1. (a) Reporting responsibilities. The reporting form must be completed and forwarded to the Texas State Board of Medical Examiners for each defendant physician against whom a professional liability claim or complaint has been filed. The information is to be reported by insurers or other entities providing medical professional liability insurance for a physician. If a nonadmitted insurance carrier does not report, reporting shall be the responsibility of the physician.
2. (b) Separate reports required and identifying information. One separate report shall be filed for each defendant insured physician. When Part II is filed, it shall be accompanied by the completed Part I or other identifying information as described in subsection (d)(1) of this section.
3. (c) Timeframes and attachments. The information in Part I of the form must be provided within 30 days of receipt of the claim or suit. A copy of the claim letter or petition must be attached. The information in Part II must be reported within 105 days after disposition of the claim. Disposed claims shall be defined as those claims where a court order has been entered, a settlement agreement has been reached, or the complaint has been dropped or dismissed.

4. (d) Alternate reporting formats. The information may be reported either on the form provided or in any other legible format which contains at least the requested data.

   1. (1) If the reporter elects to use a reporting format other than the board's form for data required in Part II, there must be enough identification data available to enable board staff to match the closure report to the original file. The data required to accomplish this include:

      1. (A) name and license number of defendant physician(s); and
      2. (B) name of plaintiff.
   2. (2) A court order or settlement agreement is an acceptable alternative submission for Part II. An order or settlement agreement should contain the necessary information to match the closure information to the original file. If the order or agreement is lacking some of the required data, the additional information may be legibly written on the order or agreement.
5. (e) Penalty. Failure by a licensed insurer to report under this section shall be referred to the State Board of Insurance. Sanctions under the Insurance Code, Article 1.10, section 7, may be imposed for failure to report.
6. (f) Definition. For the purposes of this chapter a professional liability claim or complaint shall be defined as a cause of action against a physician for treatment, lack of treatment, or other claimed departure from accepted standards of medical or health care or safety which proximately results in injury to or death of the patient, whether the patient's claim or cause of action sounds in tort or contract, to include interns, residents, supervising physicians, on-call physicians, consulting physicians, and those physicians who administer, read or interpret laboratory tests, x-rays, and other diagnostic studies.

7. (g) Claims not required to be reported. Examples of claims that are not required to be reported under this chapter but which may be reported include, but are not limited to, the following:

   1. (1) product liability claims (i.e. where a physician invented a medical device which may have injured a patient but the physician has had no personal physician-patient relationship with the specific patient claiming injury by the device);
   2. (2) antitrust allegations;
   3. (3) allegations involving improper peer review activities;
   4. (4) civil rights violations; or
   5. (5) allegations of liability for injuries occurring on a physician's property, but not involving a breach of duty in the physician-patient relationship (i.e. slip and fall accidents).
8. (h) Claims that are not required to be reported under this chapter may however be voluntarily reported pursuant to the provision of the Act.
9. (i) The reporting form shall be as follows.
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Source Note:The provisions of this §179.5 adopted to be effective June 29, 2003, 28 TexReg 4633.