Ins 17.285 History History: Cr. Register, February, 1988, No. 386, eff. 3-1-88; am. (2) (a) and (b), (3) (a) and (c) 2., (5) (b) (intro.), (7) (a), (8), (9) (a), (11) (f) and (14), cr. (2m) and (4) (c) 2., renum. (4) (c) to be (4) (c) 1., Register, June, 1990, No. 414, eff. 7-1-90; am. (2) (a), (b), (d) and (e), (7) (b), (11) (a), (c) to (e) (intro.) and 1., (f) and (12), renum. (3) (a), (4) (b) (intro.) and 1., (5) (d), (8) to be (3), (4) (c), (5) (e) and (7) (c) and am. (3), (4) (c) and (7) (c), r. (3) (b) and (d), (4) (b) 2., (c) (d), (6) and (11) (b), cr. (2) (cg) and (cr), (2s), (4) (b), (5) (d) and (f), (9) (am), r. and recr. (4) (a), (5) (a) to (c) and (9) (a), Register, January, 1992, No. 433, eff. 2-1-92; CR 03-039: cr. (14) Register October 2003 No. 574, eff. 11-1-03.

Ins 17.29 Ins 17.29 Servicing agent.

Ins 17.29(1) (1) Purpose. This section implements s. 655.27 (2), Stats., relating to contracting for claim services for the fund.

Ins 17.29(2) (2) Criteria. The board shall establish the criteria for the selection of the servicing agent prior to the expiration of each contract term.

Ins 17.29(3) (3) Selection. The commissioner, with the approval of the board, shall select a servicing agent through the competitive negotiation process.

Ins 17.29(4) (4) Contract term. The commissioner, with the approval of the board, shall establish the term of the contract with the servicing agent. The contract shall include a provision for its cancellation if performance or delivery is not made in accordance with its terms and conditions.

Ins 17.29(5) (5) The servicing agent shall perform all of the following functions:

Ins 17.29(5)(am) (am) Reporting to the claims committee of the board on claim files identified by that committee, at the times and in the manner specified by that committee.

Ins 17.29(5)(b) (b) Establishing and revising case reserves.

Ins 17.29(5)(c) (c) Contracting for annuity payments as part of structured settlements under guidelines adopted by the board.

Ins 17.29(5)(d) (d) Investigating and evaluating claims.

Ins 17.29(5)(e) (e) Negotiating to settlement all claims made against the fund except in cases where this responsibility is retained by the claims committee of the board.

Ins 17.29(5)(f) (f) Filing with the commissioner and the board the annual report required under s. 655.27 (2), Stats., and any other report requested by the commissioner or the board.

Ins 17.29(5)(g) (g) Reviewing court orders, verdicts and judgments and making recommendations on appeals.

Ins 17.29(5)(h) (h) All other functions specified in the contract.

Ins 17.29 History History: Cr. Register, February, 1984, No. 338, eff. 3-1-84; am. (1), (3) and (4), r. and recr. (2), r. (5) (a), renum. (5) (b) to be (5) and am. (5) (intro.), (b) to (g), cr. (5) (am) and (h), Register, June, 1990, No. 414, eff. 7-1-90.

Ins 17.30 Ins 17.30 Peer review council assessments.

Ins 17.30(1) (1) Purpose. This section implements ss. 655.27 (3) (am) and 655.275 (6), Stats., relating to the assessment of fees sufficient to cover the costs, including the costs of administration, of the patients compensation fund peer review council appointed under s. 655.275 (2), Stats.

Ins 17.30(2) (2) Assessments.

Ins 17.30(2)(a) (a) The following fees shall be assessed annually beginning with fiscal year 1986-87:

Ins 17.30(2)(a)1. 1. Against the fund, one-half of the actual cost of operating the council for each fiscal year, less one-half of the amounts, if any, collected under subd. 3.

Ins 17.30(2)(a)2. 2. Against the plan, one-half of the actual cost of operating the council for each fiscal year, less one-half of the amounts, if any, collected under subd. 3.

Ins 17.30(2)(a)3. 3. Against a private medical malpractice insurer, the actual cost incurred by the council for its review of any claim paid by the private insurer, if the private insurer requests a recommendation on premium adjustments with respect to that claim under s. 655.275 (5) (a) 3., Stats.

Ins 17.30(2)(b) (b) Amounts collected under par. (a) 3. shall be applied to reduce, in equal amounts, the assessments under par. (a) 1. and 2. for the same fiscal year.

Ins 17.30(3) (3) Payment. Each assessment under sub. (2) shall be paid within 30 days after the billing date.

Ins 17.30 History History: Cr. Register, June, 1987, No. 378, eff. 7-1-87; am. (2) (a) 1. and 2., Register, June, 1990, No. 414, eff. 7-1-90.

Ins 17.35 Ins 17.35 Primary coverage; requirements; permissible exclusions; deductibles.

Ins 17.35(1) (1) Purpose. This section implements ss. 631.20 and 655.24, Stats., relating to the approval of policy forms for health care liability insurance subject to s. 655.23, Stats.

Ins 17.35(2) (2) Required coverage. To qualify for approval under s. 631.20, Stats., a policy shall at a minimum provide all of the following: