Title 56, Insurance

The Insurance Code applies to: (1) A fraternal benefit society complying with ORS chapter 748, only as provided in such chapter. (2) A health care service contractor complying with ORS 750.005 to 750.095, only as provided in such sections. (3) A legal expense organization complyi…

(1) The State Accident Insurance Fund Corporation is subject as a domestic insurer to ORS 731.248, 731.252, 731.256, 731.258, 731.260, 731.296 to 731.316, 731.488, 731.574, 731.592, 731.594, 731.730, 731.731, 731.735, 731.737, 731.870, 731.988, 731.992, 733.010 to 733.060, 733.14…

Except as provided in ORS 743.029 or as specifically provided by law, the Insurance Code does not apply to any of the following to the extent of the subject matter of the exemption: (1) A bail bondsman, other than a corporate surety and its agents. (2) A fraternal benefit society…

(1) As used in this section: (a) “Charitable gift annuity” has the meaning given that term in section 501(m)(5) of the Internal Revenue Code, as amended and in effect on January 1, 2006. (b) “Charitable organization” means an organization to which contributions may be made that a…

ORS 731.038 (2)(a) and (b) does not apply to an educational institution or nonprofit corporation that holds a certificate of authority issued under ORS 731.704 (repealed in 2005) on the day before January 1, 2006. An educational institution or nonprofit corporation subject to thi…

(1) An exempt insurer who holds a certificate of exemption issued by the Director of the Department of Consumer and Business Services before January 1, 2003, may continue transacting insurance. (2) In order to continue a certificate of exemption, an exempt insurer to whom subsect…

Any policy, other than a variable annuity policy, whose form has been filed with and approved by the Director of the Department of Consumer and Business Services is exempt from the application of ORS 59.005 to 59.505, 59.710 to 59.830, 59.991 and 59.995, and the marketing of such…

Except where the context otherwise requires, the definitions given in the Insurance Code govern its construction. [1967 c.359 §11]

“Action” means any action, suit or legal proceeding. [1967 c.359 §12]

(1) An “authorized” insurer is one authorized by a subsisting certificate of authority to transact insurance in this state. (2) An “unauthorized” insurer is one not so authorized. [1967 c.359 §14]

(1) “Certificate” means a written statement evidencing the coverage of a person insured under a group insurance policy. (2) “Certificate holder” means an employee or member of a group insured under a group insurance policy. [1981 c.752 §11]

(1) A “certificate of authority” is one issued by the Director of the Department of Consumer and Business Services pursuant to the Insurance Code evidencing the authority of an insurer to transact insurance in this state. (2) A “license” is authority granted by the director pursu…

(1) “Commercial liability insurance” means insurance for a business, professional, nonprofit or governmental entity against legal, contractual or assumed liability for death, injury or disability of any human, or for damage to property, arising out of acts or omissions in the cou…

“Covered life” means a subscriber, policyholder, certificate holder, spouse, dependent child or any other individual insured under an insurance policy or whose benefits are administered by a third party administrator licensed under ORS 744.702. [2009 c.595 §1194] Note: 731.075 wa…

(1) “Department” means the Department of Consumer and Business Services. (2) “Director” means the Director of the Department of Consumer and Business Services. [1967 c.359 §16; 1987 c.373 §76; 1993 c.744 §28]

(1) “Domestic insurer” means an insurer formed under the laws of this state. (2) “Foreign insurer” means an insurer formed under the laws of a state other than this state. (3) “Alien insurer” means an insurer formed under the laws of any country other than the United States of Am…

“Domestic risk” means a subject of insurance resident, located or to be performed in this state. [1967 c.359 §18]

The “domicile” of an insurer means: (1) As to insurers formed under the laws of Canada or any province thereof, the province in which the insurer’s head office is located. (2) As to other alien insurers, as provided in ORS 731.096. (3) As to all other insurers, the state under th…

(1) The domicile of an alien insurer, other than insurers formed under the laws of Canada or a province thereof, shall be that state designated by the insurer in writing filed with the Director of the Department of Consumer and Business Services at time of admission to this state…

“Essential health benefits” are the items and services prescribed by the Department of Consumer and Business Services by rule in accordance with federal law, including: (1) Ambulatory patient services. (2) Emergency services. (3) Hospitalization. (4) Maternity and newborn care. (…

“Group health insurance” means that form of health insurance covering groups of persons described in this section, with or without one or more members of their families or one or more of their dependents, or covering one or more members of the families or one or more dependents o…

“Independently procured insurance” means insurance procured directly by an insured from a nonadmitted insurer as defined in ORS 735.405. [2011 c.660 §2] Note: 731.099 was added to and made a part of ORS chapter 731 by legislative action but was not added to any smaller series the…

(1) “Insurance” means a contract whereby one undertakes to indemnify another or pay or allow a specified or ascertainable amount or benefit upon determinable risk contingencies. (2) “Insurance” so defined includes annuities. (3) “Insurance” so defined includes a contract under wh…

“Insurance producer” means a person required to be licensed under the laws of this state to sell, solicit or negotiate insurance. For purposes of this definition: (1) “Negotiate” means to confer directly with or to offer advice directly to a purchaser or prospective purchaser of …

“Insurer” includes every person engaged in the business of entering into policies of insurance. [1967 c.359 §22]

“Judgment” includes a final order. [1967 c.359 §23; 2003 c.576 §553]

“Limited benefit coverage” means: (1) Health insurance that provides: (a) Coverage for accident only, specific disease or condition only, credit or disability income; (b) Dental only coverage; or (c) Vision only coverage; and (2) Independent, noncoordinated, hospital-only indemni…

“Person” means an individual or a business entity. For the purpose of this definition, “business entity” means a corporation, association, partnership, limited liability company, limited liability partnership or other legal entity. [1967 c.359 §24; 1983 c.327 §12; 2001 c.191 §21]

“Policy” means the written contract or written agreement for or effecting insurance, by whatever name called, and includes all clauses, riders, indorsements and papers which are a part thereof and annuities. [1967 c.359 §25]

“Reinsurance” means a contract under which an originating insurer, called the “ceding” insurer, procures insurance for itself in another insurer, called the “assuming” insurer or the “reinsurer,” with respect to part or all of an insurance risk of the originating insurer. [1967 c…

“Required capitalization” means the minimum combined paid-up capital and surplus required by the Insurance Code of a stock insurer, or the minimum surplus so required of an insurer without capital stock. [1967 c.359 §27]

When used in context signifying a jurisdiction other than the State of Oregon, “state” means any state, district, territory, commonwealth or possession of the United States of America. [1967 c.359 §28; 2001 c.191 §22]

(1) “Stock insurer” means an incorporated insurer whose capital is divided into shares and owned by its stockholders. (2) “Mutual insurer” means an incorporated insurer without capital stock and the governing body of which is elected by its policyholders. This definition does not…

“Surplus lines insurance” means any insurance on an Oregon home state risk, permitted to be placed through a surplus lines licensee with a nonadmitted insurer eligible to accept such insurance, other than reinsurance, wet marine and transportation insurance, independently procure…

(1) “Transact insurance” means one or more of the following acts effected by mail or otherwise: (a) Making or proposing to make an insurance contract. (b) Taking or receiving any application for insurance. (c) Receiving or collecting any premium, commission, membership fee, asses…

It is intended that certain insurance coverages may come within the definitions of two or more classes of insurance as defined in the Insurance Code, and the inclusion of such coverage within one definition shall not exclude it as to any other class of insurance within the defini…

(1) “Annuity” or “annuity policy” means any agreement to make periodic payments, whether fixed or variable in amount, where the making of all or some of such payments, or the amount of any such payment, is dependent upon the continuance of human life, except payments made pursuan…

“Variable life insurance” and “variable annuity” mean forms of life insurance or annuity benefits, respectively, that vary according to the investment experience of a separate account or accounts maintained by the insurer with respect to policies providing such benefits or are se…

“Casualty insurance” means: (1) Insurance against legal, contractual or assumed liability for death, injury or disability of any human, or for damage to property; and provision for medical, hospital, surgical and disability benefits to injured persons including insurance against …

“Health insurance” means insurance of humans against bodily injury, disablement or death by accident or accidental means, or the expense thereof, or against disablement or expense resulting from sickness or childbirth, or against expense incurred in prevention of sickness, in den…

(1)(a) “Home protection insurance” means that part of casualty insurance that includes only insurance which undertakes to perform or provide repair or replacement service or indemnification therefor for the operational or structural failure of the insured home, components of the …

“Industrial life insurance” means that form of life insurance written under policies of face amount of $2,500 or less, under which premiums are payable monthly or more often and the policy specifies it is an industrial life insurance policy. [1967 c.359 §36]

(1) “Life insurance” means insurance on human lives and every insurance appertaining thereto and includes the granting of endowment benefits, additional benefits in event of death or dismemberment by accident or accidental means, additional benefits in event of the insured’s or p…

“Marine and transportation insurance” includes: (1) Insurance against any and all kinds of loss of or damage to: (a) Vessels, craft, aircraft, cars, automobiles and vehicles of every kind, as well as all goods, freights, cargoes, merchandise, effects, disbursements, profits, mone…

“Mortgage insurance” means insurance against financial loss by reason of: (1) Nonpayment of principal, interest and other sums agreed to be paid under the terms of an obligation secured by a mortgage, deed of trust or other instrument constituting a lien or charge on real or pers…