ISMIE's Approach to State Reporting Requirements

In addition to the National Practitioner Data Bank (NPDB), ISMIE is required to report certain claims outcomes to various state authorities. The extent of the reporting varies from state to state.

In Illinois, following payment of a claim, a report to the Illinois Department of Financial and Professional Regulation (IDFPR) is submitted at the same time as the report to the NPDB. ISMIE provides our policyholders with a working copy of the report before the final reports are submitted. While we cannot change the allegations made by the plaintiff, we do want you to be comfortable with the description of the acts and/or omissions that are being reported.

Approximately 30 to 60 days after receiving our report, IDFPR will send a certified letter to you indicating that a report has been submitted on your behalf. IDFPR has made it mandatory that the physician replies to the report within a stated time period. There is no mandated parameter for the length or the content of that reply. Your reply will become part of your permanent record and may deter further investigation by IDFPR. Failure to respond to the IDFPR's letter may result in a minimum $1,000 fine and an appearance before the state disciplinary board.

Illinois physicians should note: Failure to reply within the time frames given could constitute grounds for action against you.

Background on Illinois Requirements: In Illinois, the Medical Practice Act of 1987 requires that all Professional Liability Insurers that offer policies of professional liability insurance to persons licensed under this Act, or any other entity which seeks to indemnify the professional liability of a person licensed under this Act, shall report to the Disciplinary Board the settlement of any claim or cause of action, or final judgment rendered in any cause of action, with alleged negligence in the furnishing of medical care by such licensed person when such settlement or final judgment is in favor of the plaintiff.

All reports required by this Act shall be submitted to the Disciplinary Board in a timely fashion. Nothing contained in this Section shall act to in any way, waive or modify the confidentiality of medical reports and committee reports. Any information reported or disclosed shall be kept for the confidential use of the Disciplinary Board.

Failure to report to the Illinois Department of Financial and Professional Regulation any adverse judgment, settlement or awards arising from a liability claim related to acts or conduct similar to acts or conduct which would constitute grounds for action against the reporting entity.

You can contact the Illinois Department of Financial and Professional Regulation at http://www.idfpr.com.