OAR 436-060-0400
Penalty and Attorney Fee for Untimely Payment of Disputed Claims Settlement

(1)

Right to request penalties and attorney fees. If the insurer fails to pay amounts due on a disputed claims settlement within five business days of receipt of notice from the worker that the payment is late, the worker or worker’s attorney may request penalties and attorney fees.

(2)

Requirements for requests. Requests for penalties and attorney fees under this rule must be in writing, state what payments were delayed or remain unpaid, and be mailed or delivered to the division within 180 days of the date of notice to the insurer. In order to be awarded an attorney fee the attorney must submit a signed, current retainer agreement.

(3)

Required response from the insurer. When notified by the director that a penalty or attorney fees have been requested under this rule, the insurer must respond in writing to the division.

(a)

The response must include any information or documentation requested by the director.

(b)

The response must be mailed or delivered to the division within 14 days of the date of the director’s inquiry letter; and

(c)

Copies of the response, including any attachments, must be sent simultaneously to the worker and the worker’s attorney, if any.

(4)

Failure to respond. If the insurer fails to meet the requirements of section (3) of this rule, the director may assess additional civil penalties under OAR 436-060-0200 (Assessment of Civil Penalties).

(5)

Penalty and fee amounts. The penalty and fee will be based on the amounts allocated to the worker and the attorney in the settlement agreement as prescribed in ORS 656.262 (Processing of claims and payment of compensation)(12)(b). Penalties will be issued in accordance with the matrix set forth in Appendix “C.”

(6)

Timely payment of penalties. Penalties and attorney fees ordered under this rule must be paid to the worker and attorney no later than the 30th day after the date of the order, unless the order is appealed. If the order is appealed and later upheld, the penalty and attorney fee will be due within 14 days of the date the order upholding the penalty becomes final. Failure to pay penalties and attorney fees in a timely manner may subject the insurer to civil penalties under OAR 436-060-0200 (Assessment of Civil Penalties).
[ED. NOTE: To view attachments referenced in rule text, click here to view rule.]

Source: Rule 436-060-0400 — Penalty and Attorney Fee for Untimely Payment of Disputed Claims Settlement, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=436-060-0400.

436‑060‑0003
Purpose, Applicability, Forms, and Bulletins 436‑060‑0005
Definitions 436‑060‑0008
Administrative Review and Contested Cases 436‑060‑0010
Employer Responsibilities 436‑060‑0011
Insurer Reporting Requirements 436‑060‑0012
Notices and Correspondence Following the Death of a Worker 436‑060‑0015
Required Notice and Information 436‑060‑0017
Release of Claim Documents 436‑060‑0018
Nondisabling and Disabling Claim Reclassification 436‑060‑0019
Determining and Paying the Three Day Waiting Period 436‑060‑0020
Payment of Temporary Total Disability Compensation 436‑060‑0025
Worker’s Weekly Wage Calculation and Rate of Temporary Disability Compensation 436‑060‑0030
Payment of Temporary Partial Disability Compensation 436‑060‑0035
Supplemental Disability for Workers with Multiple Jobs at the Time of Injury 436‑060‑0040
Payment of Permanent Partial Disability Compensation 436‑060‑0045
Payment of Compensation During Worker Incarceration 436‑060‑0055
Payment of Medical Services on Nondisabling Claims 436‑060‑0060
Lump Sum Payment of Permanent Partial Disability Awards 436‑060‑0075
Payment of Death Benefits 436‑060‑0095
Medical Examinations 436‑060‑0105
Suspension of Compensation for Insanitary or Injurious Practices, Refusal of Treatment or Failure to Participate in Rehabilitation 436‑060‑0135
Injured Worker, Worker’s Attorney Responsible to Assist in Investigation 436‑060‑0137
Vocational Evaluations for Permanent Total Disability Benefits 436‑060‑0140
Acceptance or Denial of a Claim 436‑060‑0141
Claims for COVID-19 or Exposure to SARS-CoV-2 436‑060‑0147
Worker Requested Medical Examination 436‑060‑0150
Timely Payment of Compensation 436‑060‑0153
Electronic Payment of Compensation 436‑060‑0155
Penalty to Worker for Untimely Processing 436‑060‑0160
Use of Sight Draft to Pay Compensation Prohibited 436‑060‑0170
Recovery of Overpayment of Benefits 436‑060‑0180
Designation and Responsibility of a Paying Agent 436‑060‑0190
Monetary Adjustments among Parties and Department of Consumer and Business Services 436‑060‑0195
Miscellaneous Monetary Adjustments Among Insurers 436‑060‑0200
Assessment of Civil Penalties 436‑060‑0400
Penalty and Attorney Fee for Untimely Payment of Disputed Claims Settlement 436‑060‑0500
Reimbursement of Supplemental Disability for Workers with Multiple Jobs at the Time of Injury 436‑060‑0510
Reimbursement of Permanent Total Disability Benefits from the Workers’ Benefit Fund
Last Updated

Jun. 8, 2021

Rule 436-060-0400’s source at or​.us