Ins 17.25Ins 17.25 Wisconsin health care liability insurance plan. Ins 17.25(1)(a)(a) Legislation has been enacted authorizing the commissioner to promulgate a plan to provide health care liability insurance and liability coverage normally incidental to health care liability insurance for risks in this state which are equitably entitled to but otherwise unable to obtain such coverage, or to call upon the insurance industry to prepare plans for the commissioner’s approval. Ins 17.25(1)(b)(b) Health care liability insurance, liability coverage normally incidental to health care liability insurance or both are not readily available in the voluntary market for the persons specified in sub. (5) (a). Ins 17.25(1)(c)(c) A plan for providing health care liability insurance and liability coverage normally incidental to health care liability insurance should be enacted pursuant to ch. 619, Stats. Ins 17.25(2)(2) Purpose. This section implements ss. 619.01 and 619.04, Stats., by establishing procedures and requirements for a mandatory risk sharing plan to provide health care liability insurance coverage and liability coverage normally incidental to health care liability insurance on a self-supporting basis for the persons specified in sub. (5) (a) and for their employees acting within the scope of their employment and providing health care services. This section is also intended to encourage improvement in reasonable loss prevention measures and to encourage the maximum use of the voluntary market. Ins 17.25(3)(a)(a) Each policy of health care liability insurance coverage issued by the plan shall provide occurrence coverage for all of the following: Ins 17.25(3)(a)1.1. Providing or failing to provide health care services to a patient. Ins 17.25(3)(a)2.2. Peer review, accreditation and similar professional activities in conjunction with and incidental to the provision of health care services, when conducted in good faith by the insured or an employee of the insured. Ins 17.25(3)(a)3.3. Utilization review, quality assurance and similar professional activities in conjunction with and incidental to the provision of health care services, when conducted in good faith by the insured or an employee of the insured. Ins 17.25(3)(b)(b) Each policy issued by the plan shall also provide for supplemental payments in addition to the limits of liability under par. (d), including attorney fees, litigation expenses, costs and interest. Ins 17.25(3)(c)(c) The health care liability insurance coverage issued by the plan shall exclude coverage for all of the following: Ins 17.25(3)(c)5.5. Employment, religious, racial, sexual, age and other unlawful discrimination. Ins 17.25(3)(c)7.7. Acts that occurred before the effective date of the policy of which the insured was aware or should have been aware. Ins 17.25(3)(c)8.8. Incidents occurring while and insured’s license to practice is suspended, revoked, surrendered or otherwise terminated. Ins 17.25(3)(c)11.11. Liability of the insured covered by other insurance, such as worker’s compensation, automobile, fire or general liability. Ins 17.25(3)(c)12.12. Liability arising out of the ownership, operation or supervision by the insured of a hospital, nursing home or other health care facility or business enterprise. Ins 17.25(3)(c)13.13. Liability of others assumed by the insured under a contract or agreement. Ins 17.25(3)(d)(d) The maximum limits of liability for coverage under par. (a) are the following: Ins 17.25(3)(d)1.1. For all occurrences before July 1, 1987, $200,000 for each occurrence and $600,000 per year for all occurrences in any one policy year. Ins 17.25(3)(d)2.2. For occurrences on or after July 1, 1987, and before July 1, 1988, $300,000 for each occurrence and $900,000 for all occurrences in any one policy year.