Title 56, Insurance

(1) Costs to the insured of the arbitration proceeding under ORS 742.520 (6) shall not exceed $100 and all other costs of arbitration shall be borne by the insurer. (2) As used in this section, “costs” does not include attorney fees or expenses incurred in the production of evide…

(1) Personal injury protection benefits required by ORS 742.520 consist of the following payments for the injury or death of each person: (a) All reasonable and necessary expenses of medical, hospital, dental, surgical, ambulance and prosthetic services incurred within two years …

(1) Except as provided in subsection (2) of this section, a provider shall charge a person who receives personal injury protection benefits or that person’s insurer the lesser of: (a) An amount that does not exceed the amount the provider charges the general public; or (b) An amo…

(1) The personal injury protection benefits with respect to: (a) The insured and members of the family of the insured residing in the same household injured while occupying the insured motor vehicle shall be primary. (b) Passengers injured while occupying the insured motor vehicl…

An insurer who denies payment of personal injury protection benefits to or on behalf of an insured shall: (1) Provide written notice of the denial, within 60 calendar days of receiving a claim from the provider, to the insured, stating the reason for the denial and informing the …

If personal injury protection benefits are paid based on information that appeared to establish proof of loss and the insurer paying the benefits later determines the insurer was not responsible for the payment, the insurer shall give notice and explanation to the provider that t…

(1) The insurer may exclude from the coverage for personal injury protection benefits any injured person who: (a) Intentionally causes self-injury; (b) Is participating in any prearranged or organized racing or speed contest or practice or preparation for any such contest; or (c)…

Nothing in ORS 742.518 to 742.542 is intended to prevent an insurer from providing more favorable benefits than the personal injury protection benefits described in ORS 742.520, 742.524 and 742.530. [Formerly 743.820]

(1) Except as provided in ORS 742.544, every authorized motor vehicle liability insurer whose insured is or would be held legally liable for damages for injuries sustained in a motor vehicle accident by a person for whom personal injury protection benefits have been furnished by …

(1) If an authorized motor vehicle liability insurer has furnished personal injury protection benefits, or an authorized health insurer has furnished benefits, to a person who was injured in a motor vehicle accident and the injured person makes a claim, or brings legal action, fo…

If a motor vehicle liability insurer has furnished personal injury protection benefits, or a health insurer has furnished benefits, to a person who was injured in a motor vehicle accident and the interinsurer reimbursement benefit of ORS 742.534 is not available under the terms o…

The Director of the Department of Consumer and Business Services shall have authority to issue such rules as are reasonably necessary to carry out the purposes of ORS 742.518 to 742.542. [Formerly 743.833]

Payment by a motor vehicle liability insurer of personal injury protection benefits for its own insured shall be applied in reduction of the amount of damages that the insured may be entitled to recover from the insurer under uninsured or underinsured motorist coverage for the sa…

(1)(a) As used in this subsection, “total amount of the recovery” means the amount that a person injured in a motor vehicle accident recovers from: (A) Underinsured motorist benefits described in ORS 742.502 (2); (B) Liability insurance coverage the injured person receives from o…

(1) When a motor vehicle liability insurer obtains a release for bodily injuries within 60 calendar days following an accident from a person who is eligible to receive personal injury protection benefits under ORS 742.518 to 742.542, the release must state that, subject to the mo…

If a representative of a motor vehicle liability insurer obtains a release for a claim of bodily injuries in person from a person who is eligible to receive personal injury protection benefits under ORS 742.518 to 742.542: (1) The representative of the insurer must provide the el…

When an insurer declares a motor vehicle a total loss and offers to make a cash settlement to an insured or third-party owner of the motor vehicle, the insurer shall provide the insured or third-party owner: (1) Any valuation or appraisal reports relied upon by the insurer to det…

(1) An insurer shall pay the insured or third-party owner of a motor vehicle the amount of the motor vehicle’s value that is not in dispute if the insurer declares the motor vehicle a total loss and the insurer and the insured or third-party owner are unable to agree on the value…

As used in ORS 742.560 to 742.572: (1) “Cancellation” means termination of coverage by an insurer, other than termination at the request of the insured, during a policy period. (2) “Expiration” means termination of coverage by reason of the policy having reached the end of the te…

(1) A notice of cancellation of a policy shall be effective only if it is based on one or more of the following reasons: (a) Nonpayment of premium. (b) Fraud or material misrepresentation affecting the policy or in the presentation of a claim thereunder, or violation of any of th…

(1) No notice of cancellation of a policy to which ORS 742.562 applies shall be effective unless mailed or delivered by the insurer to the named insured at least 30 days prior to the effective date of cancellation and accompanied by a statement of the reason or reasons for cancel…

(1) An insurer shall offer renewal of a policy to an insured, contingent upon payment of premium as stated in the offer, unless the insurer mails or delivers to the named insured, at the address shown in the policy, at least 30 days’ advance notice of nonrenewal. The notice must …

Proof of mailing notice of cancellation, notice of replacement, notice of intention not to renew or notice of reasons for cancellation, to the named insured at the address shown in the policy, is sufficient proof of notice. [Formerly 743.920; 2017 c.250 §2]

When automobile bodily injury and property damage liability coverage is canceled, other than for nonpayment of premium, or in the event of failure to renew automobile bodily injury and property damage liability coverage to which ORS 742.566 applies, the insurer shall notify the n…

There shall be no liability on the part of and no cause of action of any nature shall arise against the Director of the Department of Consumer and Business Services or against any insurer, its authorized representative, its agents, its employees, or any firm, person or corporatio…

Every insurer that issues motor vehicle insurance that is designed to meet either the financial or future responsibility requirements of ORS chapter 806 shall report to the Department of Transportation within 30 days of the day that a person or the insurer cancels or fails to ren…

As used in ORS 742.585 to 742.600: (1) “Owner’s insurance policy” means a private passenger motor vehicle liability insurance policy that includes: (a) All coverage necessary to comply with the financial or future responsibility requirements of ORS chapter 806; (b) The personal i…

For each vehicle that the program facilitates the use of, a personal vehicle sharing program shall: (1) Provide a program insurance policy with coverage for the vehicle, the designated operator of the vehicle and all persons who, with the consent of the named insured, use the mot…

(1) Notwithstanding any provision in the owner’s insurance policy and notwithstanding ORS chapters 742, 806, 822 and 825 and ORS 30.010 to 30.100, 30.135, 30.480 and 30.485, in the event of any loss or injury that occurs at any time when the vehicle is under the operation and con…

A private passenger motor vehicle insured by the vehicle’s registered owner under an owner’s insurance policy may not be classified as a commercial motor vehicle, for-hire motor vehicle, permissive use motor vehicle or livery solely because the vehicle’s registered owner allows t…

(1) An insurer offering casualty insurance or commercial liability insurance may not cancel or refuse to issue or renew a policy solely on the basis that the policyholder holds a public office. (2) An insurer offering casualty insurance or commercial liability insurance may not i…

As used in ORS 742.700 to 742.710: (1) “Cancellation” means termination of a policy at a date other than its expiration date. (2) “Expiration date” means the date upon which coverage under a policy ends. For a policy written for a term longer than one year or with no fixed expira…

(1) Except as provided in ORS 742.710, a contract of commercial liability insurance may not be canceled by an insurer before the expiration of the policy, except on one or more of the following grounds: (a) Nonpayment of premium. (b) Fraud or material misrepresentation made by or…

Within 30 days after receiving a notice of cancellation under ORS 742.702, an insured may request a hearing before the Director of the Department of Consumer and Business Services. The purpose of this hearing shall be limited to establishing the existence of the proof or evidence…

(1) If an insurer offers or purports to renew a commercial liability policy, but on terms less favorable to the insured or at higher rates, the new terms or rates may take effect on the renewal date, if the insurer provides the insured, and the insurance producer if any, 45 days’…

A post office certificate of mailing to the named insured at the named insured’s last-known address shall constitute conclusive proof that the named insured received the notice of cancellation or nonrenewal on the third calendar day after the date of the certificate of mailing. […

(1) ORS 742.700 to 742.708 do not apply to: (a) Any commercial liability insurance policy that has not been previously renewed if the policy has been in effect less than 60 days at the time notice of cancellation is mailed or otherwise delivered. (b) Any policy subject to the pro…

(1) Each carrier offering a health benefit plan shall submit to the Director of the Department of Consumer and Business Services on or before April 1 of each year a report that contains: (a) The following information for the preceding year that is derived from the exhibit of prem…

(1) As used in this section: (a) “Covered entity” has the meaning given that term in ORS 192.556 but excludes state agencies. (b) “Protected health information” has the meaning given that term in ORS 192.556. (2) A covered entity that is required to file an annual financial state…

(1) A carrier offering a health benefit plan, an insurer offering insurance against the risk of economic loss assumed under a less than fully insured employee health plan described in ORS 742.065 and a third party administrator licensed under ORS 744.702 shall annually submit to …

The Department of Consumer and Business Services shall develop by rule reporting requirements as necessary for the consistent and efficient implementation of ORS 743B.200, 743B.202, 743B.250 and 743B.423. In order to minimize duplicative reporting requirements, the department sha…

(1) In addition to all other powers of the Director of the Department of Consumer and Business Services with respect thereto, the director may issue rules with respect to policy forms and health benefit plan forms described in ORS 742.005 (6)(a) and (b): (a) Establishing minimum …

(1) All credit life and credit health insurance policies subject to ORS 743.371 to 743.380, and all certificates of insurance, notices of proposed insurance, applications for insurance, indorsements and riders used in connection with such kinds of policies, delivered or issued fo…

(1) Except for group life and health insurance, and except as provided in ORS 743.015, every insurer shall file with the Director of the Department of Consumer and Business Services all schedules and tables of premium rates for life and health insurance to be used on risks in thi…

(1) When an insurer files a schedule or table of premium rates for individual or small employer health benefit plans under ORS 743.018, the Department of Consumer and Business Services shall open a 30-day public comment period on the rate filing that begins on the date the insure…

An insurer licensed by the Department of Consumer and Business Services shall include in any rate filing under ORS 743.018 with respect to individual and small employer health benefit plans, as defined in ORS 743B.005, a statement of administrative expenses in the form and manner…

Premium rates for individual health benefit plans shall be subject to the following provisions: (1) Each carrier must file the carrier’s initial geographic average rate and any changes to the geographic average rate for its individual health benefit plans with the Director of the…

(1) As used in this section: (a) “Explanation of benefits” means claim processing advice or notification of action on claims. (b) “Payment, remittance and reconciliation information” means all information required for premium billing or invoicing, facilitating timely electronic p…

(1) As used in this section, “health benefit plan” has the meaning given that term in ORS 743B.005. (2) An insurer shall annually report the following information to the Department of Consumer and Business Services, in the form and manner prescribed by the department, regarding d…

The Director of the Department of Consumer and Business Services shall prescribe uniform health insurance claim forms which shall be used by all insurers transacting health insurance in this state and by all state agencies that require health insurance claim forms for their recor…