Insurance Policies


Published: 2015

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The Oregon Administrative Rules contain OARs filed through November 15, 2015

 

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DEPARTMENT OF CONSUMER AND BUSINESS SERVICES,

INSURANCE DIVISION

 

DIVISION 54
INSURANCE POLICIES


Property and Casualty Product Liability Motor Vehicle Liability Insurance

836-054-0000
Election of Lower Limits for Uninsured
Motorist Coverage
(1) This rule is adopted under the authority
of ORS 731.244 for the purpose of implementing ORS 742.502.
(2) An example of a form
that may be used by an insurer or insurance producer to comply with this rule is
posted on the Insurance Division website of the Department of Consumer and Business
Services at www.insurance.oregon.gov. If an insurer or insurance producer uses this
form, or any other selection form that has been approved by the Department, the
form is considered to be approved by the Department. Any other form electing lower
limits for uninsured motorist coverage in a motor vehicle liability insurance policy
must be approved by the Department and must contain all of the following elements
in any order:
(a) An acknowledgement by
the named insured that the named insured was offered uninsured motorist coverage
with the limits equal to those for bodily injury liability;
(b) A brief summary, which
is not part of the insurance contract, of uninsured and underinsured motorist coverages;
(c) A statement of the price
for coverage per insured vehicle with limits equal to the named insured's bodily
injury liability limits and the price for coverage per insured vehicle with the
lower limits requested by the named insured;
(d) A statement to the effect
that the statement shall remain in force until rescinded in writing by a named insured
or until such time as motor vehicle bodily injury liability limits are changed;
and
(e) Provision for signature
of a named insured, to be made within 60 days of the time the named insured makes
the election, and for the date of signature.
(3) Regarding the summary
required in subsection (2)(b) of this rule, if an insurer issuing a policy that
refers only to uninsured motorist coverage because uninsured motorist coverage under
the policy includes underinsured motorist coverage meeting statutory requirements,
the insurer need not use the term "underinsured motorist coverage."
(4) The statement required
under subsection (2)(c) of this rule may state the term of coverage to which the
prices relate.
(5) The form may include
one or both of the following statements in addition to the items required under
section (2) of this rule:
(a) A statement to the effect
that the form is required by Oregon law or specifically by ORS 742.502; and
(b) A statement to the effect
that limits for uninsured motorist coverage cannot be less than the amounts required
to comply with financial responsibility requirements under ORS 806.070.
Stat. Auth.: ORS 731.244 & 742.502

Stats. Implemented: ORS 742.502(2)

Hist.: ID 5-1994, f. &
cert. ef. 5-9-94; ID 8-2005, f. 5-18-05, cert. ef. 8-1-05; ID 19-2006, f. &
cert. ef. 9-26-06; ID 7-2015(Temp), f. & cert. ef. 9-14-15 thru 12-31-15

Workers' Compensation Large Deductible Provisions

836-054-0201
Statutory Authority and Purpose
OAR 836-054-0201 to 836-054-0210 are adopted pursuant to the general rulemaking authority of the Director of the Department of Consumer and Business Services to specify requirements for large deductible provisions of workers' compensation insurance policies which may be approved according to ORS 742.001 to 742.007
Stat. Auth.: ORS 731.244

Stats. Implemented:

Hist.: ID 4-1995, f. 7-21-95, cert. ef. 10-1-95
836-054-0205
Definitions
As used in OAR 836-054-0201 to 836-054-0210:
(1) "Insurer" means any insurer authorized to write workers' compensation insurance and includes the State Accident Insurance Fund Corporation.
(2) "Large Deductible" means a provision in a workers' compensation policy, or added by endorsement thereto, which allows a policyholder to be financially responsible for claims incurred under the policy up to a percentage of premium, a stated amount per claim, or other limit specified in the provision in exchange for a prospective premium reduction.
(3) "Workers' Compensation Insurance" means insurance providing coverage for the obligations of an employer arising from illness or injury to workers whether such obligation is imposed by ORS Chapters 654 and 656, similar laws of the United States, or agreements between states.
(4) "Workers' Compensation Premium Assessment" means the assessment imposed on insurers, self-insured employers, and self-insured employer groups by the Director of the Department of Consumer and Business Services pursuant to ORS 656.612.
Stat. Auth.: ORS 731.244

Stats. Implemented:

Hist.: ID 4-1995, f. 7-21-95, cert. ef. 10-1-95
836-054-0210
Required Content of Large Deductible Provisions
An insurer which issues a workers' compensation insurance policy with a large deductible provision must file such provision with the Director for approval as required by ORS 742.003. The provision must satisfy the following requirements:
(1) A large deductible provision must clearly and prominently state that the insured employer must report all workers' compensation insurance claims to the insurer and the insurer retains responsibility to administer claims and to pay all costs and expenses.
(2) A large deductible provision must state that the insurer will delete the provision effective not more than ten (10) days following discovery that an insured employer has on three occasions within the policy period known of but not reported a workers' compensation insurance claim to the insurer or has on any occasion within the policy period made direct payment of claim costs. The provision may further state that the insurer will cancel the policy with notice pursuant to ORS 656.427 or that the insurer will delete the provision retroactively to the date of the offense with penalties stated in the provision. When a large deductible provision is deleted, the premium for any remaining portion of a policy term will be computed using the rating plans applied by the insurer to the policy prior to deductible credits except that any system of expense gradation applied by the insurer to similar policies must be used.
(3) A large deductible provision must specify that the basis for the Workers' Compensation Premium Assessment will be premium earned prior to any premium credits or modifications for the large deductible provision.
(4) A large deductible provision must specify that the basis for any assessments by the Plan Administrator for the Workers' Compensation Insurance Plan specified by OAR 836-043-0001 to 836-043-0090 will be premium earned prior to any premium credits or modifications for the large deductible provision.
(5) A large deductible provision must define explicitly which expenses, if any, will be billed to the employer in addition to direct claim costs and specify whether such expenses are subject to the deductible limits together with direct claim costs or will be billed in addition to deductible amounts.
(6) A large deductible provision must state that the premium credit percentage and amount for the large deductible will be recalculated after final premium audit based on actual premium or exposures and after any retrospective premium adjustments for retrospectively rated policies.
(7) A large deductible provision shall contain an offer for the insurer to provide occupational safety and health loss control consultative services as required by ORS 654.097.
(8) A large deductible provision shall contain minimum eligibility requirements of not less than $500,000 estimated country-wide annual premium prior to large deductible credits or premium credits based on premium size. The minimum deductible limit per claim for each injury or illness may not be less than $75,000. An aggregate limit for deductible amounts for all claims may be specified but may not be less than the deductible limit per claim.
Stat. Auth.: ORS 731.244

Stats. Implemented: ORS 742.001 - 742.007

Hist.: ID 4-1995, f. 7-21-95, cert. ef. 10-1-95; ID 11-2010, f. 5-4-10, cert. ef. 7-1-10

Mortgage Insurance

836-054-0300
Loan to Value
(1) A mortgage insurer may provide insurance with respect to an obligation that does not exceed, solely or in combination with liens existing at the time the insured loan is made, 105 percent of the fair market value of the securing real property at the time the loan is made if permitted by the insurer's domicile and if the obligation insured is secured by a mortgage, deed of trust or other instrument constituting a first lien or charge.
(2) A mortgage insurer may provide insurance with respect to an obligation that does not exceed, solely or in combination with liens existing at the time the insured loan is made, 110 percent of the fair market value of the securing real property at the time the loan is made if permitted by the insurer's domicile and if the insured obligation is secured by a mortgage, deed of trust or other instrument constituting a junior lien or junior charge. In determining the 110 percent limitation, the full amount of a line of credit to be secured by a junior lien shall be considered the amount of the loan.
(3) This rule is adopted under the authority of ORS 731.244 for the purpose of implementing ORS 742.282(1)(a).
Stat. Auth.: ORS 731.244

Stats. Implemented: ORS 742.282

Hist.: ID 4-2001, f. & cert. ef. 4-3-01; ID 22-2002, f.& cert. ef. 11-27-02

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