Injured patients and families compensation Fund Wisconsin Office of the Commissioner of Insurance June 1, 2018

INJURED PATIENTS AND FAMILIES COMPENSATION FUND The Fund was created by the Legislature in 1975 Provides medical malpractice coverage in excess of primary limits Current limits are $1,000,000/3,000,000 Evidence of primary coverage required to be submitted by primary insurance carrier Participation in the Fund is mandatory for physicians, CRNAs, hospitals, Ambulatory Surgery Centers, and corporate entities providing the medical services of physicians and/or CRNAs

INJURED PATIENTS AND FAMILIES COMPENSATION FUND Governance of the Fund is vested with a 13 member Board of Governors. The Commissioner of Insurance is the Chair of the Board. Administrative staff is provided by OCI The Board is assisted by various committees Legal Committee Claims Committee Finance/Investment/Audit Committee Actuarial and Underwriting Committee Risk Management Committee

Fund Administration The Office of the Commissioner of Insurance provides the administrative staff to perform the day to day operations of the Fund Full time in office staff of 7 Contracts with outside vendors for: Actuarial, Claims Handling, Risk Management and Investment Performance Analysis

THE BOARD of Governors The Board of Governors takes a very active roll in the Fund; it monitors the medical malpractice environment and is proactive in addressing changes in the practice of medicine. As issues arise, the Board will establish special committees to identify any possible effects to the Fund Since the inception of the Fund, there have been multiple changes affecting the Fund, both environmental and legislative. The Board has strived to address these timely and effectively

CURRENT STATE OF MEDICAL MALPRACTICE IN WI Factors which have contributed to a favorable medical malpractice environment include: Creation of the Fund Mandatory primary insurance coverage Pro-active risk management programs performed by hospitals and health care organizations In addition, Wisconsin, as compared to some states, does not allow for punitive damages in medical malpractice

Chapter 655 Governing statute for the Injured Patients and Families Compensation Fund Defines provider Mandatory participation Physician (MD, DO) and CRNA for whom Wisconsin is the principal place of practice More than 240 hours in a fiscal year

Chapter 655 Optional Participation Practicing fewer than 241 hours in a fiscal year May elect to participate in the Fund, but only applies to claims arising out of practice in Wisconsin

Chapter 655 Exemptions Not principal place of practice, less than 50% of income or fewer than 240 hours in a fiscal year Public employees, facilities and volunteers State, county, municipal or federal employee or a contractor covered under the federal tort claims act Facilities operated by any governmental agency Volunteer Agents of the state

Fees and Rate Setting Fees are established annually by the Board based upon a recommendation from the Actuarial Committee and information provided by the outside actuaries There have been decreases in the Fund fee assessments for the last five consecutive years

Assessments Assessments are triggered when a certificate of insurance is received in the Fund computer system Assessments are based on the classification and ISO Code provided on the certificate of insurance Invoices are sent annually in the middle of June and due by July 15 of each fiscal year Approximately 80% of assessments are paid for the entire year Classification changes will trigger an increase or decrease in the assessment

Primary Insurance Primary insurance coverage must be purchased by an authorized insurer or approved risk retention group 22 Insurance Companies 2 Risk Retention Groups (RRG)

Claims Primary coverage is $1 million per incident, $3 million aggregate Fund coverage begins after primary limit is met Wisconsin is the only state that pays unlimited economic damages for claims

QUESTIONS

Internet: www.oci.wi.gov CONTACTING THE FUND Internet: www.oci.wi.gov Terri Carlson 608-267-1237 Terri.Carlson@wisconsin.gov