ORS 742.534
Reimbursement of other insurers paying benefits; arbitrating issues of liability and amount of reimbursement


(1)

Except as provided in ORS 742.544 (Reimbursement for benefits paid), every authorized motor vehicle liability insurer whose insured is or would be held legally liable for damages for injuries sustained in a motor vehicle accident by a person for whom personal injury protection benefits have been furnished by another such insurer, or for whom benefits have been furnished by an authorized health insurer, shall reimburse such other insurer for the benefits it has so furnished if it has requested such reimbursement, has not given notice as provided in ORS 742.536 (Notice of claim or legal action to insurer) that it elects recovery by lien in accordance with that section and is entitled to reimbursement under this section by the terms of its policy. Reimbursement under this subsection, together with the amount paid to injured persons by the liability insurer, shall not exceed the limits of the policy issued by the insurer.

(2)

In calculating such reimbursement, the amount of benefits so furnished shall be diminished in proportion to the amount of negligence attributable to the person for whom benefits have been so furnished, and the reimbursement shall not exceed the amount of damages legally recoverable by the person.

(3)

Disputes between insurers as to such issues of liability and the amount of reimbursement required by this section shall be decided by arbitration.

(4)

Findings and awards made in such an arbitration proceeding are not admissible in any action at law or suit in equity.

(5)

If an insurer does not request reimbursement under this section for recovery of personal injury protection payments, then the insurer may only recover personal injury protection payments under the provisions of ORS 742.536 (Notice of claim or legal action to insurer) or 742.538 (Subrogation rights of insurers to certain amounts received by injured person). [Formerly 743.825; 1993 c.709 §7; 2007 c.392 §1]

(formerly 743.825)

Notes of Decisions

An insurer who makes recovery from third party for moneys paid its insured is only required to pay attorney fees which were “reasonably and necessarily incurred” to make recovery; and, absent an agreement to contrary, an insurer is only obligated for attorney fees if it is benefited. Ridenour v. Nationwide Mut. Ins. Co., 273 Or 514, 541 P2d 1377 (1975)

No reimbursement could be compelled against insurer of party allegedly at fault by insurer who made personal injury payments if action by plaintiff-insured was barred by statute of limitations. West American Ins. Co. v. Nationwide Mutual Ins. Co., 39 Or App 525, 593 P2d 796 (1979), Sup Ct review denied

Reference to furnishing of benefits by “another insurer” and “other insurer” does not preclude insurer who by chance insures both vehicles from offset provided by [former] ORS 18.510. State Farm Mut. Auto Ins. v. Sommerholder, 65 Or App 449, 671 P2d 1194 (1983), Sup Ct review denied

“Authorized” motor vehicle liability insurer which is required to reimburse another such insurer for amount paid by it to insured for PIP benefits is not entitled to credit in that amount in determining whether reimbursing insurer has exhausted liability policy limits in settling claim against its insured by payee of the PIP benefits where payee’s damages are in excess of liability policy limits. Kessler v. Weigandt, 299 Or 38, 699 P2d 183 (1985)

Formal acknowledgment of obligation under this section to reimburse constitutes “reimbursement payment” within meaning of [former] ORS 18.510 (PIP reimbursement payments). Dougherty v. Gelco Express Corp., 79 Or App 490, 719 P2d 906 (1986)

When insurer paid passenger injured in motor vehicle accident amount equal to liability limits of insured’s policy, this section prevented further exposure to other insurer. Farmers Ins. Co. v. American Fire & Casualty, 117 Or App 347, 844 P2d 235 (1992), Sup Ct review denied

Statement that insurer would proceed pursuant to PIP reimbursement procedure was not “reimbursement payment” within meaning of [former] ORS 18.510 because insurer did not commit to specific payment amount. Heintz v. Baxter, 120 Or App 603, 853 P2d 320 (1993), Sup Ct review denied

Interinsurer reimbursement is not available for underinsured motorist coverage paid to injured insured. Providence Health Plan v. Charriere, 666 F. Supp. 2d 1169 (D. Or. 2009)

Section requires arbitration of any potential dispute pertaining to interinsurer reimbursement. California Casualty Indemnity v. Federated Mutual, 251 Or App 371, 286 P3d 901 (2012), Sup Ct review denied

§§ 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)


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Last accessed
May. 15, 2020