74th OREGON LEGISLATIVE ASSEMBLY--2007 Regular Session
Enrolled
House Bill 3490
Sponsored by Representative KOMP; Representative KRUMMEL,
Senators CARTER, KRUSE, VERGER
CHAPTER ................
AN ACT
Relating to proof of loss; creating new provisions; and amending
ORS 742.518.
Be It Enacted by the People of the State of Oregon:
SECTION 1. ORS 742.518 is amended to read:
742.518. As used in ORS 742.518 to 742.542:
(1) 'Evaluation services' means physical examinations or
reviews of medical records of beneficiaries conducted at the
request of an insurer by either an employee of the insurer or a
third-party medical record or bill review service to determine
whether the provision or continuation of medical services is
necessary or reasonable.
(2) 'Managed care services' means any system of health care
delivery that attempts to control or coordinate use of health
care services in order to contain health care expenditures or
improve quality of health care services.
(3) 'Motor vehicle' means a self-propelled land motor vehicle
or trailer, other than:
(a) A farm-type tractor or other self-propelled equipment
designed for use principally off public roads, while not upon
public roads;
(b) A vehicle operated on rails or crawler-treads; or
(c) A vehicle located for use as a residence or premises.
(4) 'Motorcycle' and 'moped' have the meanings given those
terms in ORS 801.345 and 801.365.
(5) 'Occupying' means in, or upon, or entering into or
alighting from.
(6) 'Pedestrian' means a person while not occupying a
self-propelled vehicle other than a wheelchair or a similar
low-powered motorized or mechanically propelled vehicle that is
designed specifically for use by a physically disabled person and
that is determined to be medically necessary for the occupant of
the wheelchair or other low-powered vehicle.
(7) 'Personal injury protection benefits' means the benefits
described in ORS 742.518 to 742.542.
(8) 'Private passenger motor vehicle' means a four-wheel
passenger or station wagon type motor vehicle not used as a
public or livery conveyance, and includes any other four-wheel
motor vehicle of the utility, pickup body, sedan delivery or
panel truck type not used for wholesale or retail delivery other
than farming, a self-propelled mobile home and a farm truck.
Enrolled House Bill 3490 (HB 3490-A) Page 1
{ + (9) 'Proof of loss' means documentation that allows an
insurer to determine whether a person is entitled to personal
injury protection benefits and the amount of any benefit that is
due. + }
{ - (9) - } { + (10) + } 'Provider' has the meaning given
that term in ORS 743.801.
SECTION 2. { + Section 3 of this 2007 Act is added to and made
a part of ORS 742.518 to 742.542. + }
SECTION 3. { + If personal injury protection benefits are paid
based on information that appeared to establish proof of loss and
the insurer paying the benefits later determines the insurer was
not responsible for the payment, the insurer shall give notice
and explanation to the provider that the payment was incorrectly
issued. Immediately after receiving the notice and explanation
the provider shall promptly repay the insurer. + }
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Passed by House May 9, 2007
...........................................................
Chief Clerk of House
...........................................................
Speaker of House
Passed by Senate May 29, 2007
...........................................................
President of Senate
Enrolled House Bill 3490 (HB 3490-A) Page 2
Received by Governor:
......M.,............., 2007
Approved:
......M.,............., 2007
...........................................................
Governor
Filed in Office of Secretary of State:
......M.,............., 2007
...........................................................
Secretary of State
Enrolled House Bill 3490 (HB 3490-A) Page 3