Tenn. Code Ann. § 56-54-105 - Medical Malpractice Reporting Requirements for Medical Malpractice Insurers

Medical Malpractice Reporting Requirements for Medical Malpractice Insurers

Any entity that provides health care liability insurance shall report each claim to the commissioner.  If a claim is covered under a primary policy and one or more excess policies, the insuring entity shall report the total amount paid for the claim, which includes any amount paid by the excess policy, any amount paid by the facility or provider, or any amount paid by a person acting on behalf of a facility or provider. If the entity does not cover the claim, the facility or provider must report it to the commissioner after a final claim disposition has occurred is determined. Sometimes a claim is not covered by an insuring entity if the facility or provider did not buy insurance or maintain a self-insured retention that was larger than the final judgment or settlement; the claim was denied because it did not fall within the scope of the coverage agreement; or the annual aggregate coverage limits had been exhausted by other claim payments.

Any self-insurer, risk retention group, or unauthorized insurer that is exempt due to federal preemption, may report the required data under this section. These entities must inform covered providers that they have a reporting responsibility under this chapter if they do not regularly report due to federal or jurisdictional preemption. If the self-insurer, risk retention group, or unauthorized insurer does not report due to exemption, the facility or provider named in the health care liability claim shall report the required data.

Counsels who represent claimants who are asserting claims covered by this section shall provide information about free arrangements to the commissioner which includes portion of any settlement or judgment received by claimant’s counsel and any information as to whether the healthcare provider named in the claim received payment from TennCare for the incident that the claim is about. This information shall be provided for claims closed or open and pending on or after January 1, 2012. Starting in 2009, reports made by an insuring entity or counsel for a claimant shall be filed by March 1. This information shall include data for all claims that are open and pending as of the last day of the preceding calendar year and those claims closed in the preceding calendar year and any adjustments to data reported in prior years. The commissioner may adopt rules that require insuring entities, self-insurers, facilities, providers and claimant’s counsel to submit all required claim data electronically.