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]

Source: Section 742.534 — Reimbursement of other insurers paying benefits; arbitrating issues of liability and amount of reimbursement, https://www.­oregonlegislature.­gov/bills_laws/ors/ors742.­html.

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

742.001
Scope of ORS chapters 742, 743, 743A and 743B
742.003
Filing and approval of policy forms
742.004
Exemptions from requirement to file rates and policy forms
742.005
Grounds for disapproval of policy forms
742.007
Director’s withdrawal of approval
742.008
Health savings account exemption from prohibition on deductible
742.009
Regulation of sales material
742.011
Insurable interest in property
742.013
Representations in applications
742.016
Policy constitutes entire contract
742.018
Provision for construction according to foreign law prohibited
742.021
Standard provisions in general
742.023
Contents of policies in general
742.026
Underwriters’ and combination policies
742.028
Additional policy contents
742.031
Bankruptcy clause required in certain liability policies
742.033
Charter and bylaw provisions
742.036
Assessment policies, special contents
742.038
Validity and construction of noncomplying forms
742.041
Permissible classes of insurance in one policy
742.043
Binders
742.046
Delivery of policy
742.048
Effective date and time of coverage
742.051
Renewal by certificate
742.053
Forms for proof of loss
742.056
Certain conduct not deemed waiver
742.058
Return of premium on destruction of property
742.061
Recovery of attorney fees in action on policy or contractor’s bond
742.063
Filing and approval of liability form that includes cost of defense within limits of liability
742.065
Insurance against risk of loss assumed under less than fully insured employee health benefit plan
742.150
Approval by director
742.152
Limitations on applicability of ORS 742.150
742.154
Factors to be considered by director in determining whether to approve assumption reinsurance agreement
742.156
Notice of transfer under assumption reinsurance agreement
742.158
Rejection of transfer by policyholder
742.160
Effect of novation of policy under assumption reinsurance agreement
742.162
Transfer and novation of policy effected by director
742.200
Fire insurance not to exceed value of property insured
742.202
Standard fire insurance policy
742.204
Exceptions to standard fire insurance policy requirements
742.206
Insuring agreement
742.208
Concealment
742.210
Uninsurable and excepted property
742.212
Perils not included
742.214
Other insurance
742.216
Conditions suspending insurance
742.218
Additional perils insured
742.220
Added provisions
742.222
Waiver provisions
742.224
Cancellation
742.226
Mortgagee interest and obligation of mortgagee
742.228
Pro rata liability of insurer
742.230
Requirements in case loss occurs
742.232
Appraisal
742.234
Insurer’s options
742.236
Abandonment
742.238
When loss payable
742.240
Suit on policy
742.242
Subrogation
742.244
Coverage for loss from nuclear reaction or radiation
742.246
Other fire insurance policy provisions permitted
742.248
Mutual fire insurers policyholders’ liability
742.250
Mutual fire insurer’s action to recover assessment
742.252
Mutual fire insurers
742.254
Mutual fire insurance policy cancellation
742.260
Cancellation of homeowner or fire policy
742.270
Repair, rebuilding or replacement of property under homeowner insurance policy
742.273
Property losses in locations subject to declarations of emergency
742.276
Estimates of cost to rebuild or replace covered property
742.280
Home protection insurance
742.282
Limitations on issuance of mortgage insurance
742.284
Insured obligations as legal investments and securities for deposit
742.286
Mortgage insurance
742.350
Bonds, undertakings and other obligations required by law may be executed by surety insurers
742.352
Reimbursement of private persons required to give bond, letter of credit or other obligation
742.354
Reimbursement of public officials required to give bond or letter of credit
742.356
Surety insurer may take measures to reduce risk of loss
742.358
Release of surety on official bonds by action of obligee
742.360
Release of surety on bond of public official by action of surety
742.362
Release of surety on depository bond
742.364
Fixing amount of new bond after release from original
742.366
Cancellation of bond by surety
742.368
Surety insurer may not deny power to execute bond
742.370
Bond construed as including omitted statutory provisions
742.372
Guaranteed arrest bond certificate
742.374
Surety may issue guaranteed arrest bond certificate not to exceed $1,000
742.376
Requirements to issue guaranteed arrest bond certificate
742.390
Reimbursement insurance policy
742.392
Termination of reimbursement insurance policy
742.400
Duty to report claim of professional negligence to licensing board
742.405
Conditions for issuance of medical malpractice insurance
742.407
Prohibition against refusing defense or indemnification of health practitioner or health care facility based on disclosure of adverse event or participation in discussion or mediation
742.420
Definitions for ORS 742.420 to 742.440
742.422
License requirement for conducting business as discount medical plan organization
742.424
Requirement for contract with provider
742.426
License application
742.428
Duties of licensee
742.430
License term
742.432
Duties of discount medical plan organization
742.434
Prohibited activities
742.436
Investigative powers of director
742.438
License suspension, revocation or failure to renew
742.440
Injunction
742.447
Proof of insurance
742.449
Prohibition on assignment to high risk category on certain grounds
742.450
Contents of motor vehicle liability policy
742.454
Liabilities that need not be covered
742.456
When insurer’s liability accrues
742.458
General provisions governing liability policies
742.460
Insurer’s right to provide for reimbursement and proration
742.462
Insurer’s right to settle claims
742.464
Excess coverage permitted
742.466
Disputes over coverage for physical damage
742.468
Certain policies not considered motor vehicle liability policies
742.480
Appropriate premium charge reduction for certain motorcycle insurance policies
742.483
Effective period for premium reduction
742.486
Issuance and presentation of certificates for motorcycle rider education course
742.490
Premium reduction
742.492
Duration of reduction
742.494
Certification of completion of course
742.496
Limitation on qualification for discount
742.500
Definitions for ORS 742.500 to 742.506
742.502
Uninsured motorist coverage
742.504
Required provisions of uninsured motorist coverage
742.505
Arbitration procedures under ORS 742.504
742.506
Allocation of responsibility among insurers
742.508
Definitions for ORS 742.508 and 742.510
742.510
Property damage coverage for damage to vehicle caused by uninsured vehicle
742.518
Definitions for ORS 742.518 to 742.542
742.520
Personal injury protection benefits for motor vehicle liability policies
742.521
Conditions applicable to arbitration proceedings
742.522
Binding arbitration under ORS 742.520
742.524
Contents of personal injury protection benefits
742.525
Provider charges
742.526
Primary nature of benefits
742.528
Notice of denial of payment of benefits
742.529
Payment based on incorrect determination of responsibility
742.530
Exclusions from coverage
742.532
Benefits may be more favorable than those required by ORS 742.520, 742.524 and 742.530
742.534
Reimbursement of other insurers paying benefits
742.536
Notice of claim or legal action to insurer
742.538
Subrogation rights of insurers to certain amounts received by injured person
742.540
Rules
742.542
Effect of personal injury protection benefits paid
742.544
Reimbursement for benefits paid
742.546
Required disclosure in release for bodily injuries related to personal injury protection benefits
742.548
Required language in disclosure
742.554
Disclosures required by insurer to motor vehicle owner when insurer declares vehicle total loss
742.558
Dispute resolution process for total loss vehicles
742.560
Definitions for ORS 742.560 to 742.572
742.562
Grounds for cancellation of policies
742.564
Manner of giving cancellation notice
742.566
Renewal of policies
742.568
Proof of cancellation, replacement or nonrenewal notice
742.570
Notifying insured under canceled or unrenewed policy of eligibility for participation in insurance pool
742.572
Immunity from liability of persons furnishing information regarding cancellation or nonrenewal of policies
742.580
Report of cancellation, nonrenewal or issuance of motor vehicle liability policy
742.585
Definitions for ORS 742.585 to 742.600
742.590
Personal vehicle sharing program requirements
742.595
Assumption of liability
742.600
Limitation on insurance policy reclassification for personal vehicle sharing program vehicle
742.690
Limitations on cancellation
742.700
Definitions for ORS 742.700 to 742.710
742.702
Grounds for cancellation
742.704
Hearing
742.706
Renewal
742.708
Proof of receipt of notice
742.710
Exemptions from provisions of ORS 742.700 to 742.708
Green check means up to date. Up to date