ORS 737.318
Premium audit program for workers’ compensation insurance

  • rules
  • penalties

(1)

A workers’ compensation insurer shall maintain a premium audit program to aid in achieving equitable premium charges to Oregon employers and for the collection of credible statewide data for ratemaking.

(2)

The Director of the Department of Consumer and Business Services shall prescribe by rule a premium audit program system for workers’ compensation insurance.

(3)

The premium audit system shall include provisions for:

(a)

Employer education of the audit reporting function of the rating system;

(b)

A continuing test audit program providing for auditing of all insurers;

(c)

A continuous monitoring of the audit program system pursuant to ORS 737.235 (Examining rating systems of insurers);

(d)

An appeal process pursuant to ORS 737.505 (Insured entitled to rate information) for employers to question the results of a premium audit. This process must include written notification to the employer that is included in the final premium audit billing that informs the employer of appeal rights to the director under ORS 737.505 (Insured entitled to rate information), of the requirement that a written request to initiate an appeal must be received by the director not later than the 60th day after the employer receives the final premium audit billing and of any other information the director may request by rule; and

(e)

Civil penalties pursuant to ORS 731.988 (Civil penalties) for violations of prescribed standards of the premium audit system.

(4)

Notwithstanding ORS 737.505 (Insured entitled to rate information), the provisions of this section apply to all premium audit disputes between employers and insurers in existence on July 20, 1987, regardless of the policy year involved or the date of the final audit billing. [1987 c.884 §8; 1999 c.1020 §5]

Source: Section 737.318 — Premium audit program for workers’ compensation insurance; rules; penalties, https://www.­oregonlegislature.­gov/bills_laws/ors/ors737.­html.

737.007
“Rating organization” defined
737.012
“Advisory organization” defined
737.017
“Member,” “subscriber” defined
737.025
Purpose, intent of chapter
737.035
Application of chapter
737.045
Remedies of director for violations of chapter
737.205
Filing rates, plans with director
737.207
Commercial liability insurance rate filings
737.209
Hearing on rate filings under ORS 737.207
737.215
Effect of noncompliance with rating regulation
737.225
Records requirements
737.230
Data must include certain information
737.235
Examining rating systems of insurers
737.245
Collusive ratings prohibited
737.255
Authority for cooperative ratings and systems
737.265
Unauthorized adherence to rates, rating systems
737.270
Determination of workers’ compensation premiums for worker leasing company
737.275
Preparation of rates, rating systems and other administrative matters by insurers under common ownership
737.310
Method of rate making
737.312
Agreements among insurers for assignment of risks
737.316
Combining employers for workers’ compensation insurance
737.318
Premium audit program for workers’ compensation insurance
737.320
Review of certain filings
737.322
Rating plan approval
737.325
Suspension or modification of filing requirement
737.330
Contracts to comply with effective filings
737.336
Disapproval of filings by director
737.340
Initiation of proceedings by aggrieved person to determine lawfulness of filings
737.342
Hearing and order procedure
737.350
Application for license by rating organization
737.355
Licensing rating organizations generally
737.360
Rating organization to accept insurers as subscribers
737.365
Cooperative activities among rating organizations and insurers
737.390
Regulation of joint underwriting and joint reinsurance
737.505
Insured entitled to rate information
737.510
Advisory organizations
737.515
Examination of rating, advisory and other organizations
737.526
Interchange of data
737.535
Withholding or giving false information prohibited
737.545
Procedure for suspension of rating organization license
737.560
Rating organization membership
737.600
Fictitious grouping for rate purposes prohibited
737.602
Authorization for insurance for certain projects
737.604
Rules
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