Loss Control Services

The insurer shall maintain and make available to its policyholders loss control facilities reasonably commensurate to the loss exposures and experience of the policyholder's business, and each policyholder shall be informed of the type of such services available. The specific method or methods to be used are within the insurer's discretion but shall take into account the following.

(1) Risk exposure. Classification by number and type of clinical patient care services provided; specialty of clinical and medical staff employed; probability of loss or injury; probability of illness; probability and frequency of negligent acts (commission or omissions) of policyholder's agents; severity/acuity of illness; location of services; and recent trends in malpractice litigation shall be considered.

(2) Experience. Losses incurred, loss frequency rate, and severity rate shall be considered.

(3) Size. Total number of employees, number of locations, number of patients per location, and number of employees per classification shall be considered.

(4) Other considerations. In addition to the foregoing factors, items such as the extent of policyholder loss control activities, acceptance of loss control services, and unusual circumstances should be considered.

Source Note: The provisions of this §5.1712 adopted to be effective November 9, 1990, 15 TexReg 6191.