Insurance Policies Generally

ORS 742.525
Provider charges


(1)

Except as provided in subsection (2) of this section, a provider shall charge a person who receives personal injury protection benefits or that person’s insurer the lesser of:

(a)

An amount that does not exceed the amount the provider charges the general public; or

(b)

An amount that does not exceed the fee schedules for medical services published pursuant to ORS 656.248 (Medical service fee schedules) for expenses of medical, hospital, dental, surgical and prosthetic services.

(2)

For expenses of hospital services that are subject to the adjusted cost-to-charge ratio specified for a hospital in the hospital fee schedule published pursuant to ORS 656.248 (Medical service fee schedules), a provider of hospital services shall charge a person who receives personal injury protection benefits or that person’s insurer the greater of:

(a)

The amount of the hospital charges multiplied by the adjusted cost-to-charge ratio specified for the hospital; or

(b)

Ninety percent of the hospital charges. [2003 c.813 §4; 2005 c.341 §4; 2011 c.707 §1]
§§ 742.520 to 742.542

(formerly 743.800 to 743.835)

Notes of Decisions

Nothing in PIP statutes prohibits plaintiff from pleading and proving all special damages in a civil action, even though plaintiff has received PIP benefits from his insurer. Koberstein v. Sierra Glass, 65 Or App 409, 671 P2d 1190 (1983), as modified by 66 Or App 883, 675 P2d 1126 (1984), Sup Ct review denied

PIP endorsement which offsets PIP payments against policy's liability limits does not contravene PIP scheme of these statutes. Edwards v. Bonneville Automobile Insurance Co., 68 Or App 863, 683 P2d 142 (1984), aff'd 299 Or 119, 699 P2d 670 (1985)


Source

Last accessed
Jun. 26, 2021