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 70.17 - Physicians and surgeons medical malpractice policy provisions for the period commencing July 1, 1995; established rates
Current through Register Vol. 46, No. 39, September 25, 2024
(a) Section 40 of chapter 266 of the Laws of 1986, as amended by section 4 of chapter 256 of the Laws of 1993, requires the superintendent to establish rates for physicians and surgeons medical malpractice policies for the policy period July 1, 1993 through June 30, 1996 and establish a surcharge, of up to eight percent, on the rates for such medical malpractice policies for the policy period July 1, 1995 through June 30, 1996, if required to satisfy any deficiency for the policy periods July 1, 1985 through June 30, 1994.
(b) The superintendent has reviewed the reports mandated by section 70.8(h) and former section 70.9(f) of this Part, taken into account the factors set forth for consideration in section 4 of chapter 256 of the Laws of 1993, 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 one instance, for the policy periods July 1, 1985 through June 30, 1994.
(c) Rates and surcharges for occurrence policies providing primary coverage, up to $1 million/$3 million, issued or renewed during the period July 1, 1995 through June 30, 1996, shall be as follows:
PREMIUM CLASS |
DESCRIPTION OF CLASS |
RATE CHANGE |
|
Old |
New |
||
1 | 1 | Neurosurgery | 0.0% |
2 | 2 | Obstetrics and Gynecology | 0.0% |
3 | 3 | Orthopedic Surgery | -5.0% |
4 | 4 | Gynecology Only (does not provide coverage for pre-natal care, obstetrical deliveries of any kind except for assistance at Cesarean Section, induced abortions or treatment of spontaneous abortions except for those in the first trimester); Otolaryngology (incl. otolaryngological, cosmetic plastic surgery); Plastic and Reconstructive Surgery; and Vascular Surgery | -5.0% |
5 | 5 | General Surgery | 0.0% |
6 | 6 | Colon and Rectal Surgery and/or Proctology; Urology (incl. major surgery); Family/General Practice and Limited Major Surgery and/or Anesthesiology; | 0.0% |
7 | 6 | Otolaryngology (excl. cosmetic plastic surgery); | 0.4%* |
8 | 6 | Family/General Practice and Limited Major Surgery (no referred, surgery or abortions other than treatment of spontaneous abortions); | 3.1%* |
9 | 6 | Neurology and/or Psychiatry (incl. the supervision, direction and/or performance of myelography, and/or angiography) | 8.4%* |
7 | 7 | Anesthesiology | -5.0% |
10 | 8 | ENT (with surgery limited to minor procedures not including T&A); Industrial Medicine and Minor Surgery; and Family/General Practice with Minor Surgery | 0.0% |
11 | 9 | Internal Medicine (incl. cardiac catheterization); and Ophthalmology (incl. major surgery) | 0.0% |
12 | 10 | Computerized Tomography; Diagnostic Radiology Only; and Diagnostic Radiology and Radiotherapy | 0.0% |
13 | 11 | Dermatology (incl. dermabrasion, hair transplants, micro-lipo injections, liposuction, face peels using Phenol, Mohs microsurgery and all procedures listed in Class 16, Dermatology); Internal medicine (excl. cardiac catheterization but incl. cardiology, gastroenterology, rheumatology, TB and lung diseases, endocrinology and medical oncology); Pediatrics (excl. T&A, other major surgery or general or spinal anesthesia); Radiotherapy Only; and Urology (incl. minor surgery) | 0.0% |
14 | 12 | Emergency Medicine | 10.0%* |
14 | 13 | Industrial Medicine (excl. surgery); Ophthalmology (with surgery limited to minor procedures); and Family/General Practice (no surgery) | 0.0% |
15 | 14 | Neurology (excl. the supervision, direction or performance of myelography and/or angiography) | 10.0% |
16 | 15 | Pathology/Hematology | 0.0% |
17 | 16 | Allergy (incl. pediatric allergy); Dermatology (incl. the use of laser, face peels with agents other than Phenol, collagen injections and aclerotherapy, but excl. all procedures listed in Class 11, Dermatology); Ophthalmology (excl. surgery); Physical medicine, rehabilitation, preventive medicine, public health; and Psychiatry (excl. the supervision, direction or performance of myelography and/or angiography) | -5.0% |
* The above schedule includes the following revised or new classifications:
* A revised Class 6 adding Otolaryngology (excl. cosmetic plastic surgery) previously Class 7, Family/General Practice and Limited Major Surgery (no referred, surgery or abortions other than treatment of spontaneous abortions) previously in Class 8 and Neurology and/or Psychiatry (incl. the supervision, direction and/or performance of myelography, and/or angiography) previously in Class 9; the rate increases for these specialties resulted solely from the movement of these specialties from lower rated classes to a higher rated class.
* A new Class 12, consisting of Emergency Medicine, previously in Class 14; rates for new Class 12 are 10.0% higher than old Class 14 (which has now been renumbered as Class 13).
PREMIUM CLASS |
DESCRIPTION OF CLASS |
RATE CHANGE |
|
Old |
New |
||
1 | 1A | Neurosurgery | 16.1%* |
1 | 1B | Obstetrics and Gynecology; and Open heart surgery | 6.1% |
2 | 2 | Orthopedic Surgery | 2.3% |
3 | 3 | Emergency Medicine; and Gynecology (incl. gynecological surgery) | 2.3% |
4 | 4 | Surgeon Specialists | 6.1% |
5 | 5 | General Surgery | 11.1% |
5A | 5A | Otolaryngology; Proctology; Urology; Physicians with limited major surgery | 11.1% |
6A | 6A | Neonatology | 11.1% |
6B | 6B | Anesthesiology | -3.1% |
8 | 8 | Neurology | 11.1% |
8A | 8A | Physicians, minor surgery or assisting in major surgery | 11.1% |
8B | 8B | Radiology | 25.0% |
9 | 9 | Internal medicine, no surgery | 11.1% |
9C | 9C | Family and general practice (excluding Ophthalmology, no surgery) | 11.1% |
9D | 9D | Pediatrics | 25.0% |
9E | 9E | Allergy; Dermatology; General Practice; and Public Health, no surgery | 11.1% |
9C | 9E | Ophthalmology, no surgery | -18.7%* |
10 | 10 | Administrative Medicine; and Physical Medicine and rehabilitation | 11.1% |
* The above schedule includes the following new or revised classifications:
* A new Class 1A, consisting of Neurosurgery, previously in Class 1; rates for new Class 1A are 16.1% higher than old Class 1.
* A revised Class 9E adding Ophthalmology (no surgery), previously in Class 9C; the overall rate decrease for this specialty resulted from the movement of the specialty from a higher rated class to a lower rated class coupled with an increase in the class relativity for Class 9E.
In addition, the following specialties, which were previously not written by the company, are being added:
Full-time surgical assistant | Class 5A |
Physical Medicine and Rehabilitation with invasive procedures | Class 8A |
Neurology excluding invasive procedures | Class 9 |
(d) Rates for policies providing excess coverage issued or renewed during the period July 1, 1995 through June 30, 1996 shall be as follows, and no surcharges shall be collected on these policies:
(e) Claims-made primary and excess coverage rates.
Year in claims-made program |
Claims-made factor |
First | 31% |
Second | 64 |
Third | 85 |
Fourth | 94 |
Fifth | 99 |
Sixth | 102 |
Seventh | 104 |
Eighth and later | 105 |
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 or more | 190.6 |
(f) Rates for claims-made policies where the physician, while receiving coverage under a claims-made policy, changes classification or territory.
(g) Excess coverage-types of policies.
(h) Required filings.