenant and agree there will be no disbursements out of the Fund by way of dividends, refunds or distribution of surplus other than upon the Office's approval.

(b) The members shall by executing the Agreement ratify and confirm appointment by the Trustees of the Service Agent, individually and collectively, and further, the members shall be advised of the duties and responsibilities of the Service Agent as provided by Rule 69O-187.002, F.A.C.

(c) The Trustees shall be sole judge of whether an applicant shall be admitted to membership, and whether a member shall be retained by the Fund, and further, shall give proper notice in accordance with Section 627.4147(1)(c), F.S., to any member expelled from the Fund.

(d) The Trustees shall set up, operate and enforce the bylaws and rules and regulations.

(e) There shall be provisions that require each member to abide by the following:
1. Loss prevention and risk management recommendations of the Trustees and Service Agent.

2. In the event of a loss or claim, give immediate notification to the Service Agent on the prescribed forms.

3. Pay all premiums, charges and assessments promptly as required by the Trustees.

4. The member appoints the Service Agent as his agent and attorney-in-fact to act in his behalf and to execute all contracts, reports, waivers, agreements, excess insurance contracts, and service contracts; to make or arrange for payment of claims, and all other things required or necessary insofar as they affect the terms of this Agreement.

(f) Subject to the terms, conditions, limitations and exclusions of the mutual covenants of the Fund or the policy, the Fund shall defend in the name of and on behalf of the member any suits or other proceedings which may at any time be instituted against him on account of injury, death or disablement arising out of medical malpractice including suits or other proceedings alleging such malpractice and demanding damages or compensation therefor, although such suits, other proceedings, allegations or demands are wholly groundless, false or fraudulent, and to pay all judgments, awards or costs taxed against the member in any legal proceeding defended by the Fund, all interest accruing after entry of judgment and all expenses incurred for investigation, negotiation and defense.

(g) The Trustees, the Service Agent and any of their personal representatives shall be permitted to inspect the places where the covered professional services are performed and examine the members' books, documents, and records in order to verify the charges, premiums or assessments payable.

(h) The Trustees shall set aside a reasonable sum for the operating and administrative expenses of the Fund. All other funds shall be used only for payment of claims, including settlements, awards, judgments, legal fees, costs in all contested cases and all expenses of investigation.

(i) The Fund year shall be as stated in the Agreement.

(j) Liability of the Trustees shall be in accordance with Section 624.489, F.S.

(k) The member shall be bound by all terms of the Agreement. Alteration, amendment or repeal of any part of the Agreement shall only be as specified therein.

(3) The rules and regulations shall govern and define the operation of the Fund together with the rules and regulations of the Office governing medical malpractice self-insurance trust funds, the provisions of the mutual covenants, the bylaws of the Fund and the policy issued by the Fund. The Trustees, members and Service Agent shall not borrow any monies or securities from the Fund or in the name of the Fund. The Service Agent is to manage the Fund subject to the overall supervision of the Trustees. Any assessment shall be made in accordance with Section 627.357(7), F.S., and Rule 69O-187.006, F.A.C. The rejection or expulsion of a member is the decision of the Trustees. Notice of any expulsion shall be in accordance with Section 627.4147(1)(c), F.S. The Service Agent shall prepare statistical reports for the Trustees as relates to the overall claims status, trends and loss experience of the Fund. The Trustees shall have the accounts and records of the Fund audited as required by Rule 69O-187.007, F.A.C., and file the appropriate forms as required by the same. The Trustees and Service Agent shall be bonded as required by Rule 69O-187.005, F.A.C. Alteration, amendment or repeal of any part of this document shall only be as specified therein.

(4) The Service Agent's contract shall detail the duties and responsibilities of the Service Agent as required by Rule 69O-187.002, F.A.C. Expenses to be borne by the Service Agent and by the Fund shall be specified. The compensation for the Service Agent and the terms of termination shall be as stated. Alteration, amendment or repeal of any part of this document shall only be as specified therein.

Rulemaking Authority 627.357(6), 624.308(1) FS. Law Implemented 624.307(1), 627.357 FS.

New 5-10-89, Formerly 4-39.0081, 4-187.010.

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