56-54-106 - Contents of report. - Tennessee Statutes

56-54-106. Contents of report.

With the exception of reports received pursuant to § 56-54-105(c), reports required under § 56-54-105 must contain the following information in a format and coding protocol prescribed by the commissioner; however, for all open claims, an insuring entity, self-insurer, facility and provider shall only be required to report the information in its possession as of the date of the report. To the greatest extent possible while still fulfilling the purposes of this chapter, the format and coding protocol shall be consistent with the format and coding protocol for data reported to the National Practitioner Data Bank.

     (1)  Claim and incident identifiers, including:

          (A)  A claim identifier assigned to the claim by the insuring entity, self-insurer, facility or provider; and

          (B)  An incident identifier if companion claims have been made by a claimant;

     (2)  The policy limits of the medical professional liability insurance policy covering the claim; however, no information concerning policy limits shall be included in the report prepared pursuant to § 56-54-111;

     (3)  If applicable, the medical specialty of the provider named in the claim;

     (4)  The type of health care facility where the medical malpractice incident occurred;

     (5)  The primary location within a facility where the medical malpractice incident occurred;

     (6)  The geographic location, by city and county, where the medical malpractice incident occurred;

     (7)  The injured person's sex and age on the incident date;

     (8)  The severity of malpractice injury using the National Practitioner Data Bank severity scale;

     (9)  The dates of:

          (A)  The incident that was the proximate cause of the claim;

          (B)  Notice to the insuring entity, self-insurer, facility or provider;

          (C)  Suit, if a suit was filed;

          (D)  Final indemnity payment, if any; and

          (E)  Final action by the insuring entity, self-insurer, facility or provider to close the claim;

     (10)  Settlement information that identifies the timing and final method of claim disposition, including:

          (A)  Claims settled by the parties;

          (B)  Claims disposed of by a court, including the date disposed;

          (C)  Claims disposed of by alternative dispute resolution, such as arbitration, mediation, private trial and other common dispute resolution methods; and

          (D)  Whether the settlement occurred before or after trial, if a trial occurred;

     (11)  Specific information about the indemnity payments and defense and cost containment expenses, including:

          (A)  For claims disposed of by a court that result in a verdict or judgment that itemizes damages:

                (i)  The total verdict or judgment;

                (ii)  If there is more than one (1) defendant, the total indemnity paid by or on behalf of this facility or provider;

                (iii)  Economic damages;

                (iv)  Noneconomic damages;

                (v)  Punitive damages, if applicable; and

                (vi)  Defense and cost containment expenses, including court costs, attorneys' fees, and costs of expert witnesses; and

          (B)  For claims that do not result in a verdict or judgment that itemizes damages:

                (i)  The total amount of the settlement;

                (ii)  If there is more than one (1) defendant, the total indemnity paid by or on behalf of this facility or provider;

                (iii)  The insuring entity's or self-insurer's best estimate of economic damages included in the settlement;

                (iv)  The insuring entity's or self-insurer's best estimate of noneconomic damages included in the settlement; and

                (v)  Defense and cost containment expenses, including court costs, attorneys' fees, and costs of expert witnesses;

     (12)  The reason for the medical malpractice claim. The reporting entity must use the same allegation group and specific allegation codes that are used for mandatory reporting to the National Practitioner Data Bank; and

     (13)  Any other open or closed claim data the commissioner determines to be necessary to accomplish the purpose of this chapter and requires by adopting a rule. The commissioner is also authorized by rule to determine certain open or closed claim data not to necessary for submission to the commissioner.

[Acts 2008, ch. 1009, § 7.]