PRINTER'S NO. 1491
No. 1186 Session of 1999
INTRODUCED BY MOWERY, WHITE AND WENGER, NOVEMBER 15, 1999
REFERRED TO BANKING AND INSURANCE, NOVEMBER 15, 1999
AN ACT 1 Amending the act of May 17, 1921 (P.L.789, No.285), entitled, as 2 amended, "An act relating to insurance; establishing an 3 insurance department; and amending, revising, and 4 consolidating the law relating to the licensing, 5 qualification, regulation, examination, suspension, and 6 dissolution of insurance companies, Lloyds associations, 7 reciprocal and inter-insurance exchanges, and certain 8 societies and orders, the examination and regulation of fire 9 insurance rating bureaus, and the licensing and regulation of 10 insurance agents and brokers; the service of legal process 11 upon foreign insurance companies, associations or exchanges; 12 providing penalties, and repealing existing laws," providing 13 for self-critical analysis privilege for insurers. 14 The General Assembly of the Commonwealth of Pennsylvania 15 hereby enacts as follows: 16 Section 1. The act of May 17, 1921 (P.L.789, No.285), known 17 as The Insurance Department Act of 1921, is amended by adding an 18 article to read: 19 ARTICLE II-B. 20 SELF-CRITICAL ANALYSIS PRIVILEGE. 21 Section 201-B. Definitions.--The following words and phrases 22 when used in this article shall have the meanings given to them 23 in this section unless the context clearly indicates otherwise:
1 "Compliance review committee" means either of the following: 2 (1) An audit, review or compliance individual or committee 3 appointed by the board of directors of an insurer or by the 4 president of an insurer and subsequently ratified by the board 5 of directors. 6 (2) Any other person to the extent the person acts in an 7 investigatory capacity at the direction of a compliance review 8 committee. 9 "Compliance review documents" means documents solely prepared 10 for or created by a compliance review committee after the 11 appointment of such committee. 12 "Insurer" means any insurance company, association or 13 exchange authorized to transact the business of insurance in 14 this Commonwealth. This shall also include any entity operating 15 under any of the following: 16 (1) Section 630 of the act of May 17, 1921 (P.L.682, 17 No.284), known as "The Insurance Company Law of 1921." 18 (2) The act of December 29, 1972 (P.L.1701, No.364), known 19 as the "Health Maintenance Organization Act." 20 (3) The act of December 14, 1992 (P.L.835, No.134), known as 21 the "Fraternal Benefit Societies Code." 22 (4) 40 Pa.C.S. Ch. 61 (relating to hospital plan 23 corporations). 24 (5) 40 Pa.C.S. Ch. 63 (relating to professional health 25 services plan corporations). 26 (6) 40 Pa.C.S. Ch. 67 (relating to beneficial societies). 27 "Person" means an individual, group of individuals, board, 28 committee, partnership, firm, association, corporation or other 29 entity. 30 Section 202-B. Compliance Review Committee.--This article 19990S1186B1491 - 2 -
1 applies to a compliance review committee whose functions are 2 solely to evaluate and seek to improve one or more of the 3 following: 4 (1) Reporting to Federal or State regulatory agencies or 5 national accrediting organizations. 6 (2) Compliance with Federal or State statutory or regulatory 7 requirements. 8 Section 203-B. Documents Confidential.--(a) Except as 9 provided in subsection (b): 10 (1) Compliance review documents or any information contained 11 therein, to the extent that such information is not otherwise 12 obtained from a source independent of the compliance review 13 committee, are confidential and are not discoverable or 14 admissible in any civil action as to evidence arising out of 15 matters evaluated by the compliance review committee. 16 (2) Compliance review documents or any information contained 17 therein, to the extent that such information is not otherwise 18 obtained from a source independent of a compliance review 19 committee, delivered to a Federal or State governmental agency 20 remain confidential and are not discoverable or admissible in 21 any civil action as to evidence arising out of matters evaluated 22 by the compliance review committee. 23 (3) The compliance review committee may not be examined in 24 any civil action as to evidence arising out of matters evaluated 25 by the compliance review committee. 26 (b) This section does not apply to any information required 27 by statute or regulation to be maintained by or provided to a 28 governmental agency while the information is in the possession 29 of the governmental agency to the extent applicable law 30 expressly authorizes its disclosure. Further, this section does 19990S1186B1491 - 3 -
1 not prohibit the admission or use of compliance review documents 2 or any information contained therein in administrative actions 3 initiated by the Insurance Department to enforce insurance laws 4 or regulations. The use of such documents or any information 5 contained therein in an administrative action initiated by the 6 Insurance Department shall not constitute a waiver of the 7 privilege for any other purposes or actions. 8 Section 204-B. Construction.--This article shall not be 9 construed to limit the Insurance Department's authority to 10 obtain documents or information under Article IX or the 11 Insurance Commissioner's ability to share or receive 12 confidential documents or information under Article II-A or 13 limit the discovery or admissibility in any civil action of any 14 documents that are not compliance review documents. Further, 15 this article shall not apply to peer reviews performed by an 16 insurer under section 306(f.1) of the act of June 2, 1915 17 (P.L.736, No.338), known as the Workers' Compensation Act, 18 Subdivision (h) of Article XXI of the act of May 17, 1921 19 (P.L.682, No.284), known as The Insurance Company Law of 1921, 20 or 75 Pa.C.S. § 1797 (relating to customary charges for 21 treatment). 22 Section 2. This act shall take effect in 60 days. K5L40BIL/19990S1186B1491 - 4 -