§928.30. Definitions

"Code" means the Illinois Insurance Code [215 ILCS 5].

 

"Department" means the Illinois Department of Insurance.

 

"Director" means the Director of the Illinois Department of Insurance.

 

"Insurance Claim" means a formal or written demand for compensation under a medical professional liability insurance policy relating to allegations of liability on the part of one or more providers, as defined in this Section, for any act, error or omission in the rendering of, or failure to render, medical services for medically related injuries. Insurance claim includes any instance for which benefits or compensation are payable or eligible to be paid under any coverage under the policy.

 

"Insurance Claim Closed" means any insurance claim, as defined in this Section, for which all indemnity and/or expense payments have been made or for which the loss or loss expense reserve is withdrawn by the insurer.

 

"Insurance Claim Filed" means any insurance claim, as defined in this Section, that alleges liability on the part of any provider, as defined in this Section, for medically related injuries and/or for which coverage is provided, for which a loss or loss expense reserve is established under a medical professional liability insurance policy.

 

"Insurer" means an insurance company that has delivered or issued for delivery in this State a medical professional liability insurance policy.

 

"Lawsuit" means a complaint filed in any court in this State alleging liability on the part of one or more providers, as defined in this Section, for any act, error or omission in the rendering of, or failure to render, medical services for medically related injuries.

 

"Lawsuit Closed" means any lawsuit, as defined in this Section, for which final disposition has been reached.

 

"Lawsuit Filed" means a lawsuit filed in any court of this State that alleges liability on the part of any physician, hospital or other health care provider for medically related injuries.

 

"Other Entity" means any stop loss insurer, captive insurer, risk retention group, county risk retention trust, religious or charitable risk pooling trust or surplus line insurer, or any other entity authorized or permitted by law to provide medical professional liability insurance as identified in Section 155.19 of the Code [215 ILCS 5/155.19].

 

"Provider" means any physician, hospital facility, or other person that is licensed or otherwise authorized to furnish health care services and also includes any other entity that arranges for the delivery or furnishing of health care services. [215 ILCS 125/1-2(12)].

 

(Source:  Amended at 36 Ill. Reg. 18677, effective December 17, 2012)