Oklahoma § 36-6811 - Time for filing closed claim report

§ 36-6811. Time for filing closed claim report

A. The Insurance Commissioner may require that an insuring

entity or self-insured entity shall file a closed claim report.

These reports shall be filed within thirty (30) days after the

Commissioner's request and shall include data for all claims closed

in the preceding calendar year and other information required by the

Commissioner.

B. Any violation by an insurer of the Medical Professional

Liability Insurance Closed Claim Reports Act shall subject the

insurer to discipline including a civil penalty of not less than

Five Thousand Dollars ($5,000.00).

C. A closed claim that is covered under a primary policy and

one or more excess policies shall be reported only by the insuring

entity that issued the primary policy. The insuring entity that

issued the primary policy shall report the total amount, if any,

paid with respect to the closed claim, including any amount paid

under an excess policy, any amount paid by the facility or provider,

and any amount paid by any other person on behalf of the facility or

provider.

D. If a claim is not covered by an insuring entity or selfinsurer, the facility or provider named in the claim shall report it

to the Commissioner after a final claim disposition has occurred due

to a court proceeding or a settlement by the parties. Instances in

which a claim may not be covered by an insuring entity or selfinsurer include situations in which:

1. The facility or provider did not buy insurance or maintained

a self-insured retention that was larger than the final judgment or

settlement;

2. The claim was denied by an insuring entity or self-insurer

because it did not fall within the scope of the insurance coverage

agreement; or

Oklahoma Statutes - Title 36. Insurance

3. The annual aggregate coverage limits had been exhausted by

other claim payments.

E. If a claim is covered by an insuring entity or self-insurer

that fails to report the claim to the Commissioner, the facility or

provider named in the claim shall report it to the Commissioner

after a final claim disposition has occurred due to a court

proceeding or a settlement by the parties.

1. If a facility or provider is insured by a risk retention

group and the risk retention group refuses to report closed claims

and asserts that the federal Liability Risk Retention Act (95 Stat.

949; 15 U.S.C. Sec. 3901 et seq.) preempts state law, the facility

or provider shall report all data required by the Medical

Professional Liability Insurance Closed Claim Reports Act on behalf

of the risk retention group.

2. If a facility or provider is insured by an unauthorized

insurer and the unauthorized insurer refuses to report closed claims

and asserts a federal exemption or other jurisdictional preemption,

the facility or provider shall report all data required by the

Medical Professional Liability Insurance Closed Claim Reports Act on

behalf of the unauthorized insurer.

3. If a facility or provider is insured by a captive insurer

and the captive insurer refuses to report closed claims and asserts

a federal exemption or other jurisdictional preemption, the facility

or provider shall report all data required by the Medical

Professional Liability Insurance Closed Claim Reports Act on behalf

of the captive insurer.

Added by Laws 2003, c.390 , § 12, eff. July 1, 2003. Amended by

Laws 2009, c. 176, § 55, eff. Nov. 1, 2009; Laws 2010, c. 222, § 52,

eff. Nov. 1, 2010; Laws 2011, c. 278, § 52, eff. Nov. 1, 2011; Laws

2015, c. 298, § 28, eff. Nov. 1, 2015.