The Vendor is required to provide to administer claims services on behalf of the fund which includes, but is not limited to, administration, adjusting and management of claims including monitoring a case through to final resolution, management and oversight of all litigation, maintenance of claims data, and production of reports as directed by office, and all in accordance with all applicable state and federal statutes, rules, and regulations.
- Provide to protect the best interests of the insurance consumers of state through the development of trade practice regulations, monitoring and enforcement activities, and consumer education and outreach efforts.
- The Fund pays the portion of a medical malpractice claim that exceeds the statutory limits of liability of a covered health care provider.
- Health care providers participating in the Fund pay for the protection through an annual assessment.
- The money collected is held in trust to pay for medical malpractice claims and administrative costs of the Fund.
- Must prepare quarterly updated case summaries and furnish additional information on, and access to, claim files as requested by office and/or Claims Committee.
- Must manage Future Medical Expense accounts.
- Receive all claims filed against the Fund, and establish and maintain files, records, and materials on all claims, including significant documentation affecting the decision-making process on each claim.
- As of June 30, 2024, there were a total of 19,732 Fund active participants comprised of 155 hospitals with 12 affiliated nursing homes, 17,193 physicians, 1,111 nurse anesthetists, 16 hospital-owned or controlled entities, 64 ambulatory surgery centers, one cooperative, 10 partnerships, and 1,170 corporations. As of June 30, 2024, Fund participants consisted of 87% physicians, 6% corporations, and the remaining 7% included all other participants.
- There are approximately 100 claims filed with the Fund each year and this number may vary significantly. Historically there have been as many as 250 cases open at any given time, although that number has decreased over the last several years.
- The administration of Fund claims is done on the Oracle Insurance Policy Administration system. Claims information generated by the system is used by the company currently administering the claims function as well as fund staff in area.
- Office is responsible for the format of reports generated.
- Contract Period/Term: 1 year
- Questions/Inquires Deadline: January 19, 2026
