PRINTER'S NO. 459
No. 352 Session of 2001
INTRODUCED BY MOWERY, KITCHEN, WENGER AND M. WHITE,
FEBRUARY 15, 2001
REFERRED TO BANKING AND INSURANCE, FEBRUARY 15, 2001
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
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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
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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.
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