DOC

TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 23

By Don Duncan,2014-05-17 14:05
6 views 0
TITLE 114 LEGISLATIVE RULE INSURANCE COMMISSIONER SERIES 23

    TITLE 114

    LEGISLATIVE RULE

    INSURANCE COMMISSIONER

    SERIES 23

    MEDICAL MALPRACTICE LOSS EXPERIENCE

    AND LOSS EXPENSE ANNUAL REPORTING REQUIREMENTS

?114-23-1. General.

     1.1. Scope. -- This legislative rule establishes guidelines and procedures under which each

    insurer providing five percent (5%) or more of the medical malpractice insurance coverage in West

    Virginia shall report to the Insurance Commissioner on an annual basis certain specified information

    concerning loss experience and loss expense in regard to such medical malpractice insurance coverage.

     1.2. Authority. -- W. Va. Code ??33-20B-6(a) and 33-2-10.

     1.3. Filing Date. -- April 8, 2002.

     1.4. Effective Date. -- April 8, 2002.

?114-23-2. Definitions.

     As used in this legislative rule:

     2.1. Annual financial statement. Shall mean the financial statement required to be filed annually

    with the Commissioner pursuant to W. Va. Code ??33-3-14 and 33-4-14.

     2.2. Commissioner. Shall mean the Insurance Commissioner of the state of West Virginia.

     2.3. Insurer. Shall mean the insurance company licensed by the Commissioner and authorized to

    write medical malpractice insurance coverage in the state of West Virginia.

?114-23-3. Insurers Subject To Reporting Requirements.

     3.1. Insurers subject to annual reporting requirements. This rule shall apply to every insurer which

    provided five percent (5%) or more of the medical malpractice insurance coverage in West Virginia

    during the preceding calendar year.

     3.2. Notification by Commissioner. The Commissioner shall annually, on or before May 1, notify

    in writing those insurers which he has determined provided five percent (5%) or more of the medical

    malpractice insurance coverage in West Virginia during the preceding calendar year of their obligation to

    report to the Commissioner the information specified in section 5 of this rule.

     3.3. Method of determination. The Commissioner's determination pursuant to subsection 3.2 shall

    be based upon a comparison of every insurer's gross direct written malpractice premiums in West Virginia

    during the preceding calendar year to the total gross direct written malpractice premium in West Virginia

    for that calendar year.

    1

?114-23-4. Filing Deadline; Failure To Submit Information.

     4.1. Filing deadline. Insurers shall submit all information specified in section 5 of this rule to the

    Commissioner on or before August 1 immediately succeeding notification by the Commissioner pursuant

    to subsection 3.2.

     4.2. Failure to submit information. Pursuant to W. Va. Code ?33-20B-6(b), any insurer which

    fails to timely submit any and all information specified in section 5 of this rule to the Commissioner shall

    be fined ten thousand dollars ($10,000.00) for each of the first five (5) such failures per year and shall be

    fined one hundred thousand dollars ($100,000.00) for the sixth (6th) and each subsequent such failure per

    year.

?114-23-5. Information Required To Be Reported.

     5.1. Information required to be reported. The information required to be reported to the

    Commissioner shall be that specified in the Annual Loss Experience and Loss Expense Reporting Form,

    attached to and made a part of this rule as Exhibit A.

     5.2. Information by individual coverage classifications. A separate Annual Loss Experience and

    Loss Expense Reporting Form must be filed for each and every individual coverage classification written

    by the insurer in West Virginia.

?114-23-6. Evaluation By Commissioner.

     6.1. Evaluation by Commissioner. The Commissioner shall evaluate the information reported

    pursuant to section 5 of the rule in order to determine whether the filing insurers have fairly and

    accurately determined the loss experience and loss expense data in the filing.

?114-23-7. Severability.

     7.1. Severability. If any provision of this legislative rule is held invalid, the remainder of the rule

    shall not be affected thereby.

    2

     Exhibit A

     Annual Loss Experience and Loss Expense Reporting Form

     (Note: Attach Additional Sheets For Answers When Necessary)

1. Company Name:

     If part of a group, specify group name:

2. Coverage Classification:

3. Provide, on a West Virginia basis and on a countrywide basis, the following information by

    twelve-month accident year for the preceding ninety-six months:

     a. paid losses;

     b. accumulated paid losses;

     c. paid loss adjustment expenses; and,

     d. incurred but not reported losses.

4. Provide, on a West Virginia basis and on a countrywide basis, the calculation of loss

    development factors by twelve-month accident year for the preceding ninety-six months for the

    following:

     a. paid losses;

     b. accumulated paid losses;

     c. paid loss adjustment expenses; and,

     d. incurred but not reported losses.

5. Provide, on a West Virginia basis and a countrywide basis, the ratio of accumulated paid losses to

    earned premiums by twelve-month accident year for the preceding ninety-six months.

6. Provide, on a West Virginia basis and a countrywide basis, the number of policies in force and the

    paid losses per policy by twelve-month accident year for the preceding ninety-six months.

7. Provide a comparison of allocated West Virginia operating expenses and actual West Virginia

    operating expenses by twelve-month accident year for the preceding ninety-six months.

8. Provide, on a West Virginia basis and on a countrywide basis, a linear trend analysis which

    shows the indicated projected trended development factors for paid losses, accumulated paid loss,

    paid loss adjustment expenses and incurred but not reported losses. Provide the R squared results

    of the linear models.

9. Provide the methodology by which the credibility of West Virginia data in relationship to

    countrywide data is weighted in calculating an indicated percentage of premium rate increase by

    twelve-month accident year for the preceding ninety-six months. Provide formulas used in the

    methodology and a narrative explanation and justification of use of the particular methodology.

10. Provide the following information with regard to actual expenses:

    3

     a. Actual paid claims by policy type by year (please separate underlying tort payments from bad faith,

    unfair claims practices and other extra contractual payments).

     b. Actual legal fees by policy type by year.

     c. Actual administrative costs paid by policy type by year.

11. Provide audited financial statements inclusive of income statements and balance sheets, statements

    of cash flow and footnotes to financials.

The above information is correct to the best of my knowledge and belief.

     Name (type or print)

     Title

     Address

     Telephone Number

     Signature

    4

Report this document

For any questions or suggestions please email
cust-service@docsford.com