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 70.20 - Physicians and surgeons medical malpractice policy provisions for the period commencing July 1, 1998; established rates

(1) For Academic Health Professional Insurance Association, the rate adjustments shall be as indicated in paragraph (8) of this subdivision. No surcharge shall be collected for this insurer.

(2) For Frontier Insurance Company, the rate adjustments shall be as indicated in paragraph (9) of this subdivision. No surcharge shall be collected for this insurer.

(3) For Group Council Mutual Insurance Company, rates shall be those established pursuant to section 70.19(c)(3) of this Part. In addition, a surcharge of four percent shall be collected for this insurer.

(4) For Medical Liability Mutual Insurance Company, the rate adjustments shall be as indicated in paragraph (10) of this subdivision. No surcharge shall be collected for this insurer.

(5) For the Medical Malpractice Insurance Association, the rate adjustments shall be as indicated in paragraph (10) of this subdivision. No surcharge shall be collected for this insurer.

(6) For Physicians Reciprocal Insurers, the rate adjustments shall be as indicated in paragraph (11) of this subdivision, which also reflects classification modifications approved by the superintendent in accordance with section 2307 (a) of the Insurance Law. No surcharge shall be collected for this insurer.

(7) For all other insurers, rates shall be those established by paragraph (4) of this subdivision, modified by the difference between the insurer's expenses and those of the Medical Liability Mutual Insurance Company, 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.

(8) Rate adjustments for Academic Health Professional Insurance Association:

* Territory 01: New York, Orange and Westchester Counties

Territory 02: Bronx, Kings, Queens, Richmond, Rockland and Sullivan Counties

Territory 03: Nassau and Suffolk Counties

Territory 04: Putnam, Dutchess, Columbia, Greene and Ulster Counties

Territory 05: Erie and Niagara Counties

Territory 06: Livingston, Monroe, Ontario, Seneca, Wayne and Yates Counties

Territory 00: Remainder of State

(9) Rate adjustments for the Frontier Insurance Company:

* Territory 01: New York, Orange and Westchester Counties

Territory 02: Bronx, Kings, Queens, Richmond, Rockland and Sullivan Counties

Territory 03: Nassau and Suffolk Counties

Territory 04: Putnam, Dutchess, Columbia, Greene and Ulster Counties

Territory 05: Erie and Niagara Counties

Territory 06: Livingston, Monroe, Ontario, Seneca, Wayne and Yates Counties

Territory 00: Remainder of State

(10) Rate adjustments for the Medical Liability Mutual Insurance Company and the Medical Malpractice Insurance Association:

* Territory 01: New York, Orange and Westchester Counties

Territory 02: Bronx, Kings, Queens, Richmond, Rockland and Sullivan Counties

Territory 03: Nassau and Suffolk Counties

Territory 04: Putnam, Dutchess, Columbia, Greene and Ulster Counties

Territory 05: Erie and Niagara Counties

Territory 06: Livingston, Monroe, Ontario, Seneca, Wayne and Yates Counties

Territory 00: Remainder of State

(11) Rate adjustments for Physicians Reciprocal Insurers:

* Territory 01: New York, Orange and Westchester Counties

Territory 02: Bronx, Kings, Queens, Richmond, Rockland and Sullivan Counties

Territory 03: Nassau and Suffolk Counties

Territory 04: Putnam, Dutchess, Columbia, Greene and Ulster Counties

Territory 05: Erie and Niagara Counties

Territory 06: Livingston, Monroe, Ontario, Seneca, Wayne and Yates Counties

Territory 00: Remainder of State

(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 12.6 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 as amended by chapter 148 of the Laws of 1998, the rate shall be 13.1 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 the first layer of excess coverage described in paragraph (1) or (2) of this subdivision, the rate shall be 7.8 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.

(1) Claims-made coverage rate. The rate for a claims-made policy shall be the corresponding occurrence rate multiplied by the appropriate claims-made factor, as follows:

(2) Optional extended reporting period (tail) rates:

(1) When a physician insured under a claims-made policy changes either classification, territory or both, the rate applicable to such physician shall be adjusted to reflect the fact that claims made under the policy after the change could include claims for occurrences which took place under the former classification or territory. The presence of a loading for pre-paid extended reporting period coverage in the rate structure complicates what would otherwise be a relatively simple calculation, in that the amount of such loading applicable to the difference in rates before and after the change must be considered. Accordingly, all insurers should use the procedure established by section 70.14(f)(2) of this Part.

(2) All insurers providing claims-made coverage subject to this Part shall:

(3) For the purposes of this subdivision, the term "classification" shall include changes from full time to part time or part time to full time practice.

(1) Pursuant to chapter 148 of the Laws of 1998, excess coverage policies providing $1 million/$3 million of excess coverage above $1 million/$3 million of primary coverage, purchased by general hospitals on behalf of physicians, shall cover occurrences from July 1, 1998, through June 30, 1999. Accordingly, all physicians' and surgeons' medical malpractice liability insurers, and only such insurers, shall issue such an excess policy on an occurrence basis.

(2) Excess coverage policies issued or renewed on and after July 1, 1998, shall provide coverage on either an occurrence or claims-made basis, subject to paragraph (1) of this subdivision, provided that:

(1) No later than November 30, 1998, all physicians' medical malpractice liability insurers shall file required amended rate manual pages with the superintendent in accordance with the rates established by this Part. Insurers writing, or required to write, coverage for which rates are not specifically established by this Part shall file proposed rates with supporting documentation by November 30, 1998.

(2) A physicians' medical malpractice liability rate filed by a rate service organization on behalf of its members and subscribers shall be established in accordance with this Part and any such organization shall make appropriate filings by November 30, 1998.

(3) 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 purchasing group have complied with all applicable provisions of the Liability Risk Retention Act, 15 USC 3901 et seq. (see section 70.1[m] of this Part) and Part 301 of this Title, and if the insurer submits rates or a rating plan affording advantages, based upon 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 presently issuing such coverage shall file proposed rates with adequate documentation by November 30, 1998.