OAR 836-031-0230
Claim Reserves


(1)

The following provisions apply to claim reserves generally:

(a)

An insurer must maintain claim reserves for all incurred but unpaid claims on all health insurance policies;

(b)

An insurer must maintain appropriate claim expense reserves with respect to the estimated expense of settlement of all incurred but unpaid claims; and

(c)

An insurer must test all such reserves for prior valuation years for adequacy and reasonableness using claim runoff schedules in accordance with the statutory financial statement, including consideration of any residual unpaid liability.

(2)

The following minimum standards apply to claim reserves for disability income insurance:

(a)

Interest. The maximum interest rate for claim reserves is specified in OAR 836-031-0280 (Specific Standards for Interest);

(b)

Morbidity. Minimum standards with respect to morbidity are those specified in OAR 836-031-0270 (Specific Standards for Morbidity) except that at the option of the insurer:

(A)

For claims with a duration from date of disablement of less than two years, reserves may be based on the experience of the insurer, if such experience is considered credible, or upon other assumptions that to place a sound value on the liabilities; and

(B)

For group disability income claims with a duration from date of disablement of more than two years but less than five years, reserves may, with the approval of the Director, be based on the experience of the insurer. The request for such approval of a plan of modification to the reserve basis must include:
(i)
An analysis of the credibility of the experience;
(ii)
A description of how the experience of the insurer is proposed to be used in setting reserves;
(iii)
A description and quantification of the margins to be included;
(iv)
A summary of the financial impact that the proposed plan of modification would have had on the last filed annual statement of the insurer;
(v)
A copy of the approval of the proposed plan of modification by the commissioner of the state of domicile; and
(vi)
Any other information requested by the Director; and

(c)

Duration of disablement. For contracts with an elimination period, the duration of disablement must be measured as dating from the time that benefits would have begun to accrue had there been no elimination period.

(3)

The following minimum standards apply to claim reserves for all other benefits:

(a)

Interest. The maximum interest rate for claim reserves is specified in OAR 836-031-0280 (Specific Standards for Interest);

(b)

Morbidity or other contingency. The reserve must be based on the experience of the insurer, if such experience is considered credible, or upon other assumptions that place a sound value on the liabilities.

(4)

Any generally accepted or reasonable actuarial method or combination of methods may be used to estimate all claim liabilities. The methods used for estimating liabilities generally may be aggregate methods, or various reserve items may be separately valued. Approximations based on groupings and averages may also be employed. Adequacy of the claim reserves, however, shall be determined in the aggregate.
836‑031‑0200
Scope, Authority
836‑031‑0210
Definitions, Application and Explanation of Technical Terms Used
836‑031‑0220
Principles Governing Reserves
836‑031‑0230
Claim Reserves
836‑031‑0240
Premium Reserves
836‑031‑0250
Contract Reserves
836‑031‑0260
Reinsurance
836‑031‑0270
Specific Standards for Morbidity
836‑031‑0280
Specific Standards for Interest
836‑031‑0290
Specific Standards for Mortality
836‑031‑0300
Reserves for Waiver of Premium
836‑031‑0400
Allowed Assets
836‑031‑0410
Title Insurance Unearned Premium Reserve
836‑031‑0600
Purpose
836‑031‑0605
Valuation Manual
836‑031‑0610
Authority
836‑031‑0620
Scope
836‑031‑0630
Definitions
836‑031‑0640
General Requirements
836‑031‑0670
Statement of Actuarial Opinion Based On an Asset Adequacy Analysis
836‑031‑0680
Description of Actuarial Memorandum Including an Asset Adequacy Analysis and Regulatory Asset Adequacy Summary
836‑031‑0690
Additional Considerations for Analysis
836‑031‑0750
Purpose, Authority and Applicability
836‑031‑0755
Applicability
836‑031‑0760
Definitions
836‑031‑0765
General Calculation Requirements for Basic Reserves and Premium Deficiency Reserves
836‑031‑0770
Calculation of Minimum Valuation Standard for Policies with Guaranteed Nonlevel Gross Premiums or Guaranteed Nonlevel Benefits (Other than Universal Life Policies)
836‑031‑0775
Calculation of Minimum Valuation Standard for Flexible Premium and Fixed Premium Universal Life Insurance Policies that Contain Provisions Resulting in the Ability of a Policyowner to Keep a Policy in Force Over a Secondary Guarantee Period
836‑031‑0800
Purpose, authority
836‑031‑0805
Definitions
836‑031‑0810
2001 CSO Preferred Class Structure Table
836‑031‑0815
Conditions
836‑031‑0855
Recoupment of Assessments by Oregon Insurance Guaranty Association
Last Updated

Jun. 8, 2021

Rule 836-031-0230’s source at or​.us