Current through Register Vol. 46, No. 39, September 25, 2024
(a) Section 19 of chapter 184 of the Laws of
1988 requires the superintendent to establish rates for physicians and surgeons
medical malpractice policies for the policy period July 1, 1989 through June
30, 1990. Section 40 of chapter 266 of the Laws of 1986, as amended by chapters
184 and 186 of the Laws of 1988, requires the superintendent to establish a
surcharge, of up to eight percent, on the established rates for such medical
malpractice policies for the policy period July 1, 1989 through June 30, 1990,
if required to satisfy any deficiency for the policy periods July 1, 1985
through June 30, 1989.
(b) The
superintendent has reviewed the reports mandated by sections
70.8(h) and
70.9(f) of this
Part, taken into account the factors set forth for consideration in section 1
of chapter 184 of the Laws of 1988, and evaluated the financial condition of
insurers issuing policies of medical malpractice insurance, as reflected by
examinations conducted in accordance with section
310 of the
Insurance Law. As a result of review and consideration, the superintendent has
determined that a deficiency exists, in certain instances, for the policy
periods July 1, 1985 through June 30, 1989.
(c) Rates and surcharges for occurrence
policies providing primary coverage, up to $1 million/$3 million, issued or
renewed during the period July 1, 1989 through June 30, 1990, shall be as
follows:
(1) For Frontier Insurance Company,
rates shall be those established pursuant to section
70.9(c)(1)(i) of
this Part and no surcharge shall be collected for this insurer.
(2) For Group Council Mutual Insurance
Company, rates shall be five percent greater than those established pursuant to
section 70.9(c)(1)(i) of
this Part and, in addition, a surcharge of four percent shall be collected for
this insurer.
(3) For Medical
Liability Mutual Insurance Company, rates in the counties of Bronx, Columbia,
Dutchess, Greene, Kings, Nassau, New York, Orange, Queens, Putnam, Richmond,
Rockland, Suffolk, Sullivan, Ulster and Westchester shall be 1.6 percent
greater than those established pursuant to section
70.9(c)(1)(i) of
this Part. Rates for this insurer in all other counties shall be five percent
less than those established pursuant to section
70.9(c)(1)(i) of
this Part. No surcharge shall be collected for this insurer.
(4) For the Medical Malpractice Insurance
Association, rates in the counties of Bronx, Columbia, Dutchess, Greene, Kings,
Nassau, New York, Orange, Queens, Putnam, Richmond, Rockland, Suffolk,
Sullivan, Ulster and Westchester shall be 1.6 percent greater than those
established pursuant to section
70.9(c)(1)(i) of
this Part. Rates for this insurer in all other counties shall be five percent
less than those established pursuant to section
70.9(c)(1)(i) of
this Part. No surcharge shall be collected for this insurer.
(5) For Physicians Reciprocal Insurers rates
shall be five percent greater than those established pursuant to section
70.9(c)(1)(i) of
this Part and, in addition, a surcharge of four percent shall be collected for
this insurer.
(6) For all other
insurers, rates shall be those established by paragraph (3) of this
subdivision, unless the insurer can demonstrate to the satisfaction of the
Superintendent that another rate is appropriate. No surcharge shall be
collected for any such insurer unless specifically required by the
superintendent.
(d)
Rates for policies providing excess coverage issued or renewed during the
period July 1, 1989 through June 30, 1990 shall be as follows, and no
surcharges shall be collected on these policies:
(1) For a first excess layer providing $1
million/$3 million of excess coverage above $1 million/$3 million primary
coverage, and purchased directly by a physician, the rate shall be 40 percent
of the $1 million/$3 million rate for primary coverage established for the
Medical Malpractice Insurance Association in accordance with subdivision (c) of
this section.
(2) For a first
excess layer providing $1 million/$3 million of excess coverage above $1
million/$3 million primary coverage, and purchased by a hospital in accordance
with section 18 of chapter 184 of the Laws of 1988, the rate shall be 43
percent of the $1 million/$3 million rate for primary coverage established for
the Medical Malpractice Insurance Association in accordance with subdivision
(c) of this section.
(3) For a
second excess layer providing $1 million/$3 million of excess coverage above
the underlying primary coverage and first layer of excess coverage, described
in paragraphs (1) and (2) of this subdivision, the rate shall be 30 percent of
the $1 million/$3 million rate for primary coverage established for the Medical
Malpractice Insurance Association in accordance with subdivision (c) of this
section.
(e)
Claims-made primary and excess coverage rates.
(1) Claims-made coverage rates. The rate for
a claims-made policy shall be the corresponding occurrence rate multiplied by
the appropriate claims-made factor, as follows:
|
Year in claims-made
program |
Claims-made
factor |
|
First: |
31% |
|
Second: |
64 |
|
Third: |
85 |
|
Fourth: |
94 |
|
Fifth: |
99 |
|
Sixth: |
102 |
|
Seventh: |
104 |
|
Eighth: |
105 |
(2) Optional extended reporting period (tail)
rates.
(i) The rate for optional tail
coverage required to be offered for a claims-made policy shall be the
corresponding occurrence rate multiplied by the appropriate tail factor, as
follows:
|
Number of years
completed in claims-made program |
Tail
factor |
|
One: |
74.8% |
|
Two: |
122.1 |
|
Three: |
146.4 |
|
Four: |
162.4 |
|
Five: |
173.3 |
|
Six: |
181.0 |
|
Seven: |
186.7 |
|
Eight: |
190.6 |
(ii) For a policy terminated on a date other
than its anniversary date, the tail factor shall be obtained by interpolation,
on a daily basis, between the tail factors applicable to the preceding and
following policy anniversaries.
(iii) For any policy written at a reduced
rate because the insured was eligible for a new-doctor discount, the tail
premium shall be reduced by the percentage that the current year's rate
(exclusive of any surplus contributions) was reduced as a result of such
new-doctor discount.
(3)
Rates for claims-made and tail excess coverage policies purchased by hospitals.
The aggregate rate for a claims-made excess coverage policy and its
simultaneously issued tail mandated subdivision (f) of this section, purchased
by a general hospital on behalf of a physician, shall equal the corresponding
occurrence excess coverage rate.
(f)
Excess coverage-types of policies:
required tail.
(1) Pursuant to section
18 of chapter 184 of the laws of 1988, excess coverage policies providing $1
million/$3 million of excess coverage above $1 million/$3 million primary
coverage, purchased by general hospitals on behalf of physicians, shall cover
occurrences from July 1, 1989 through June 30, 1990. Accordingly, all
physicians and surgeons medical malpractice liability insurers that issue such
an excess policy on a claims-made basis shall simultaneously issue full tail
coverage.
(2) Except where required
to be issued on a claims-made basis pursuant to section 5504(f), excess
coverage policies issued or renewed on and after July 1, 1989 shall provide
coverage on either an occurrence or claims-made basis, subject to paragraph (1)
of this subdivision, provided that:
(i) An
excess coverage policy shall be renewed on the same basis (occurrence or
claims-made) as previously issued, except that the insured may choose to
substitute claims-made coverage for occurrence coverage.
(ii) If the insured so requests, an excess
coverage policy issued by the same insurer that issued the underlying primary
coverage shall be issued with the same type of coverage (occurrence or
claims-made) as the primary coverage.
(3) The provisions of section
70.7(b)(2) and
(d) of this Part, continue to apply to all
medical malpractice liability insurers.
(g)
Required filings-primary
coverage.
(1) No later than August 1,
1989, all physicians medical malpractice liability insurers are required to
file amended rate manual pages with the superintendent in accordance with the
primary coverage rates established by this Part.
(h)
Required filings-excess
coverage.
(1) No later than August 1,
1989, all physicians medical malpractice liability insurers are required to
file amended rate manual pages with the superintendent in accordance with the
excess coverage rates established by this Part.
(2) No later than August 1, 1989, insurers
writing, or required to write, excess layers other than for which rates are
specifically established by this Part shall file proposed rates with supporting
documentation.
(i)
Rate service organizations.
(1) A
physicians medical malpractice liability insurance rate filed by a rate service
organization on behalf of its members and subscribers shall be established in
accordance with this Part. Any such organization shall make the appropriate
rate filing required by subdivisions (g) and (h) of this section no later than
August 1, 1989.
(j)
Purchasing groups.
The rates and rating plans for medical malpractice
liability insurance issued by an insurer to a Federal purchasing group and its
members shall be established in accordance with the provisions of this Part,
except that, if the insurer and the purchasing group have complied with all
applicable provisions of the Liability Risk Retention Act,
15 USC
3901
et seq., and Part 301
of this Title, and if the insurer submits rates or a rating plan affording
advantages, based on the purchasing group's loss and expense experience, not
afforded to other persons, the superintendent shall review such submission, and
thereafter establish rates or a rating plan, as appropriate, reflecting such
advantages. Any such insurer shall file no later than August 1, 1989 proposed
rates with adequate supporting documentation.
