Wis. Admin. Code Office of the Commissioner of Insurance § Ins 17.40 - Notice to fund of filing of action outside this state

Current through March 28, 2022

(1) PURPOSE. This section implements s. 655.27(5) (a) and (b), Stats., relating to the requirement that the fund be notified of an action filed outside this state within 60 days of service of process on the health care provider or the employee of the health care provider and relating to the duty of the insurer or self-insurer of the provider to provide an adequate defense of the fund and act in good faith and in a fiduciary relationship with respect to any claim affecting the fund.

(2) PRIMARY INSURER OR SELF-INSURER TO GIVE NOTICE TO FUND. A primary insurer or self-insurer for a health care provider or employee of a health care provider shall notify the fund in writing within 60 days of the insurer or self-insurer's first notice of the filing of an action outside this state alleging medical malpractice against its insured health care provider or the employee of its insured health care provider or within 60 days of service of process on the insured health care provider or employee thereof, whichever is later. The notice shall provide at a minimum the names and addresses of the parties plaintiff and defendant, the court in which the action is filed, the case number, and copies, if available, of the complaint in the action and answer filed on behalf of the defendant provider.

(3) FAILURE TO GIVE NOTICE. If the primary insurer or self-insurer fails to give notice to the fund as required in sub. (2), the board shall deny fund coverage for the action filed outside this state unless the primary insurer demonstrates, and the board finds, all of the following:

(a) The fund was not prejudiced by the failure to give notice as required, and

(b) It was not reasonably possible to give notice within the time limit.

(4) FAILURE TO ACT IN GOOD FAITH. If the board denies coverage pursuant to sub. (3), then failure to give notice to the fund of the filing of an action outside this state as required in sub. (2) constitutes a failure to act in good faith on the part of the insurer or self-insurer in violation of s. 655.27(5) (b), Stats.

Notes

Wis. Admin. Code Office of the Commissioner of Insurance § Ins 17.40

CR 03-038: cr. Register October 2003 No. 574, eff. 11-1-03.