ORS 742.544
Reimbursement for benefits paid

Text
Annotations 4

(1)

(a)

As used in this subsection, “total amount of the recovery” means the amount that a person injured in a motor vehicle accident recovers from:

(A)

Underinsured motorist benefits described in ORS 742.502 (Uninsured motorist coverage) (2);

(B)

Liability insurance coverage the injured person receives from other parties involved in the motor vehicle accident;

(C)

Personal injury protection benefits or health insurance benefits; and

(D)

Any other payment by or on behalf of the party that caused the motor vehicle accident.

(b)

An insurer may not receive a reimbursement or subrogation for personal injury protection benefits or health benefits the insurer provided to a person injured in a motor vehicle accident from any recovery the injured person obtains in an action for damages except to the extent that:

(A)

The injured person first receives full compensation for the injured person’s injuries; and

(B)

The reimbursement or subrogation is paid only from the total amount of the recovery in excess of the amount that fully compensates for the injured person’s injuries.

(2)

For purposes of this section, the following rebuttable presumptions apply:

(a)

The amount of any judgment that an injured person obtains is the amount necessary to fully compensate for the injured person’s injuries.

(b)

An injured person has received full compensation for the injured person’s injuries if the amount of the recovery is less than the coverage available to the injured person from the sum of benefits paid under another person’s motor vehicle liability policy, under an underinsured motorist policy described in ORS 742.502 (Uninsured motorist coverage) (2), as personal injury protection payments and from any other source of payment from or on behalf of the party whose fault caused the injuries.

(c)

An injured person has not received full compensation for the injured person’s injuries if the injured person recovers an amount that is equal to the coverage available to the injured person from the sum of benefits paid under another person’s motor vehicle liability policy, under an underinsured motorist policy described in ORS 742.502 (Uninsured motorist coverage) (2), as personal injury protection payments and from any other source of payment from or on behalf of the party whose fault caused the injuries.

(3)

An insurer may not deny or refuse to provide benefits that are otherwise available to an injured person because of the potential the injured person has to make a claim or bring an action against another person or enter into a settlement with another person.

(4)

A person with whom an injured person enters into a settlement or from whom the injured person obtains a judgment in connection with a claim or action may not name an insurer that seeks a reimbursement or subrogation under 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) as a payee on a check, draft or other form of payment in satisfaction of the claim or judgment.

(5)

An insurer may not delay, withhold or reduce benefits to an injured person because of an act or omission for which a third party is or may be liable or as a means of enforcing or attempting to enforce a claim for reimbursement or subrogation.

(6)

An insurer that receives a reimbursement for benefits the insurer provided to an injured person shall apply the amount of the reimbursement as a credit against any lifetime maximum benefit set forth for the injured person in the policy, benefit plan or contract under which the insurer paid the benefits.

(7)

A provision in a policy, benefit plan or contract that permits reimbursement or subrogation other than as provided in this section is void and unenforceable.

(8)

This section does not:

(a)

Prohibit insurers from coordinating benefits;

(b)

Limit an insurer’s right to seek reimbursement or subrogation to recover, without reduction, amounts the insurer paid for property damage;

(c)

Limit an insurer that provided coverage against underinsured motorists from pursuing a claim against a party at fault; or

(d)

Require a person to repay more than the amount of personal injury protection benefits that the person actually received. [1993 c.709 §9; 2015 c.5 §5; 2019 c.460 §4]

Source: Section 742.544 — Reimbursement for benefits paid, https://www.oregonlegislature.gov/bills_laws/ors/ors742.html.

Notes of Decisions

Offset is available only if cause of injury or damage occurred on or after November 1, 1993, regardless of when full measure of damages became known. Horlacher v. Mid-Century Insurance, 143 Or App 564, 923 P2d 1317 (1996)

This section limits amount of reimbursement available to insurer under other statutes, but does not confer independent entitlement to reimbursement. Gaucin v. Farmers Insurance Co., 209 Or App 99, 146 P3d 370 (2006)

Where insurer has paid uninsured/underinsured motorist benefits, personal injury protection payment reimbursement from insured is subject to limitations imposed by ORS 742.542. Farmers Insurance Co. v. Conner, 219 Or App 337, 182 P3d 878 (2008), Sup Ct review denied

Law Review Citations

44 WLR 253 (2007)

California:	Codes
Colorado:	C.R.S.
Nevada:	NRS
New York:	Laws
Oregon:	OAR, ORS
Texas:	Statutes
World:	Rome Statute, International Dictionary

ORS 742.544 Reimbursement for benefits paid

(1)

(a)

(A)

(B)

(C)

(D)

(b)

(A)

(B)

(2)

(a)

(b)

(c)

(3)

(4)

(5)

(6)

(7)

(8)

(a)

(b)

(c)

(d)

Notes of Decisions

Law Review Citations

ORS 742.544
Reimbursement for benefits paid