ORS 743.543
Payment of benefits under blanket health insurance policies

All benefits under a blanket health insurance policy shall be payable to the person insured, or to the designated beneficiary or beneficiaries of the person, or to the estate of the person, except that if the person insured is a minor or otherwise not competent to give a valid release, such benefits may be made payable to the parent, guardian or other person actually supporting the person. However, the policy may provide that all or a portion of any indemnities provided by such policy on account of hospital, nursing, medical or surgical services may, at the option of the insurer and unless the insured requests otherwise in writing not later than the time of filing proofs of such loss, be paid directly to the hospital or person rendering such services; but the policy may not require that the services be rendered by a particular hospital or person. Payment so made shall discharge the obligation of the insurer with respect to the amount of insurance so paid. [1967 c.359 §468]

Source: Section 743.543 — Payment of benefits under blanket health insurance policies, https://www.­oregonlegislature.­gov/bills_laws/ors/ors743.­html.

743.004
Submission of information by carriers offering health benefit plans 743.005
Protection of health information report 743.007
Data reporting 743.008
Reporting requirements 743.010
Health insurance policy and health benefit plan forms 743.015
Filing and approval of credit life and credit health insurance forms 743.018
Filing of rates for life and health insurance 743.019
Procedure for review of proposed rates for health benefit plans 743.020
Rate filing to include statement of administrative expenses 743.022
Premium rates for individual health benefit plans 743.023
Electronic administration 743.025
Rate filing to include prescription drug cost information 743.028
Uniform health insurance claim forms 743.029
Uniform standards for health care financial and administrative transactions 743.031
Stakeholder work group to recommend uniform standards 743.034
Coordination with Oregon Health Authority concerning uniform standards 743.035
Uniform prior authorization form for prescription drug benefits 743.038
Consent of individual required for life and health insurance 743.039
Alteration of application for life or health insurance 743.040
Personal insurance, insurable interest and beneficiaries 743.041
Payment discharges insurer 743.043
Assignment of policies 743.044
Life insurance for benefit of charity 743.046
Exemption of proceeds of individual life insurance other than annuities 743.047
Exemption of proceeds of group life insurance 743.049
Exemption of proceeds of annuity policies 743.050
Exemption of proceeds of health insurance 743.053
Prohibition on requirement that death or dismemberment occur in less than 180 days after accident 743.100
Short title 743.101
Purpose 743.103
Definitions for ORS 743.100 to 743.109 743.104
Scope of ORS 743.100 to 743.109 743.106
Reading ease standards for life and health insurance policies 743.107
When director may authorize lower standards 743.109
Approval of certain policy forms containing specified provisions 743.150
Scope of ORS 743.150, 743.153 and 743.156 743.153
Statement of benefits 743.154
Acceleration of death benefits 743.156
Statement of premium 743.159
Scope of ORS 743.162 to 743.243 743.162
Payment of premium 743.165
Grace period 743.168
Incontestability 743.171
Incontestability and limitation of liability after reinstatement 743.174
Entire contract 743.177
Statements of insured 743.180
Misstatement of age 743.183
Dividends 743.186
Policy loan 743.187
Maximum interest rate on policy loan 743.189
Reinstatement 743.192
Payment of claim 743.195
Installment payments 743.198
Title 743.201
Beneficiary of industrial policies 743.204
Standard Nonforfeiture Law for Life Insurance 743.207
Required provisions relating to nonforfeiture 743.210
Determination of cash surrender values 743.213
Determination of paid-up nonforfeiture benefits 743.215
Calculation of adjusted premiums 743.216
Adjusted premiums 743.218
Requirements for determination of future premium amounts or minimum values 743.219
Supplemental rules for calculating nonforfeiture benefits 743.221
Cash surrender values upon default in premium payment 743.222
Policy benefits and premiums that shall be disregarded in calculating cash surrender values and paid-up nonforfeiture benefits 743.225
Prohibited provisions 743.228
Acts of corporate insured or beneficiary with respect to policy 743.230
Variable life policy provisions 743.231
“Profit-sharing policy” defined 743.234
“Charter policy” or “founders policy” defined 743.237
“Coupon policy” defined 743.240
Profit-sharing, charter or founders policies prohibited 743.243
Restrictions on form of coupon policy 743.245
Variable life insurance policy provisions 743.247
Notice to variable life insurance policyholders 743.252
Scope of ORS 743.255 to 743.273 743.255
Grace period for annuities 743.258
Incontestability 743.261
Entire contract 743.264
Misstatement of age or sex 743.267
Dividends 743.268
Advancement of policy loans 743.269
Periodic payments for period certain 743.270
Reinstatement 743.271
Periodic stipulated payments on variable annuities 743.272
Computing benefits 743.273
Standard provisions of reversionary annuities 743.275
Standard Nonforfeiture Law for Individual Deferred Annuities 743.278
Required provisions in annuity policies 743.284
Computation of benefits 743.287
Commencement of annuity payments at optional maturity dates 743.290
Notice of nonpayment of certain benefits to be included in annuity policy 743.293
Minimum forfeiture amounts for annuity policies 743.295
Effect of certain life insurance and disability benefits on minimum nonforfeiture amounts 743.298
Penalties, fees or charges 743.303
Requirements for issuance of group life insurance policies 743.306
Required provisions in group life insurance policies 743.309
Nonforfeiture provisions 743.312
Grace period 743.315
Incontestability 743.318
Application 743.321
Evidence of insurability 743.324
Misstatement of age 743.327
Payments under policy 743.330
Issuance of certificates 743.333
Termination of individual coverage 743.336
Termination of policy or class of insured persons 743.339
Death during period for conversion to individual policy 743.342
Statement furnished to insured under credit life insurance policy 743.345
Assignability of group life policies 743.348
Certain sales practices prohibited 743.351
Eligibility of association to be group life policyholder 743.354
Requirements for certain group life policies issued to trustees of certain funds 743.356
Continuing coverage upon replacement of group life policy 743.358
Borrowing by certificate holders under group life policy 743.360
Alternative group life insurance coverage 743.371
Definitions for credit life and credit health insurance provisions 743.372
Applicability of credit life and credit health insurance provisions 743.373
Forms of credit life and credit health insurance 743.374
Limits on amount of credit life insurance 743.375
Limit on amount of credit health insurance 743.376
Duration of credit life and credit health insurance 743.377
Credit life and credit health insurance policy or group certificate 743.378
Charges and refunds to debtor 743.379
Status of remuneration to creditor 743.380
Claim report and payment 743.402
Exceptions to individual health insurance policy requirements 743.405
General requirements for health insurance policies 743.406
Required provisions in group health insurance policies 743.408
Mandatory provisions 743.411
Entire contract 743.414
Time limit on certain defenses 743.416
Due date for first premium payment 743.417
Grace period for subsequent premium payments 743.420
Reinstatement 743.423
Notice of claim 743.426
Claim forms 743.429
Proofs of loss 743.432
Time of payment of claims 743.435
Payment of claims 743.438
Physical examinations and autopsy 743.441
Legal actions 743.444
Change of beneficiary 743.447
Optional provisions 743.450
Change of occupation 743.453
Misstatement of age 743.456
Other insurance in same insurer 743.459
Insurance with other insurers 743.462
Insurance with other insurers 743.465
Relation of earnings to insurance 743.468
Unpaid premium 743.471
Cancellation 743.472
Permissible reasons for cancellation or refusal to renew 743.474
Conformity with state statutes 743.477
Illegal occupation 743.483
Arrangement of provisions 743.486
Scope of term “insured” in statutory policy provisions 743.489
Extension of coverage beyond policy period 743.492
Policy return and premium refund provision 743.495
Use of terms “noncancelable” or “guaranteed renewable” 743.498
Statement in policy of cancelability or renewability 743.521
Leased workers 743.522
Additional groups designated by director 743.523
Certain sales practices prohibited 743.524
Eligibility of association to be group health policyholder 743.526
Determination of whether trustees are policyholders 743.535
Health benefit coverage for guaranteed association 743.536
“Blanket health insurance” defined 743.537
Required provisions for blanket health insurance policies 743.540
Application and certificates not required for blanket health insurance policies 743.543
Payment of benefits under blanket health insurance policies 743.546
Exemption of policy form approval for blanket health insurance policies 743.550
Student health insurance 743.551
Student health benefit plans 743.650
Long Term Care Insurance Act 743.652
Definitions for ORS 743.650 to 743.665 743.653
Prohibition on certain policies 743.655
Rules 743.656
Eligibility for benefits 743.658
Notice of lapse or termination 743.662
Rescission of policy and denial of claims 743.664
Offer of nonforfeiture benefit 743.665
Prompt pay requirements 743.680
Definitions for ORS 743.680 to 743.689 743.682
Application of ORS 743.680 to 743.689 743.683
Policy contents 743.684
Filing of policy 743.685
Outline of coverage 743.686
Right to return of policy 743.687
Advertising 743.688
Rules 743.689
Director’s authority upon violation of ORS 743.680 to 743.689 743.787
Definitions for ORS 743.788 743.788
Prescription drug identification card 743.790
Rules for prescription drug identification cards 743.824
Cash dividends for healthy behaviors 743.826
Requirements for catastrophic plans
Green check means up to date. Up to date

Current through early 2024

§ 743.543’s source at oregon​.gov