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.

Source: Rule 836-031-0230 — Claim Reserves, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=836-031-0230.

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