New York Codes, Rules and Regulations
Title 11 - INSURANCE
Chapter III - Policy and Certificate Provisions
Subchapter B - Property and Casualty Insurance
Part 70 - Medical Malpractice Insurance Rate Modifications, Provisional Rates, Required Policy Provisions And Availability Of Additional Coverages
Section 70.1 - Definitions
Current through Register Vol. 46, No. 12, March 20, 2024
(a) Medical malpractice insurance, as used in this Part, means insurance against legal liability of the insured and against loss, damage or expense incident to a claim of such liability arising out of the death or injury of any person due to medical or hospital malpractice by any licensed physician or hospital, as such latter term is defined in section 5501(b) of the Insurance Law.
(b) No-consent policy, as used in this Part, means a policy which provides that the insurer has the sole authority to settle any claim, up to the policy limits, without the consent of the insured.
(c) Consent policy, as used in this Part, means:
(d) Claims-made policy means an insurance policy that covers liability for injury or damage that the insured is legally obligated to pay (including injury or damage occurring prior to the effective date of the policy, but subsequent to the retroactive date, if any), arising out of incidents, acts or omissions, as long as the claim is first made during the policy period or any extended reporting period (tail).
(e) Occurrence policy means an insurance policy that covers liability for injury or damage that the insured is legally obligated to pay arising out of incidents, acts or omissions that occurred during the policy period, and where a claim may be made during or subsequent to the policy period.
(f) Extended reporting period coverage, tail or tail coverage means that period of time specified in the policy wherein claims first made after the termination date of the policy, for injury or damage that occurs during the policy term, or that occurs on or after the retroactive date, if any, will be considered made during the policy term.
(g) Base year occurrence rate shall have the meaning ascribed to it in section 70.8(c) of this Part.
(h) Primary coverage shall mean a policy affording coverage up to $1 million per claimant and up to $3 million ($1 million/$3 million) for all claimants in any one year.
(i) Excess coverage shall mean a policy affording coverage above a primary coverage policy of $1 million/$3 million.
(j) Rating plan shall mean classifications, territories, corresponding relativities, rating rules and merit rating plans (pursuant to Part 152 of this Title [Regulation 124]).
(k) Retroactive date means a date concurrent with the effective date of the policy or a particular date prior to the effective date of the policy upon which the insurer and insured agree in the policy that policy coverage will be applicable.
(l) Insurer shall include the Medical Malpractice Insurance Association ("the Association" or "MMIA").
(m) Purchasing group means any group formed pursuant to the Federal Liability Risk Retention Act of 1986 (LRRA) ( 15 USC 3901 et seq.) (published by the U.S. Government Printing Office, Washington, DC. Copies may be obtained by writing to the Superintendent of Documents, U.S. Government Printing Office, Washington, DC 20402. In addition, copies are available for viewing and copying at the New York State Insurance Department, 25 Beaver Street, New York, NY 10004 and at the Albany Office of the Secretary of State, 41 State Street, Albany, NY 12231) and:
