Ins 17.35(2)(f)(f) That the insurer will provide a defense of the insured and the fund until there has been a determination that coverage does not exist under the policy or unless otherwise agreed to by the insurer and the fund.
Ins 17.35(2)(g)(g) If the policy is a claims-made policy:
Ins 17.35(2)(g)1.1. A guarantee that the insured can purchase an unlimited extended reporting endorsement upon cancellation or nonrenewal of the policy.
Ins 17.35(2)(g)2.2. If the policy is a group policy, a provision that any health care provider, as defined under s. 655.001 (8), Stats., whose participation in the group terminates has the right to purchase an individual unlimited extended reporting endorsement.
Ins 17.35(2)(g)3.3. A prominent notice that the insured has the obligation under s. 655.23 (3) (a), Stats., to purchase the extended reporting endorsement unless other insurance is available to ensure continuing coverage for the liability of all insureds under the policy for the term the claims-made policy was in effect.
Ins 17.35(2)(g)4.4. A prominent notice that the insurer will notify the commissioner if the insured does not purchase the extended reporting endorsement and that the insured, if a natural person, may be subject to administrative action by his or her licensing board.
Ins 17.35(2b)(2b)Aggregate limits; unlimited extended reporting endorsements.
Ins 17.35(2b)(a)(a) This subsection interprets and implements s. 655.23 (4), Stats.
Ins 17.35(2b)(b)(b) Highest aggregate limit applies.
Ins 17.35(2b)(b)1.1. ‘Claims-made coverage.’ The aggregate limit applicable to all claims reported during a reporting year of a claims-made policy shall be the highest limit specified in s. 655.23 (4) (b), Stats., that applies during the reporting year.
Ins 17.35(2b)(b)2.2. ‘Occurrence coverage.’ The limit applicable to all occurrences during an occurrence year of an occurrence policy shall be the highest limit specified in s. 655.23 (4), Stats., that applies during the occurrence year.
Ins 17.35(2b)(c)(c) Unlimited extended reporting endorsements issued before January 1, 1999. Before January 1, 1999, the aggregate limit applicable to an unlimited extended reporting endorsement shall be one of the following:
Ins 17.35(2b)(c)1.1. The total amount of the annual aggregate limit specified in s. 655.23 (4), Stats., as it applied on the date of the occurrence, shall be available for each occurrence year, less amounts previously paid under any policy for that occurrence year.
Ins 17.35(2b)(c)2.2. The following minimum percentage of the annual aggregate limit specified in s. 655.23 (4), Stats., as it applied to the last reporting year of the canceled or nonrenewed claims-made policy shall be available for all claims reported under the extended reporting endorsement: 100% when the policy was in effect for 1 year or less, including any retroactive coverage period; 130% when the policy was in effect for more than 1 year, but less than or equal to 2 years, including any retroactive coverage period; 150% when the policy was in effect for more than 2 years, but less than or equal to 3 years, including any retroactive coverage period; 160% when the policy was in effect for more than 3 years, including any retroactive coverage period.
Ins 17.35(2b)(d)(d) Unlimited extended reporting endorsements issued on and after January 1, 1999. On and after January 1, 1999 the minimum aggregate limit applicable to an unlimited extended reporting endorsement shall be that specified in par. (c) 2.
Ins 17.35(2e)(2e)Requirements for group coverage.
Ins 17.35(2e)(a)(a) In this section, “provider” means a health care provider, as defined in s. 655.001 (8), Stats.
Ins 17.35(2e)(b)(b) An insurer or self-insured provider that provides primary coverage under a group policy or self-insured plan shall do all of the following:
Ins 17.35(2e)(b)1.1. At the time of original issuance of the policy or when the self-insured plan takes effect, and each time coverage for an individual provider is added:
Ins 17.35(2e)(b)1.a.a. Furnish each covered provider with a copy of the policy or a certificate of coverage specifying the coverage provided and whether the coverage is limited to a specific practice location, to services performed for a specific employer or in any other way.
Ins 17.35(2e)(b)1.b.b. Include on the first page of the policy or the certificate of coverage, or in the form of a sticker, letter or other form included with the policy or certificate of coverage, that it is the responsibility of the individual provider to ensure that he or she has health care liability insurance coverage meeting the requirements of ch. 655, Stats., in effect for all of his or her practice in this state, unless the provider is exempt from the requirements of that chapter.
Ins 17.35(2e)(b)2.2. For a policy or self-insured plan in effect on October 1, 1993, furnish the documents specified in subd. 1. a. and b. to each individual covered provider before the next renewal date or anniversary date of the policy or self-insured plan.
Ins 17.35(2e)(b)3.3. Notify each covered provider individually when the policy or self-insured plan is cancelled, nonrenewed or otherwise terminated, or amended to affect the coverage provisions.
Ins 17.35(2e)(b)4.4. On the certificate of insurance filed with the fund under s. 655.23 (3) (b) or (c), Stats., and s. Ins 17.28 (5), specify whether the coverage is limited to a specific practice location, to services performed for a specific employer or in any other way.
Ins 17.35(2m)(2m)Risk retention groups. If the policy is issued by a risk retention group, as defined under s. 600.03 (41e), Stats., each new and renewal application form shall include the following notice in 10-point type:
NOTICE
Under the federal liability risk retention act of 1986 (15 USC 3901 to 3906) the Wisconsin insurance security fund is not available for payment of claims if this risk retention group becomes insolvent. In that event, you will be personally liable for payment of claims up to your limit of liability under s. 655.23 (4), Wis. Stat.
Ins 17.35 NoteNote: Subsection (2m) first applies to applications taken on October 1, 1991.
Ins 17.35(3)(3)Permissible exclusions. A policy may exclude coverage, or permit subrogation against or recovery from the insured, for any of the following: