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31 Pa. Code § 243.2. Definitions.

§ 243.2. Definitions.

 The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:

   Act—The Health Care Services Malpractice Act (40 P.S. § §  1301.101—1301.1006).

   Asserted claim—An incident about which the potential claimant has made a communication and which, after review of the circumstances, leads to the reasonable conclusion that the provider may have possible claim liability.

   Commissioner—The Insurance Commissioner of the Commonwealth.

   Department—The Insurance Department of the Commonwealth.

   Effective date—The date on which the Commissioner initially approved a self-insurance plan, whether under this chapter or prior regulations.

   Government—The government of the United States, a state, a political subdivision of a state, an instrumentality of one or more states or an agency, subdivision or department of these forms of government. The term includes a corporation or other association organized by a government for the execution of a government program and subject to control by a government or corporation or agency established under an interstate compact or international treaty.

   Health care provider—A primary health center or person, corporation, facility, institution or other entity licensed or approved by the Commonwealth to provide health care or professional medical services as a physician, an osteopathic physician, a surgeon, a certified nurse midwife, a podiatrist, hospital, nursing home, birth center and, except as to section 701(a) of the act (40 P.S. §  1301.701(a)), an officer, employe or agent of any of the providers acting in the course and scope of employment.

   Plan of risk management—A plan established and maintained for the purpose of reducing, through loss prevention, loss reduction and other generally accepted risk management techniques, the frequency and severity of personal injuries arising out of the rendition of or failure to render professional services by a health care provider.

   Primary health center—A community-based nonprofit corporation, meeting standards prescribed by the Department of Health, which provides preventative, diagnostic, therapeutic and basic emergency health care by licensed practitioners who are employes of the corporation or under contract to the corporation.

   Professional liability insurance—Insurance against liability on the part of the health care provider arising out of a tort or breach of contract causing injury or death, resulting from the furnishing of medical services which were or should have been provided.

   Self-insurance—The assumption by a health care provider of a professional liability risk arising out of a tort or breach of contract causing injury or death resulting from the furnishing of medical services which were or should have been provided.


   The provisions of this §  243.2 amended under The Insurance Department Act of 1921 (40 P. S. § §  1—321); The Insurance Company Law of 1921 (40 P. S. § §  341—991); and sections 206, 506, 1501 and 1502 of The Administrative Code of 1929 (71 P. S. § §  66, 186, 411 and 412); and the Health Care Services Malpractice Act (40 P. S. § §  1301.101—1301.1006).


   The provisions of this §  243.2 adopted July 1, 1977, effective July 2, 1977, 7 Pa.B. 1816; renumbered February 9, 1979, 9 Pa.B. 498; amended September 18, 1987, effective November 18, 1987, 17 Pa.B. 3742. Immediately preceding text appears at serial pages (109902), (63282) and (39843).

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