Florida Office of Insurance Regulation Rule Hearing re Reports by Insurers of Professional Liability Claims and Actions Required & Medical Malpractice Insurance Open Claims Reporting 3/21/2006

Jan 5, 2007 | By

Today the Florida Office of Insurance Regulation (OIR) held a rule hearing with regard to proposed Rule 690-171.003 relating to Reports by Insurers of Professional Liability Claims and Actions Required and Rule 690-171.009 relating to Medical Malpractice Insurance Open Claims Reporting. The rule hearing was held in order for affected persons to present evidence and argument on all issues under consideration pertaining to the Rules.

In particular, industry representatives commented on Rule 690-171.009 relating to Medical Malpractice Insurance Open Claims Reporting. One industry representative explained that medical malpractice insurers have recently undergone data checks for closed claims, and the preliminary results show confusion on the part of the companies towards certain terms that are loosely defined or not defined by OIR. Industry representatives stated that during initial rule workshops for proposed Rule 690-171.009, OIR and the affected companies seemed to understand what was required; however, after seeing examination reports over the last 30 days, it is clear that definitions for such terms as “settlement” and “closed claims” are ambiguous and company practices vary throughout the industry.

Therefore, industry representatives recommended that OIR revisit the Rule and attempt to better define certain terms in order to provide guidance to the industry so that claims reporting is meaningful and uniform throughout the industry.

Lee Roddenberry, from OIR, explained that OIR would need to keep a broad yet specific scope when defining certain terms, considering the various groups reporting data. He stated that OIR can endeavor to better define certain terms; however, OIR also will be looking at companies’ consistency in their practices and whether they had a reasonable approach, and not only whether the practices comply with the definitions within the Rule.

OIR representatives requested that the industry provide language for the specific definitions that the industry finds ambiguous, as well as provide scenarios where the current definitions within the proposed Rule could be applied in different manners. The record for both Rules will remain open for 10 days for industry comment.

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