Amendment 1418 to Senate Bill 406

Senate Judiciary
March  22, 2012
Amendment to SB 406

1    Amend the bill by replacing all after  the enacting clause  with the following:
3              1 Findings and Purpose.
4                    I.   The  general court  finds  that the  legal  system   for  resolving claims  for  medical  injury
5      requires reform   to  encourage the  fast   and  efficient   payment of  meritorious claims.   Under   the
6       current system  individuals with  meritorious claims  wait  for  an  uncertain recovery  while  medical
7      providers are deprived of a fair and  reasonable opportunity to address and resolve claims in a timely
8     manner.  In  addition,  the  general public  is  adversely affected   because   significant resources are
9       diverted from  health care  and  spent on  litigation costs  and  defensive   medicine.    The  result is  a
10      system  that has higher than necessary health care costs, higher  liability insurance premiums, higher
11      health insurance premiums, and  ultimately reduced  access to care.
12                    II.  These overarching conclusions  are based  upon the following factual findings:
13                           (a)    Inconsistent  Results: Recent   data   presented  to  the  general court   by  the   New
14      Hampshire insurance department pursuant  to  RSA 519-B:14,  II  shows  that the  current  medical
15      injury  liability system   produces inconsistent results with  average indemnity payments on similar
16      claims varying substantially from year to year.
17                           (b)  Long waits for the parties: The testimony before the general court  demonstrates that
18      medical  injury  cases are highly  complex, requiring specialized medical evidence  and  testimony.  This
19      complex  medical  evidence  and  testimony requires additional discovery  and  case  preparation that
20       results in a particularly lengthy process for resolving cases.
21                           (c)  Costly litigation: Recent  data  presented to the  general court  by the  New Hampshire
22       insurance department pursuant to RSA 519-B:14,  II shows  that the  aggregate administrative and
23      litigation costs for all claims  for medical  injury nearly  exceed the  amount that claimants receive for
24       their  injuries.
25                           (d)  Access to care:  The testimony before the  general court  has established that access to
26       care  in  New Hampshire can  be compromised by the  negative aspects of the  current medical  injury
27       system   as  physicians and  other   providers avoid  high  risk   medical  specialties and/  or  high  risk
28      treatments in order  to avoid exposure to liability.
29                           (e)  Defensive  medicine:  Data  from  the  American Medical  Association, Gallup,  Harvard
30       School of Public  Health, Health Affairs  Magazine,  and  other  reliable sources estimate that defensive
31       medicine,  practiced in  response to the  current medical  injury  system, increases the  annual health
32       care expenditures in the United  States by billions of dollars. These  organizations consider  defensive

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1    medicine  to be diagnostic tests or treatments that have  little  or  no expected  benefit  to the  patient,
2     .  ordered primarily as a means to guard  against claims ofliability.
3                    III.  The legislature further finds that the slow, inconsistent, and costly nature of the existing
4       medical  injury  litigation system  has  a detrimental impact  upon  injured claimants, whose  medical
5      and economic needs  require rapid  resolution of their  claims  with  less uncertainty, risk,  and  costs, as
6       well as  upon  medical  providers whose  provision  of patient care  is disrupted by lengthy and  costly
7      litigation of medical injury  claims.
8                    IV.  Therefore,  the important governmental objective of this  act is to supplement the existing
9       medical  injury  compensation system  with  an  alternative system that will provide  fast  and  certain
10       results for those who use it, while preserving access to the court system  and  medical injury  screening
11       panels for parties that choose to resolve claims  under  the current system. The general court further
12      finds  that the  early  offer process  set  forth  in  RSA 519·C as inserted by this  act  to resolve  medical
13      injury  claims is substantially related to this important governmental objective.
14                    V.  The general court further finds that medical  injury claimants will benefit  from the early
15      offer process set forth  in RSA 519·C as inserted by this  act as it provides  the option of a simple,  clear
16      process  defined  in statute that provides  prompt  and  sure  recovery  of all economic losses  associated
17      with  meritorious claims  settled pursuant to RSA 519·C.  The early  offer process,  if elected,  would be
18      more  efficient  and  cost  effective  in  many  cases  than the  high  risk,  high  cost  traditional litigation
19      process.
20                    VI.    In  exchange   for  the  benefits of the  early  offer  process  established in  this  act,  the
21      claimant agrees  to participate fully in  the  process,  which  may  affect  the  damages the  claimant can
22      recover,  the fees the claimant’s attorney may receive, and  other  important rights or claims  that may
23       exist under  the existing system.
24                    VII.   The  general court  finds  that the  benefits to the  public  and  to the  parties to medical
25       injury  claims from the process established in this  act far exceed the burdens imposed  on the general
26      public and medical injury claimants.
27             2  New Chapter; Early  Offers for Medical Injury Claims.   Amend  RSA by inserting after  chapter
28       519-B the following new chapter:

29                                                                                 CHAPTER 519·C
30                                                 EARLY OFFERS  FOR MEDICAL INJURY  CLAIMS
31             519-C:1  Definitions. In this chapter:
32                    I.   “Claim  for  medical  injury”  means  any  claim  against a  medical  care  provider,   whether
33      based in tort, contract, or otherwise, to recover damages on account of a medical injury.
34                    II.   “Claimant” means  an  individual who, in his or her  own right,  or on behalf  of another as
35      ·otherwise permitted by law, is seeking  compensation for a medical injury.
36                    III.   “Early  offer” means  an offer to pay an injured person’s  economic loss,  and  a reasonable
37      attorney fee related to a medical  injury.   No other  damages of any kind shall be included  in an early

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1    offer under  this chapter.
2                    IV.    “Economic  loss”  means   monetary  expenses incurred  by  or  on  behalf  of  a  claimant
3      reasonably related to a medical  injury, including actual out-of-pocket  medical  expenses, replacement
4       services,   additional payment to  the  claimant pursuant to  RSA  519-C:7,  and  100  percent of  the
5      claimant’s wages  or income  from  self-employment or contract work  lost  as  a result of the  medical
6       mJury.      Economic   loss   does   not   include:   pain    and   suffering,  punitive  damages,  enhanced
7     compensatory damages, exemplary damages, hedonic  damages, inconvenience, physical impairment,
8     mental  anguish,  emotional pain   and   suffering,  and   loss   of  the   following:  earning  capacity,
9      consortium,  society,   companionship,  comfort,   protection, marital  care,   parental care,   attention,
10      advice, counsel,  training, guidance  or education, and all other  non-economic damages of any kind.
11                    V.   “Medical  care  provider”  means a physician, physician’s assistant,  registered or licensed
12      practical nurse, hospital, clinic,  or  other  health care  provider  or  agency  licensed   by the  state,  or
13      otherwise lawfully  providing medical care or services,  or an officer, employee,  or agent thereof  acting
14      in the course of and scope of employment.
15                    VI.   “Medical  injury”  or “injury”  means  any  adverse, untoward, or  undesired consequences
16      caused   by  professional services  rendered  by  a  medical   care   provider,  whether  resulting  from
17       negligence,  error,  or  omission  in  the  performance of such  services; from  rendition of such  services
18      without  informed   consent   or  in  breach   of  warranty or  in  violation   of  contract; from  failure  to
19      diagnose; from  premature  abandonment of  a  patient or  of  a  course  of  treatment; from  failure
20       properly  to  maintain  equipment or  appliances  necessary  to  the   rendition  of  such   services;  or
21      otherwise arising out of or sustained in the course of such services.
22                    VII.  “Notice of injury”  means  written notice provided  to the medical  care  provider  alleged  to

23       have caused  a medical  injury, and containing:

24                            (a)  The name and address of the claimant;
25                            (b)  The date and  place of the medical injury;

26                             (c) The nature of the injury;

27                             (d)  An explanation, if known,  as to how the injury is alleged  to have been caused;

28                            (e)  The severity of the injury using the National Practitioner Data Bank  severity scale;

29                           (f)      Medical   records    and   medical   bills   associated  with   the   injury    or   a   limited

30       authorization  allowing   the   medical   care   provider   to  obtain  medical   records   and   medical   bills

31       associated with  the injury;

32                           (g)   Evidence  of lost  wages  or  mcome  from  self-employment or  contract work  for  the

33       individual  suffering  a  medical   injury,   which   may   be  supplied  through  income   tax   returns  or

34      paycheck  stubs for  the  year  prior  to the  injury  and  any  subsequent records  up  to the  date  of the

35      notice of injury, or a limited authorization allowing the medical care provider to obtain
such records;

36                           (h)   A demand for economic  loss  resulting from  the  injury,   that includes only  medical

37      expenses,  replacement  services,   reasonable attorney  fees,  and  lost  wages,  or  income  from  self-

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1     employment or contract work; and

2                           (i)  A request that the  medical  care  provider  extend  an  early  offer of settlement of the
3      claim.

4                    VIII.     “Personal  representative”  means  an   executor,   administrator,  successor   personal

5      representative, or  special administrator  of  a  decedent’s estate  or  a  person   legally  authorized  to

6      perform  substantially the same functions.

7                    IX.    “Reasonable attorney  fee”  means 20  percent of the  present value  of the  claimant’s

8       economic loss.

9                    X.  “Replacement services”  means  expenses reasonably incurred in  obtaining ordinary and

10      necessary services  from  others,   who are  not  members  of the  injured person’s household, in  lieu  of

11       those  the  injured person   would  have  performed for  the  benefit   of  the household,  but  could  not

12      because  ofthe injury.

13                    XI.   “Wages”  means monetary payment for services rendered, and  the reasonable value  of

14      board,  rent,  housing,  lodging, fuel, or a similar advantage received  from the employer  and  gratuities

15      received  in the  course  of employment from others than the  employer; but  “wages” shall  not include

16       any  sum   paid  by  the  employer   to  the  employee  to  cover  any  special   expenses incurred  by  the

17      employee   because   of  the   nature  of  the   employment.    For  individuals  receiving   unemployment

18      benefits  pursuant to RSA 282-A:25 at the time of the injury, wages shall equal  the wage rate  used to

19       determine the  unemployed individual’s  unemployment benefit  pursuant to  RSA 282-A:25.   For  a

20       minor  who is injured prior  to reaching the  age of 18 and  who is unable  to perform  any  gainful  work

21       as  a  result of the  medical  injury,   upon  reaching the  age  of 18  wages  shall equal  the  mean   New

22       Hampshire per  capita   income  as  shown   by  the  American  Community Survey’s  1-year

23       (inflation adjusted), produced  by the United  States Census  Bureau.

24              519-C:2  Procedure.

25                    I.  After a medical injury, the injured claimant or personal representative may:

26                           (a)  Pursue resolution of a claim for medical injury pursuant to this chapter; or

27                           (b)  Pursue an action for medical injury as provided in RSA 507-E and RSA 519-B.

28                    II.  For so long as the claimant and  medical  provider  are proceeding under  this chapter, this

29       section  shall govern  the  procedure for  resolving the  medical  injury   claim  at issue  between the  2

30      parties, notwithstanding any other  provision  oflaw.

31                    III.   If the claimant elects  to pursue a remedy  under  this  chapter, the claimant shall serve  a

32       notice of injury  to the  medical  care provider  alleged  to be responsible for the injury  and  an executed

33       notification and  waiver  of rights in  the  form  set  forth  in  RSA 519-C:13,  by certified mail,  return

34      receipt  requested.

35                    IV.   Upon  the  receipt   by  the  medical  care  provider  of a  notice  of injury and  an  executed

36       notification and waiver  of rights, the medical care provider  may elect to:

37                           (a)  Extend an early  offer of settlement; or

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1                    (b)  Decline to extend  an early offer of settlement.

2                    V.  A claimant’s failure to submit a notice of injury requesting an  early offer, or a provider’s

3      failure   to  extend   an  early   offer,  shall not  be  subject to  review   in  any  hearing, court,  or  other

4      proceeding of any kind.

5                    VI.   The  medical  care  provider  shall  respond  to the  claimant’s notice  of injury in  writing,

6      within 90 days, setting forth  the details of its early  offer, or indicating that the  medical care provider

7      has decided  not to extend  an early  offer of settlement.  The medical  care  provider’s written response

8       shall  be sent  by certified mail,  return receipt  requested, to the  address provided  in  the  claimant’s

9       notice of injury.

10                    VII.    The  medical  care  provider  may  request in  writing that an  individual who  alleges  a

11      medical  injury   submit  to  an  examination  by  a  qualified   physician  chosen  by  the   medical  care

12      provider  at a time and  place reasonably convenient for the claimant.  The examining physician shall

13      not  be affiliated with  the  medical  care  provider  alleged  to have  caused  the injury.  The cost of the

14      examination, including reasonable travel expenses for the claimant, shall be the responsibility of the

15      medical  care  provider.  Any physician conducting medical  examinations under  this  section  shall  be

16      certified   by  the   appropriate  specialty  board   as  recognized   by  the   American   Board   of  Medical

17      Specialties and  in  good standing with  the  New Hampshire board  of medicine.   The  claimant may

18      request a video recording of the examination at his or her own expense.

19                    VIII.     If the   medical   care   provider   requests that  the   claimant  submit  to  a  physical

20       examination as set forth  in paragraph VII, the time allowed for a medical care provider  to respond  to

21       the claimant’s notice of injury  shall  be extended by 30 days.

22                    IX. If the medical care provider  extends an early offer, the claimant shall accept or reject the

23       medical  care  provider’s written  offer  in  writing within   60  days  of the  offer  being  made  to  the

24       claimant.  If the claimant requests a hearing pursuant to RSA 519-C:10, to resolve  any dispute with

25       respect to the content of an early offer, the timeframe within which the claimant may accept or reject

26      the  early  offer shall  be extended until  10 days  after  the  decision  on the  disputed issue  is issued  by

27      the insurance commissioner.

28                    X.  If the  claimant accepts  the  medical  care  provider’s early  offer, the  claimant shall  notify

29      the  medical  care  provider  in writing  by certified  mail,  return receipt  requested, and  thereafter, the

30      claimant is barred from  pursuing any  claim  for the  same  medical  injury against any  medical  care

31      provider.

32                    XI.   If the  claimant does  not  accept  the  medical  care  provider’s early  offer as  provided  by

33      paragraphs IX and  X, the  early  offer shall be considered rejected  by the  claimant 60 days  after  the

34      medical  care provider  made  the early  offer.  When an early  offer is rejected,  a claimant may pursue

35       an action  for medical injury against the medical  care provider  pursuant to RSA 507-E and  RSA 519-

36      B.    However,  in  order   to  prevail  against a  medical  care  provider   that  extended an  early  offer

37      pursuant to this chapter, the claimant shall prove by clear  and  convincing  evidence  that the  medical

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1    care provider acted  with gross negligence  in causing the injury.

2              519·C:3   Unrepresented  Claimant.   If the  claimant is  not  represented by legal  counsel,  upon

3      receiving notice  of the  claim  for  medical  injury,   the  medical  care  provider shall provide  a  neutral

4       mediator, at  the medical care  provider’s expense,  to offer assistance to the claimant and  medical  care

5      provider under this chapter.

6             519-C:4  Confidentiality.

7                    I.   Proceedings, records,  and  communications during negotiation of an  early  offer shall be

8      treated as private and  confidential by the  claimant and  the  medical  care provider.  The outcome  and

9       any  other  writings, evidence, or statements made  or offered  by a party or a party’s representative

10      during negotiation of an early  offer are  not admissible in court or in a screening panel  hearing under

11      RSA 519-B, shall not  be submitted or used  for any  purpose in a subsequent trial, and shall not  be

12      publicly disclosed.

13                    II.   A notice of injury  provided  pursuant to RSA 519-C:2,  III,  and subsequent actions  taken

14      pursuant to  this  chapter shall be  exempt   from  the  reporting requirements of   RSA 329:17  and

15      administrative rules  adopted thereunder, unless  the  parties reach  a settlement under  this  chapter.

16      Settlements reached pursuant  to this  chapter are  not  exempt  from  the  reporting requirements of

17      RSA 329:17 and said administrative rules.

18             519-C:5  Payment of Early  Offer.

19                    I.   If an  early  offer is  accepted,  economic  losses  previously incurred  by the  claimant as’ a

20       result of  the  medical  injury   and  the  reasonable attorney  fee  shall be  paid  by the  medical  care

21       provider to the claimant within 15 days of the claimant accepting an early  offer.

22                    II. early  offer is accepted, future economic  losses  incurred by the  claimant shall be

23       payable  by  the  medical   care  provider   to  the  claimant as  such  losses  accrue.  If  any  requested

24       payment is denied,  the  medical  provider shall  notify  the  claimant in  writing of the  denial  and  the

25       basis  for  denial,   and  inform   the  claimant that  any  request for  a  hearing under   RSA  519-C:lO

26       regarding the denial must  be made  within  30 days of the date of denial.

27                            (a)  Payments for medical  bills arising after  the early  offer settlement is reached shall  be

28       made  within  30 days  after  the  medical  care  provider receives  reasonable proof of the  fact  and  the

29       amount of loss  sustained.  If reasonable proof  is  not  supplied as  to  the  entire claim,  the  amount

30       supported by reasonable proof shall be paid within  30 days after  such  proof is received.   Any part or

31       all of the  remainder of the  claim  that is later supported by reasonable proof shall  be paid  within  30

32       days  after  such  proof is received  by the  medical  care  provider.   The medical  care  provider  shall  pay

33       any and  all fees and charges incurred by the claimant resulting from failure to make timely  payment

34      of medical  bills.

35                           (b)  Payment of lost wages shall  be made weekly.

36                           (c)  Payment of any other  amounts due  under  an early  offer shall be paid  within  30 days

37       of the date  that the provider receives  notice and proof of the fact and amount that is due.

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1               III.   Interest shall accrue  at  the  rate  of 1-1/2 percent per  month  on any  amounts due  under

2       an early  offer that are not paid as prescribed by this section.

3                    IV.  In lieu  of periodic  payments, the  claimant and  medical  care  provider  may agree  upon a

4      lump  sum  payment for any and  all potential future economic losses suffered by the claimant.

5             519·C:6  Compensation for Death. If death results from a medical injury,  the amount of an early

6       offer pursuant to this chapter shall  include:

7                    I. Any economic loss incurred by the decedent prior to death;

8                II.  The value  at the time of death of what  would have been the net earnings of the deceased,

9      less living expenses during the period of his or her life expectance, but for the medical injury;

10                    III.  The value  of replacement services  during the period of the decedent’s life expectance, but

11      for the medical injury;

12                    IV.  The additional payment determined pursuant to RSA 519-C:7; and

13                    V.  A reasonable attorney fee.

14             519-C:7  Additional Payment to the Claimant.

15                    I.   In addition to the  lost wages,  medical  expenses, and  replacement services,  economic loss

16      included in any early  offer under  this chapter shall include  an additional payment to the claimant.

17                    II.   The  additional payment, as  adjusted under  paragraph V, that must  be included in  an

18      early  offer shall be:

19                           (a)    For  a  temporary injury involving  only  emotional harm,  without physical   injury:

20       $5,500.

21                           (b)  For a temporary injury  involving insignificant harm:  $1,700.

22                            (c) For a temporary injury  involving  minor harm:  $6,500.

23                           (d)  For a temporary injury  involving  major harm:  $26,250.

24                           (e)  For a permanent injury  involving  minor harm:  $29,750.

25                            (f)  For a permanent injury  involving significant harm:  $68,250.

26                           (g)  For a permanent injury  involving  major harm: $107,000.

27                           (h)  For a permanent injury  involving  grave harm: $117,500.

28                           (i)  For an injury resulting in death:  $57,000.

29                    III.    Classification of injuries under   paragraph II  shall  be determined using  the  National

30      Practitioner Data  Bank severity scale.

31                    IV.   Either party may  request a  hearing pursuant to  RSA 519-C:10  to  resolve  a  dispute

32      regarding classification of injury severity under  this section.

33                    V.  The  additional payment amounts in  paragraph II shall be adjusted annually on July  1

34      beginning in 2013 by a factor  equal  to the percentage change  in the  CPI·U index  for medical care for

35      the  Northeast Region for the prior 12 months  established by the Federal Bureau of Labor Statistics.

36              519-C:8  Assignments; Certain Claims of Creditors.

37                    I.  Payments for economic loss under  this chapter shall  not be assignable.

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1             II.    Claims  for  child  support, spousal support, or  combination child  and  spousal support

2      payments, pursuant to RSA 458-B, may be enforced against economic loss settlements.

3             519-C:9  Multiple Parties Alleged to have Contributed to Causing Medical Injury.

4                     I.  Every early  offer to settle  a claim  under  this chapter shall include  all of the economic loss,

5      plus  a reasonable attorney fee as set  forth  herein, and shall  not be reduced  or apportioned based  on

6      comparative fault  of multiple providers.  Any  medical  care  provider,   or  combination of providers

7      alleged   to  have  contributed to  causing an  injury   may  extend an  early   offer  as  provided  in  this

8     chapter, and acceptance of that offer by the claimant shall bar any further lawsuit or other  claims for

9      compensation by  the  claimant against all  medical  care  providers arising as  a  result of the  same

10      medical  injury.  However,  any  medical  care  provider  that extends an  early  offer to a claimant may

11      seek   contribution  in  a  separate  action   against  any   medical   care   provider   or  other   party   that

12      contributed to causing the  medical  injury.  The injured individual shall not be a party to any  action

13      for  contribution between medical  care  providers, however,  the  injured individual shall reasonably

14      cooperate with  the  proceedings and  provide  such  reasonable information and  testimony as may  be

15      necessary  to  resolve   the   contribution  claim.     The  parties  to  the   action   shall pay  the  injured

16      individual all  reasonable costs  associated with  such  reasonable cooperation and  testimony.   The

17      parties to  the  action  shall pay  the  injured individual all  reasonable costs  associated  with  such

18      reasonable cooperation and testimony.

19                    II.    Nothing  in  this  section  shall  be  regarded as  exempting contribution claims  from  any

20       applicable provisions ofRSA  519-B.

21                    III.   Nothing  in this  section  shall limit  claims  by the  claimant against any  party  other  than

22       medical  care  providers who participated in  providing medical  care  which  gave  rise  to the  medical

23       injury.

24              519-C:lO  Dispute  Resolution.

25                     I.   Upon  the  request of either party, the  insurance commissioner shall appoint a qualified

26       hearing officer to resolve a dispute regarding an early  offer made under  this chapter.

27                     II.  Dispute  resolution under  this chapter shall be limited to the following issues:

28                           (a)  Whether an  early  offer includes all of the  economic loss related to the  injury that is

29       required by this chapter;

30                           (b)    Whether economic  loss  of any  kind,  past  or  future, asserted by  the  claimant, is

31       reasonably related to an injury  that is the subject  of an early  offer;

32                           (c)  Which severity level, pursuant to RSA 519-C:7, most closely describes the injury  that

33       is the subject  of an early  offer; or

34                           (d)  What  the  net  present value  of an  early  offer is, for the  purposes of calculating the

35       appropriate payment for reasonable attorney fees.

36                    III.   No other  disputes arising under  this chapter may be the subject  of, or resolved  through a

37       hearing under, this section.

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1             IV.  Any request for a hearing pursuant to this section  shall contain a complete  statement of

2      the issue  or issues  to be resolved  in the  hearing, and  shall be served  upon  the  opposing  party.  Any

3      issue  not  listed  in  paragraph II  shall not  be considered.  Hearings concerning economic loss  that

4      arises after  a settlement under  this  chapter shall  be requested within 30 days  of the  date  payment

5      for such economic loss is denied  under  RSA 519-C:5, II.

6                    V.  The medical  care  provider  or, if applicable, the  medical  care  provider’s insurer shall  pay

7      all reasonable costs associated with a hearing under  this section.

8               VI.   Hearings conducted under  this  chapter shall be governed  solely  by this  section  and  by

9      any  rules  specific  to  this  chapter that  the  commissioner may  adopt   pursuant to  RSA  519-C:15.

10      Hearings under   this  section   shall not  be  subject   to  the  requirements of  RSA  541,  RSA  541-A,

11      RSA 400-A, the rules  of evidence, or any other statute or rule  that is not specific to this chapter.

12                    VII.   Any  hearing conducted under   this  chapter shall be conducted  within  45 days  of the

13      request and a decision  shall be issued within  10 days of completion of the hearing.  Hearings may be

14      conducted in person  or telephonically.

15                    VIII.    On  a  motion  from  any  party,   or  on  his  or  her  own  motion,  a  hearing officer  may

16      summarily determine any issue  in dispute without a hearing if it appears from the record  that there

17      are   no  material issues “of  fact  in  dispute.   By  agreement of  the  parties,  any  dispute  may   be

18      determined by the hearing officer on the written record without a hearing.

19                    IX.  Hearings conducted  pursuant to this chapter shall be limited to not more than one day in

20      length, divided  equally  among   the  parties, however  the  hearing length may  be  extended at  the

21       discretion of the  hearing officer.   A   record  of the  hearing shall  be maintained, including an  audio

22       recording of all testimony.

23                    X. Parties to a hearing under  this section shall exchange exhibits and witness lists  at least  3

24       days  prior  to  the  hearing.   No exhibit may  be introduced or  witness called  in  a  hearing unless

25       exchanged with the opposing party pursuant to this  paragraph.

26                    XI.  The hearing officer shall  issue  a written decision  resolving the  issues  in dispute.  If the

27       hearing officer finds against the medical  provider  on any issue,  the decision shall  modify the terms of

28      the early  offer.  The early  offer, as modified by the decision  of the hearing officer, shall  be binding  on

29       the parties.

30                    XII.  In a hearing conducted  pursuant to paragraph II (b) of this section,  if the hearing officer

31       determines the  claimant’s position  to  be frivolous,  the  claimant shall reimburse the  medical  care

32      provider  for its  costs  related to presenting the  dispute to the  hearing officer,  up to a maximum of

33       $1,000.

34                    XIII.  In a hearing conducted pursuant to paragraph II(b) of this section,  if the hearing officer

35      determines the  medical  care  provider’s position  to be frivolous,  the  medical  care
provider  shall pay

36      the claimant double the amount that was frivolously disputed or denied.

37              519-C:ll  Limitations of Claims.

Amendment to SB 406
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1             I.    Except   for  claims   on  behalf  of  deceased   individuals,  claims  for  medical   injury   to  a

2      competent adult under  this chapter shall be subject to the limitation set forth in RSA 508:4.

3                    II.   Except  for claims  on behalf  of deceased  individuals, claims for medical  injury  to a minor

4       or incompetent under  this chapter shall be subject  to the limitation set forth in RSA 508:8.

5                    III.    Claims  for  medical  injuries on  behalf  of deceased  individuals shall  be  subject  to  the

6      limitations set forth  in RSA 556:7.

7                    IV.  Providing a notice of injury  to a medical  care  provider as provided  in this  chapter shall

8      operate to toll the  applicable statute  of limitation with  respect to that injury  from  the  time   such

9       notice is provided  to a medical  care  provider until  the  expiration of time for a medical  care  provider

10       to extend an  early  offer, or if an  early  offer is extended, until  the  acceptance or rejection of an early

11       offer by the claimant, whichever occurs later.

12             519-C:12   Subrogation.  Any insurer or third  party  who has  paid  or reimbursed economic losses

13      to or for the  benefit  of the claimant, shall have  the right  of subrogation against the medical  provider

14      entering into an early  offer of settlement under  this  chapter.

15             519-C:13  Notice and  Waiver of Rights.

16                    I.    Claimants electing to  pursue  resolution of a  medical  injury   under   this  chapter shall

17      execute a notice and  waiver  of rights which contains the following wording:

18                                                                            WAIVER OF RIGHTS

19             By agreeing to submit a  notice  of injury   to  the  medical  care  provider,  I  understand that  my

20       rights to seek legal remedies and  a jury trial for my injuries guaranteed by Part I, Articles  14 and  20

21       of the  New Hampshire Constitution may be affected.

22              I understand that I have  the  right to consult  and  retain an  attorney to represent me regarding

23       this  matter, and  that if an  early  offer settlement is reached, my attorney will be paid  pursuant  to

24       RSA 519-C:6, V by the  health care  provider,  in addition to any amount that is paid for my economic

25       loss.

26             If after  submitting a notice of injury, the  medical  care  provider does NOT extend  an  early  offer

27       (RSA 519-C:1 III),  I am free to pursue my legal  remedies as defined  in  New Hampshire law without

28       restriction.

29              If after   submitting a  notice  of injury,   the  medical  care  provider   does  extend   an  early   offer

30       (RSA 519-C:1, III), I may either:

31                     (1)  Accept the early  offer,

32                     (2)  Request a hearing before a hearing officer appointed by the  Department of Insurance to

33       determine whether the early  offer includes all of the economic loss I am entitled to under the statute,

34       and if necessary, the  hearing officer may order  the medical care provider  to increase the early  offer to

35       meet the  requirements of the early  offer law, or

36                     (3)  Reject the  early  offer and seek  legal  remedies. However,  if I reject  the early  offer, I may

37       only sue for gross negligence  and  will be required to prove my case by clear and convincing evidence.

Amendment to SB 406
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7             I understand that if an  early  offer is made  by the  medical  care  provider  and  I accept  that offer,

8       disputes regarding the early offer can be resolved only in accordance with RSA 519-C:lO by a hearing

9       officer appointed by the  New Hampshire Department of Insurance at  my request or the  request of

10      the medical care provider. If, after  submitting disputes to the Department of Insurance, either party

11       believes that the result is unlawful, that party  may seek discretionary review in the  New Hampshire

12      court system; however,  there  is no assurance that the courts will undertake such review.

13      Date                                                                              Signature———–
14                    II.  A properly  executed  waiver form by a claimant who is competent at the time the waiver is

15      executed  shall  be conclusively  presumed to  be a sufficient, knowing,  and  voluntary waiver  if the

16      waiver form complies with this section.
17             519-C:14  Other  Action for Injury.  Except  as set forth  in RSA 519·C:2, IX, a claimant may only
18      pursue an action for medical injury  as provided  in RSA 507-E and RSA 519·B when:
19                    I. The claimant elects not to submit a notice of injury  pursuant to this chapter; or
20                    II.   The medical  care provider elects  not to extend  an early  offer pursuant to this  chapter in
21      response to the notice of injury.
22              519·C:15   Rulemaking.  The insurance commissioner shall adopt  rules,  pursuant to RSA 541-A,
23       necessary to carry  out this chapter.
24              3  Effective Date.  This act shall  take  effect 60 days after  its passage.




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