board. Whenever a claim of personal injury is made against any practitioner of the healing arts or a licensed hospital, a report shall be made to the appropriate licensing board or agency by the liability insurer of such practitioner or hospital within sixty (60) days after receipt of information that a claim is being made. In the event that such claim is made against a party not insured, the report shall be made by the party. The report shall be in writing on a form containing the following information: 1. The name and address of the practitioner or hospital; 2. The name, age and address of the claimant; 3. A brief statement of the nature of the injury, illness or condition complained of and the act or omission complained of; and 4. Whether a suit is pending and, if so, the court, style and docket number of the action. And whenever such claim or suit is concluded, the disposition shall be reported to the appropriate board or agency promptly. This report shall be privileged except as hereinafter provided. The licensing board or agency shall take any remedial, disciplinary or corrective action as it may deem warranted by the facts contained in the report. Any person or liability insurer failing to furnish a report on a claim as required in this section shall be guilty of a misdemeanor. Further, the board or agency shall annually furnish the President Pro Tempore of the Senate and the Speaker of the House of Representatives a full report of all such claims except that names and addresses of all parties shall be omitted. Such report shall include disposition of the claim as well as a report of all action taken by the board or agency and the reason therefor.
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