CHAPTER 2212. SELF-INSURANCE TRUSTS FOR HEALTH CARE LIABILITY CLAIMS
INSURANCE CODE
TITLE 10. PROPERTY AND CASUALTY INSURANCE
SUBTITLE G. POOLS, GROUPS, PLANS, AND SELF-INSURANCE
CHAPTER 2212. SELF-INSURANCE TRUSTS FOR HEALTH CARE
LIABILITY CLAIMS
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 2212.001. DEFINITIONS. In this chapter:
(1) "Charitable organization" has the meaning assigned by
Section 84.003, Civil Practice and Remedies Code.
(2) "Dentist" means a person licensed to practice dentistry in
this state.
(3) "Health care liability claim" means a cause of action
against a physician or dentist for treatment, lack of treatment,
or other claimed departure from accepted standards of health care
or safety that proximately results in injury to or death of the
patient, whether the patient's claim or cause of action sounds in
tort or contract.
(4) "Physician" means a person licensed to practice medicine in
this state.
(5) "Trust" means a self-insurance trust organized and operated
under this chapter.
(6) "Volunteer health care provider" has the meaning assigned by
Section 84.003, Civil Practice and Remedies Code.
Added by Acts 2005, 79th Leg., Ch.
727, Sec. 2, eff. April 1, 2007.
Amended by:
Acts 2007, 80th Leg., R.S., Ch.
730, Sec. 3B.069(a), eff. September 1, 2007.
Acts 2007, 80th Leg., R.S., Ch.
921, Sec. 9.069(a), eff. September 1, 2007.
Sec. 2212.002. TRUST NOT ENGAGED IN BUSINESS OF INSURANCE. A
trust is not engaged in the business of insurance under this code
and other laws of this state, and this code, other than this
chapter, does not apply to the trust, except as provided by
Section 2212.052.
Added by Acts 2005, 79th Leg., Ch.
727, Sec. 2, eff. April 1, 2007.
SUBCHAPTER B. CREATION AND OPERATION OF TRUST
Sec. 2212.051. CREATION OF TRUST. (a) Subject to Subsection
(b), an incorporated association, a purpose of which is to unite
in one compact organization the entire profession licensed to
practice medicine or dentistry in this state, or a portion of the
members of the profession licensed to practice medicine who are
practicing a particular specialty within the practice of medicine
in the state or are practicing within a particular region of the
state, may create a trust to self-insure physicians or dentists
and agree, by contract or otherwise, to insure other members of
the organization or association against health care liability
claims and related risks.
(b) The organization or association must:
(1) have been in continuing existence for at least two years;
(2) have established a health care liability claim trust or
other agreement to provide coverage against health care liability
claims and related risks; and
(3) employ appropriate professional staff and consultants for
program management.
Added by Acts 2005, 79th Leg., Ch.
727, Sec. 2, eff. April 1, 2007.
Sec. 2212.052. MINIMUM REQUIREMENTS. (a) The department may
require a trust to satisfy reasonable minimum requirements that
ensure the trust is able to satisfy the trust's contractual
obligations.
(b) On request, a trust shall provide books, records, and
documents required by the department to fulfill the requirements
of this section relating to the trust's solvency.
Added by Acts 2005, 79th Leg., Ch.
727, Sec. 2, eff. April 1, 2007.
Sec. 2212.053. FILING REQUIREMENTS. (a) A trust shall file
with the department:
(1) all rates and forms, for informational purposes only;
(2) all liability claims reports required under Subchapter D,
Chapter 38; and
(3) the trust's independently audited annual financial
statement.
(b) An audited annual financial statement filed under this
section may not be considered an examination document.
Added by Acts 2005, 79th Leg., Ch.
727, Sec. 2, eff. April 1, 2007.
Sec. 2212.054. POWERS OF TRUST. (a) A trust may:
(1) purchase, on behalf of the members of the association that
created the trust, medical professional liability insurance,
specific excess insurance, aggregate excess insurance, and
reinsurance, as necessary in the opinion of the trustees;
(2) purchase required risk management services; and
(3) pay claims that arise under any deductible provisions.
(b) A trust's investment powers and limitations are the same as
the investment powers and limitations of a state bank with trust
powers.
Added by Acts 2005, 79th Leg., Ch.
727, Sec. 2, eff. April 1, 2007.
Sec. 2212.055. GUARANTEE OF CERTAIN LIABILITIES. The trust
shall adopt rules to guarantee all contingent liabilities in the
event of dissolution.
Added by Acts 2005, 79th Leg., Ch.
727, Sec. 2, eff. April 1, 2007.
Sec. 2212.056. ADMINISTRATIVE SANCTIONS. If a trust is found to
have violated this code or a rule adopted by the commissioner
that is declared applicable to the trust, the commissioner may
order sanctions under Chapter 82 for the violation.
Added by Acts 2005, 79th Leg., Ch.
727, Sec. 2, eff. April 1, 2007.
SUBCHAPTER C. INSURANCE CONTRACTS ISSUED BY TRUST
Sec. 2212.101. COVERAGE UNDER CONTRACT. A contract of
professional liability insurance issued by a trust may include
coverage of:
(1) a professional association or partnership of physicians,
with respect to health care liability claims and related risks if
a majority of the persons having a proprietary interest in the
association or partnership are members of the association that
created the trust;
(2) proprietary members, associates, stockholders, and executive
officers and directors of an association or partnership described
by Subdivision (1), with respect to potential vicarious liability
for acts or omissions of others giving rise to health care
liability claims and related risks;
(3) an insured physician and, as applicable, an insured
professional association or partnership, including proprietary
members, associates, stockholders, and executive officers and
directors of the association or partnership, with respect to
liability of an insured arising out of:
(A) injury to a patient related to ownership, maintenance, or
use of premises for the practice of medicine, including necessary
or incidental operations;
(B) service by an insured physician as a member of a committee,
board, or similar group of a hospital medical staff or of a
professional association or society with respect to medical staff
privileges, accreditation, or disciplinary matters relating to
competency or patient safety and risk reduction programs; or
(C) a health care liability claim or related risk based in whole
or part on an act or omission occurring before the date a
contract of professional insurance is issued by the trust; or
(4) an applicant for membership in the association that created
the trust, pending final action on the application, with respect
to health care liability claims and related risks, including
coverage described by Subdivision (1), (2), or (3), as
applicable.
Added by Acts 2005, 79th Leg., Ch.
727, Sec. 2, eff. April 1, 2007.
Sec. 2212.102. COVERAGE FOR VOLUNTEER HEALTH CARE PROVIDERS.
(a) The trust, in accordance with Section 2212.054, may make
available professional liability insurance covering a volunteer
health care provider for an act or omission resulting in death,
damage, or injury to a patient while the person is acting in the
course and scope of the person's duties as a volunteer health
care provider as described by Chapter 84, Civil Practice and
Remedies Code.
(b) This section does not affect the liability of a volunteer
health care provider who is serving as a direct service volunteer
of a charitable organization. Section 84.004(c), Civil Practice
and Remedies Code, applies to the volunteer health care provider
without regard to whether the volunteer health care provider
obtains liability insurance under this section.
(c) The trust may make professional liability insurance
available under this section to a volunteer health care provider
without regard to whether the volunteer health care provider is a
physician or dentist.
Added by Acts 2007, 80th Leg., R.S., Ch.
730, Sec. 3B.070(a), eff. September 1, 2007.
Added by Acts 2007, 80th Leg., R.S., Ch.
921, Sec. 9.070(a), eff. September 1, 2007.