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SECOND REGULAR SESSION
SENATE BILL NO. 1310
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR TRENT.
4702S.01I KRISTINA MARTIN, Secretary
AN ACT
To repeal section 383.155, RSMo, and to enact in lieu thereof one new section relating to the
medical malpractice joint underwriting association.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Section 383.155, RSMo, is repealed and one new 1
section enacted in lieu thereof, to be known as section 383.155, 2
to read as follows:3
383.155. 1. A joint underwriting association may be 1
created, or directed to resume operations, upon 2
determination by the director after a public hearing that 3
medical malpractice liability insurance is not reasonably 4
available for health care providers in the voluntary 5
market. The association shall contain as members all 6
companies authorized to write and engaged in writing, on a 7
direct basis, any insurance or benefit, the premium for 8
which is included under the definition of "net direct 9
premiums". Membership in the association shall be a 10
condition of continued authority to do business in this 11
state. 12
2. A plan of operation shall be adopted to be 13
effective concurrently with the effective date of the 14
association. 15
3. The association shall, pursuant to the provisions 16
of sections 383.150 to 383.195 and the plan of operation, 17
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with respect to medical malpractice insurance, have the 18
authority on behalf of its members: 19
(1) To issue, or to cause to be issued, policies of 20
insurance to applicants, including incidental coverages and 21
subject to limits as specified in the plan of operation but 22
not to exceed one million dollars for each claimant under 23
one policy and three million dollars for all claimants under 24
one policy in any one policy year; 25
(2) To underwrite such insurance and to adjust and pay 26
losses with respect thereto, or to appoint a service company 27
to perform those functions; 28
(3) To assume reinsurance from its members; and 29
(4) To cede reinsurance. 30
4. Within forty-five days following the creation of 31
the association, the directors of the association shall 32
submit to the director for his or her review, a proposed 33
plan of operation, consistent with the provisions of 34
sections 383.150 to 383.195. 35
5. The plan of operation shall provide for economic, 36
fair and nondiscriminatory administration and for the prompt 37
and efficient distribution of medical malpractice insurance, 38
and shall contain other provisions including, but not 39
limited to, preliminary assessment of all members for 40
initial expenses to commence operations, establishment of 41
necessary facilities, management of the association, 42
assessment of members to defray losses and expenses, 43
reasonable and objective underwriting standards, acceptance 44
and cession of reinsurance, appointment of a servicing 45
company and procedures for determining amounts of insurance 46
to be provided by the association. The preliminary 47
assessment shall be an advance to be recouped under the 48
provisions of subsection 5 of section 383.160. 49
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6. The composition of the board and the terms of 50
directors of the board shall be established by the plan of 51
operation. 52
7. The plan of operation shall be subject to approval 53
by the director after consultation with the members of the 54
association, representatives of the public and other 55
affected individuals and organizations. If the director 56
disapproves all or any part of the proposed plan of 57
operation, the directors shall within fifteen days submit 58
for review a revised plan of operation. If the directors 59
fail to do so, the director shall promulgate a plan of 60
operation or part thereof, as the case may be. The plan of 61
operation approved or promulgated by the director shall 62
become effective and operational upon his or her order. 63
8. Amendments to the plan of operation may be made by 64
the directors of the association, subject to the approval of 65
the director or shall be made at his direction. 66
9. There shall be no liability imposed on the part of 67
and no cause of action of any nature shall arise against any 68
member insurer or any member of the board of directors for 69
any omission or action taken by them in the performance of 70
their powers and duties under sections 383.150 to 383.195. 71
10. (1) The directors of the board may suspend the 72
operations of the association if the directors determine 73
that medical malpractice insurance is reasonably available 74
to health care providers in the voluntary market if there 75
are two or fewer individual physicians insured annually for 76
at least two consecutive years. 77
(2) Suspension of operations of the association is to 78
be in accordance with its plan of operation, or any 79
amendment thereto. The plan of operation shall establish 80
the process for suspension of operations and shall include 81
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provisions for the administration of association funds until 82
the director determines either to resume operations under 83
subsection 1 of this section, or to terminate operations in 84
compliance with section 383.195. 85
(3) During any period of suspension, the association 86
shall not collect dues or fees from its members unless and 87
until the director authorizes an assessment or authorizes 88
the resumption of operations as provided herein. 89
(4) As used in this section, "reasonably available" 90
shall mean that medical malpractice insurance products are 91
offered to health care providers through voluntary markets 92
by insurance carriers in the ordinary course of business. 93
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