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The Bergen County Medical Society - latest reform 2 20 03 (Page 15)

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The Bergen County Medical Society - latest reform 2 20 03
15
EXPLANATION - Matter enclosed in bold-faced brackets
[
thus
]
in the above bill
is not enacted and is intended to be omitted in the law.

Matter underlined thus is new matter.
against the insured or the cost of defending against the claim exceeds
$10,000 per covered health care provider.
b. An insurer authorized to transact medical malpractice liability
insurance in this State that provides medical malpractice liability
insurance to a health care provider who is a recipient of a notice of intent
to file an action pursuant to section 6 of P.L. , c. (C. ) (pending before
the Legislature as this bill), which health care provider is not
subsequently made a party to an action, shall not consider the notice or
investigation therefrom as part of the insured's claims experience or for
the purposes of underwriting or establishing a premium for the health
care provider.
c. An insurer authorized to transact medical malpractice liability
insurance shall, in all policies and contracts issued in the State on and
after the effective date of P.L. , c. (pending before the Legislature as
this bill), define the term "claim" to mean any demand received by an
insured seeking damages that results from a medical incident, or an
insured's notice to the insurer of a specific professional services act or
omission that an insured reasonably believes may result in a demand for
damages.
d. An insurer who violates this section shall be subject to a penalty
of up to $25,000 for each violation unless the insurer knew or reasonably
should have known it was in violation of this section, in which case the
penalty shall not be more than $250,000 for each violation. The penalty
shall be sued for and collected by the Commissioner of Banking and
Insurance in a summary proceeding in accordance with the "Penalty
Enforcement Law of 1999," P.L.1999, C.274 (C.2A:58-10 et seq.).

21. (New section) Each annual statement, made after the effective
date of P.L. , c. (pending before the Legislature as this bill), pursuant
to the provisions of section 16 of P.L. 1982, c. 114 (C.17:29AA-1 et
seq.) by an insurer writing medical malpractice in this State, shall
include a certification by the chief executive officer or chief financial
officer that the rates for every category, subcategory, or risk
classification are:
a. adequate to cover expected losses and expenses of the insurer and
to ensure the safety and soundness of the insurer; or
b. not adequate to cover expected losses and expenses of the insurer,
but the insurer will create and maintain reserves adequate to ensure the
safety and soundness of the insurer.

22. (New section) Notwithstanding the provisions of section 1 of
P.L.1968, c.131 (C.17:29C-1) to the contrary, each
notice of renewal or
nonrenewal by an insurer authorized to transact medical malpractice
liability insurance in this State shall be mailed or delivered by the insurer
to the insured not less than 60 days prior to the expiration of the policy
and, in the case of a nonrenewal, shall contain the reason for the
nonrenewal.

23. Section 10 of P.L.1982, c.114 (C.17:29AA-10) is amended to
read as follows:
10. a. Rates shall not be excessive, inadequate or unfairly
discriminatory.
b. In the case of rates for medical malpractice liability insurance, if
the commissioner finds, after a hearing, that a rate in effect for any
insurer is not in compliance with the standards of P.L.1982, c.114

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