Chapter 742
742.003
(formerly
743.006)
See
also annotations under ORS 743.006 in permanent edition.
NOTES OF DECISIONS
Failure
to file policy endorsement does not render endorsement invalid. Gifford v.
Western Aviation Ins. Group, 77 Or App 645, 713 P2d 1085 (1986)
Approval
of form by Director of Department of Consumer and Business Services does not
prevent court from reviewing form for compliance with statutory requirements.
Fleming v. United Services Automobile Association, 330 Or 62, 996 P2d 501 (2000)
742.013
(formerly
743.042)
See
also annotations under ORS 743.042 in permanent edition.
NOTES OF DECISIONS
Not
reliance alone, but reliance where there is right to rely will relieve party
from another’s fraud under this section. Kubeck v.
Consol. Underwriters, 267 Or 548, 517 P2d 1039 (1974)
Incorrect
answers on the insurance application were not material as matter of law. Santilli v. State Farm Life Ins. Co., 278 Or 53, 562 P2d
965 (1977)
Insurer
has no duty to investigate representations of policy application where
application is incomplete on its face unless omissions are so obviously
material that reliance on incomplete application would be reckless. Kraus v.
Prudential Ins. Co. of America, 799 F2d 502 (1986)
Where
affidavit of Pacific Hospital Association’s (PHA) executive vice president
states that omitted condition from health insurance application was material to
acceptance of risk, PHA relied on accuracy of plaintiff’s information in
issuing earlier policy and court did not err in granting summary judgment.
Martin v. Pacific Hospital Assoc., 101 Or App 37, 788 P2d 1029 (1990)
Where
typewritten version did not vary materially from original and statutes do not
require “copy” be signed and insured signed Part II of typewritten version,
thereby affirming all parts, unsigned typewritten attachment to policy was “copy”
of original signed, handwritten application. Ives v. INA Life Ins. Co., 101 Or
App 429, 790 P2d 1206 (1990), Sup Ct review denied
To
establish reliance on representations, insurer must show reliance in fact;
reliance that was justified in light of facts known to insurer at time; and
insurer’s right to rely on representations. Story v. Safeco Life Insurance Co.,
179 Or App 688, 40 P3d 1112 (2002)
Where
insurer makes prima facie showing of
reasonable reliance on insured’s representation, insured has burden to show
insurer knew facts that revealed falsity of representation or should have led
insurer to learn falsity of representation. Story v. Safeco Life Insurance Co.,
179 Or App 688, 40 P3d 1112 (2002)
For
copy of application to be “indorsed upon” policy, material information from
application must be inscribed or otherwise reproduced on policy itself. Brock
v. State Farm Mutual Automobile Insurance Co., 195 Or App 519, 98 P3d 759
(2004)
To
deny coverage based on misrepresentation in application, indorsement
upon, or attachment to, insurance policy must be sufficient to fully and
precisely apprise applicant of information being relied upon by insurer in
issuing policy. Brock v. State Farm Mutual Automobile Insurance Co., 195 Or App
519, 98 P3d 759 (2004)
742.016
(formerly
743.045)
See
also annotations under ORS 743.045 in permanent edition.
NOTES OF DECISIONS
Where
application that plaintiff signed and which was part of insurance contract
provided policy could be canceled if plaintiff omitted any material preexisting
health condition and plaintiff failed to list breast condition, Pacific
Hospital Association could cancel policy. Martin v. Pacific Hospital Assoc., 101
Or App 37, 788 P2d 1029 (1990)
742.018
LAW REVIEW CITATIONS: 38 WLR 397 (2002)
742.031
(formerly
743.783, then 743.772)
See
also annotations under ORS 743.783 in permanent edition.
NOTES OF DECISIONS
Evidence
proffered by automobile insurer was insufficient to prove that its insured
willfully avoided cooperation in defending personal injury action, and thus
person injured by insured in automobile accident was entitled to recover from
insurer under this section. Rosalez v. Unigard Insurance Co., 283 Or 63, 581 P2d 945 (1978)
This
section requires that every insurance contract contain clause allowing judgment
creditor to proceed against insurance company. NW Marine Iron v. Western
Casualty, 45 Or App 269, 608 P2d 199 (1980), Sup Ct review denied
742.038
(formerly
743.069)
NOTES OF DECISIONS
Under
circumstances, insurance contract provision limiting coverage for dental
services to expenses incurred within 90 days of accidental injury was not
contrary to public policy and void but trial court erred in striking plaintiff’s
allegation that 90-day limitation negated statutorily required coverage of
maxillofacial prosthetic services allegedly received. Allen v. Pacific Hospital
Assoc., 91 Or App 356, 757 P2d 428 (1988)
742.043
(formerly
743.075)
NOTES OF DECISIONS
In
circumstances where an oral binder and an issued policy are not substantially
the same, the oral binder allowing greater coverage, a plaintiff will be
limited to recovery on the policy. Farley v. United Pac. Ins. Co., 269 Or 549,
525 P2d 1003 (1974)
Insurer,
who wished to exclude renter pilot as insured under binder, should have
designated specified provision in binder as indorsement
or by clear and express terms in binder excluded renter pilot as insured. Avemco Ins. Co. v. Hill, 76 Or App 185, 708 P2d 640 (1985)
742.061
(formerly
743.114)
See
also annotations under ORS 743.114 in permanent edition.
NOTES OF DECISIONS
Lack
of specificity regarding amount of damages does not forestall commencement of
six-month settlement period. State Hwy. Comm. v. DeLong
Corp., 9 Or App 550, 495 P2d 1215 (1972), Sup Ct review denied
If
contingent fee agreement makes no specific reference to any possible attorney
fees which may be awarded by court and makes no specific provision for manner
in which any such fee is to be considered in computing the amount, source and
manner of distribution of contingent fee, any attorney fees awarded by court
shall be offset as a credit or deduction from the amount of the agreed
contingent fee, as computed upon the basis of amount of the judgment. Chalmers
v. Ore. Auto. Ins. Co., 263 Or 449, 502 P2d 1378 (1972)
The
fact that plaintiff’s attorneys in the case are engaged on a contingent fee
basis does not bar an allowance of attorney fees. Chalmers v. Ore. Auto. Ins.
Co., 263 Or 449, 502 P2d 1378 (1972)
Where
the insured seeks both declaratory relief and a money judgment under an
insurance policy, attorney fees may be allowed. Cornell, Howland, Hayes, &
M., Inc. v. Continental Cas. Co., 465 F2d 22 (1972)
This
section was not intended to apply to any situation where an insurer, as an
innocent stakeholder, is willing to pay policy proceeds to whomever they might
belong. Gore v. Prudential Ins. Co. of Am., 265 Or 12, 507 P2d 20 (1973)
Since
this section equates attorney fees with costs, 20-day deadline specified by ORS
20.320 for filing verified statement of costs and disbursements applies. State
ex rel. Town Concrete Pipe, Inc. v. Andersen, 265 Or 593, 510 P2d 564 (1973)
In
action on surety performance bond prevailing party bears the burden of proving
amount and reasonableness of attorney fees. City of Hillsboro ex rel Lenchitsky Heating and Air
Conditioning, Inc. v. Maintenance and Constr. Serv., Inc., 269 Or 169, 523 P2d
1036 (1974)
Where
insurer is estopped from making assertions denying
coverage, recovery on estoppel is recovery on policy
and therefore qualifies for attorney fees. Farley v. United Pacific Ins. Co.,
269 Or 549, 525 P2d 1003 (1974)
Liability
for attorney fees cannot be avoided merely because the litigation was cast in
the form of a declaratory judgment proceeding. Hartford v. Aetna/Mt. Hood
Radio, 270 Or 226, 527 P2d 406 (1974)
Where
there was no bad faith refusal of liability insurer to settle, in that insurer
satisfied entire judgment which was in excess of policy limits, this section
provided no authority to award attorney fees. Kricar,
Inc. v. Gen. Acc., Fire and Life Assur. Corp., 542
F2d 1135 (1976)
The
claimant under an insurance policy is entitled to the attorney fees if he
establishes a claim for more than the tendered amount on his initiative, either
as a plaintiff or defendant who emerges with a money “recovery” in his favor.
Travelers Ins. Co. v. Plummer, 278 Or 387, 563 P2d 1218 (1977)
Appellant
obtaining remand is not entitled to attorney fees and costs incurred on appeal
unless also prevailing at trial following remand. Stanford v. American Guaranty
Life Insurance Company, 281 Or 325, 574 P2d 646 (1978)
In
action against insurance agency to recover losses for agency’s negligent
failure to procure insurance for claimant, defendant was not an insurer and
thus claimant was not entitled to award of attorney fees. Monsantofils
v. Gacek Insurance Agency, 282 Or 3, 576 P2d 789
(1978)
In
order to secure attorney fees under this section, insured must recover money
judgment against insurer; it is not sufficient that insured establish coverage
which may in turn lead to subsequent recovery of money. McGraw v. Gwinner, 282 Or 393, 578 P2d 1250 (1978)
Plaintiff’s
excess insurer was entitled to attorney fees under this section when primary
insurer refused, in bad faith, to pay claim. Portland Gen. Electric Co. v.
Pacific Idem. Co., 579 F2d 514 (1978)
Insurer
acting as assignee of contractual right rather than subrogee
may recover attorney fees. Fisk v. Dairyland Ins.
Co., 42 Or App 777, 601 P2d 868 (1979)
Judgment
creditors may recover attorney fees. Rowley v. Dairyland
Ins. Co., 44 Or App 333, 605 P2d 1356 (1980); NW Marine Iron v. Western
Casualty, 45 Or App 269, 608 P2d 199 (1980), Sup Ct review denied
Excess
carrier who defended claim after primary carrier declined defense was
subrogated to rights of insured and could recover attorney fees pursuant to
this section. Sch. Dist. No. 1 v. Mission Ins. Co., 58 Or App 692, 650 P2d 929 (1982),
Sup Ct review denied
Where
policy for dredge owner covering liability for pollution under Federal Water
Pollution Control Act was more nearly analogous to “general marine” type than
to “wet marine” type, attorney fees may be awarded. Port of Portland v. Water
Quality Insurance Syndicate, 549 F Supp 233 (1982)
Where
plaintiff settled claim against defendant for full amount of policy limits,
then litigated with insurer whether advance payments should be included in
those limits, plaintiff is entitled to recover from insurer attorney fees
incurred in litigation. Kessler v. Weigandt, 73 Or
App 48, 697 P2d 574 (1985), Sup Ct review denied
Although
Washington law governed substantive insurance issues, attorney fees were
awardable as procedural matter subject to Oregon law. Vancouver Furniture v.
Industrial Indemnity, 74 Or App 642, 704 P2d 518 (1985), Sup Ct review
denied
Where
insurer settled within six weeks from date of proof of loss, but then filed
adversary proceedings, sought injunction and asked for constructive trust
throughout remainder of six-month statutory period, prerequisite for award of
attorney fees was not met. American Universal Ins. Co., v. Pugh, 821 F2d 1352
(1987)
Court’s
striking of allegation for attorney fees, incurred by plaintiff in arbitration
proceeding, was not reviewable by appellate court after action on policy, in
which plaintiff sought fees, was dismissed without prejudice. Rossi v. State
Farm Mutual Auto Ins. Co., 90 Or App 589, 752 P2d 1298 (1988), Sup Ct review
denied
Where
general contractor for installation of fire sprinkling system brought action
for declaratory relief that its insurer was required to defend property owner’s
action against general contractor and subcontractors to recover for damage to
tank and reservoir site, general contractor not entitled to attorney’s fees
because it had not recovered money judgment against insurer. Fireguard
Sprinkler Systems v. Scottsdale Ins., 864 F 2d 648 (9th Cir. 1988)
Where
defendant made timely settlement tender and this section did not require that
settlement offer be made before commencement of litigation nor allow for award
of fees incurred before offer, trial court erred in awarding plaintiff attorney
fees. Durflinger v. Statesman Life Ins. Co., 100 Or
App 581, 787 P2d 892 (1990)
Although
action against insurance company was abated and arbitrators established gross
amount of damages suffered by plaintiffs in automobile accident, court
subsequently decided in favor of plaintiffs on legal issues raised by defendant
insurance company in affirmative defenses and counterclaim so plaintiffs were
entitled to attorney fees. Wick v. Viking Ins. Co., 105 Or App 33, 803 P2d 1199
(1990)
Tender
must be absolute and unconditional, except that tender may be accompanied by condition
on which tendering party has right to insist. Gardner v. Cox, 117 Or App 57,
843 P2d 469 (1992)
Attorney
fees incurred before action on insurance policy is filed are recoverable if
reasonably related to action. Farmers Ins. Co. v. Trutanich,
123 Or App 6, 858 P2d 1332 (1993)
Recovery
of attorney fees is not limited to cases involving coverage disputes. Douglass
v. Allstate Ins. Co., 152 Or App 216, 953 P2d 770 (1998), Sup Ct review
denied
Tender
in excess of plaintiff’s recovery does not preclude award of attorney fees if
not made within six months from date of proof of loss. Petersen v. Farmers
Insurance Co., 162 Or App 462, 986 P2d 659 (1999)
“Proof
of loss” means any event or submission that would permit insurer to estimate
obligations. Dockins v. State Farm Insurance Co., 329
Or 20, 985 P2d 796 (1999); Scott v. State Farm Mutual Automobile Insurance Co.,
345 Or 146, 190 P3d 372 (2008)
Proof
of loss submitted less than six months prior to litigation is effective to
commence running of six-month period for settlement without attorney fees. Dockins v. State Farm Insurance Co., 329 Or 20, 985 P2d 796
(1999); Wilson v. Tri-Met, 234 Or App 615, 228 P3d 1225 (2010), Sup Ct review
denied
“Tender”
means timely, unconditional offer of payment made before or after commencement
of litigation. Dockins v. State Farm Insurance Co.,
329 Or 20, 985 P2d 796 (1999)
In
suit brought to enforce insurer compliance with policy, attorney fees are
available notwithstanding that plaintiff may be person other than insured. Webb
v. National Union Fire Insurance Company of Pittsburgh, 207 F3d 579 (9th Cir.
2000)
Self-insurer
providing uninsured motorist coverage is insurer for purposes of being subject
to payment of attorney fees for insurer’s failure to make settlement within six
months following proof of loss. Haynes v. Tri-County Metropolitan
Transportation District of Oregon, 337 Or 659, 103 P3d 101 (2004)
Successful
defendant need not have made tender to settle action against contractor or
subcontractor bond in order for defendant to be entitled to attorney fees.
North Marion School District #15 v. Acstar Insurance
Co., 206 Or App 593, 138 P3d 876 (2006)
Dispute
over insurer’s denial of particular claim for benefits is not dispute over “amount
of benefits.” Grisby v. Progressive Preferred
Insurance Co., 343 Or 175, 166 P3d 519 (2007), modified 343 Or 394, 171
P3d 352 (2007)
Dispute
over enforceability of insurer’s release from rights, claims, demands or
damages that result from accident is not dispute over “amount of benefits.”
Cardenas v. Farmers Insurance Co., 230 Or App 403, 215 P3d 919 (2009)
“Proof
of loss” does not need to be in writing. Parks v. Farmers Insurance Co., 347 Or
374, 227 P3d 1127 (2009)
Multiplier
or other fee enhancement may be used to calculate reasonable attorney fees for
work done at trial or on appeal or work done before an appellate court sitting
pursuant to its original jurisdiction. Strawn v. Farmers Insurance Co., 233 Or
App 401, 226 P3d 86 (2010)
Process
of recovering fees for appellate work may be considered part of appeal for
purpose of fee petition. Strawn v. Farmers Insurance Co., 233 Or App 401, 226
P3d 86 (2010)
Requirement
that attorney fees be imposed if settlement is not made within six months from
date of proof of loss is exception to ORCP 54 E. Wilson v. Tri-Met, 234 Or App
615, 228 P3d 1225 (2010), Sup Ct review denied
“Policy
of insurance” includes enforceable oral binder of insurance. Stuart v. Pittman,
350 Or 410, 255 P3d 482 (2011)
LAW REVIEW CITATIONS: 44 WLR 253 (2008)
742.206
(formerly
743.609)
NOTES OF DECISIONS
Fire
insurance policy terminates at 12:01 a.m. on last date of coverage regardless
of whether policy included this provision or whether insured received policy “jacket”
containing provision. Cambron v. North-West Ins. Co.,
70 Or App 51, 687 P2d 1132 (1984), Sup Ct review denied
742.208
(formerly
743.612)
See
also annotations under ORS 743.612 in permanent edition.
NOTES OF DECISIONS
In
action for insurance fraud or false swearing brought under this section,
standard of proof is preponderance of evidence. Mutual of Enumclaw Ins. v.
McBride, 295 Or 398, 667 P2d 494 (1983)
“Reliance”
means ordinary reliance requiring evidence of detrimental action or change in
position. Eslamizar v. American States Ins. Co., 134
Or App 138, 894 P2d 1195 (1995), Sup Ct review denied
Restriction
of fraud and concealment exclusion to actions by “the insured” does not mandate
similar restriction of nonconflicting contractual
exclusions. Traders and General Insurance Co. v. Freeman, 81 F. Supp. 2d 1070
(D. Or. 2000)
742.216
NOTES OF DECISIONS
House
is “unoccupied” if not in actual use by person as usual place of habitation.
Schmidt v. Underwriters at Lloyds of London, 191 Or App 340, 82 P3d 649 (2004)
742.222
NOTES OF DECISIONS
Estoppel is not included under term “waiver” in this
section. Kabban v. Mackin,
104 Or App 422, 801 P2d 883 (1990)
742.232
(formerly
743.648)
See
also annotations under ORS 743.648 in permanent edition.
NOTES OF DECISIONS
Where
defendant-insurers demanded appraisal under this section to determine actual
cash value of plaintiff’s building which was destroyed by fire, action by
plaintiffs, seeking determination of various policy provisions relevant to
fixing amount of loss, was premature and this section, together with [former]
ORS 743.660, required plaintiffs to proceed with the appraisal before bringing
declaratory judgment action. Director v. So. Carolina Ins. Co., 49 Or App 179,
619 P2d 649 (1980), Sup Ct review denied
This
section, in requiring that all fire insurance policies sold in state include
provision that disputed amounts of loss be submitted to appraisal does not
violate Article I, section 17, of Oregon Constitution by depriving plaintiff of
right to jury trial when construed as non-binding as to party who does not
demand appraisal. Molodyh v. Truck Insurance
Exchange, 304 Or 290, 744 P2d 992 (1987)
LAW REVIEW CITATIONS: 31 WLR 737 (1995)
742.240
(formerly
743.660)
See
also annotations under ORS 743.660 in permanent edition.
NOTES OF DECISIONS
Commencement
of an action within the limitation in this section was governed by ORS 12.220. Hatley v. Truck Ins. Exch., 261 Or 606, 484 P2d 426, 495
P2d 1196 (1972)
Where
defendant-insurers demanded appraisal under [former] ORS 743.648 to determine
actual cash value of plaintiffs’ building which was destroyed by fire, action
by plaintiffs, seeking determination of various policy provision relevant to
fixing amount of loss, was premature and this section, together with [former]
ORS 743.648, required plaintiffs to proceed with the appraisal before bringing
declaratory judgment action. Director v. So. Carolina Ins. Co., 49 Or App 179,
619 P2d 649 (1980), Sup Ct review denied
Since
purpose of this section is not to be statutory limitation period but to be
limit on ability of insurers to impose shorter limitation period by operation
of contract, ORS 12.155 cannot toll the running of this limitation period. Ben Rybke, Co. v. Royal Globe Ins. Co., 293 Or 513, 651 P2d 138
(1982)
Where
policy does not comply with this section, courts must construe policy to
contain mandatory statutory requirements and applicable limitation period is
one-year period under this section. Olson v. National Indemnity Co., 112 Or App
359, 829 P2d 716 (1992)
Statutory
language prevents application of discovery rule to determine date of loss.
Moore v. Mutual of Enumclaw Insurance Co., 317 Or 235, 855 P2d 626 (1993)
Suit
limitation provision is neither statute of limitations nor forfeiture of coverage.
Herman v. Valley Insurance Co., 145 Or App 124, 928 P2d 985 (1996), Sup Ct review
denied
Insurer
is not required to show prejudice in order to assert suit limitation defense.
Herman v. Valley Insurance Co., 145 Or App 124, 928 P2d 985 (1996), Sup Ct review
denied
742.246
NOTES OF DECISIONS
“Sufficiently
explanatory” means title must put reader on notice that provisions appearing
under title restrict or abridge right to coverage or other rights of insured
under policy. Fleming v. United Services Automobile Association, 329 Or 449,
988 P2d 378 (1999), modified 330 Or 62, 996 P2d 501 (2000)
Requirement
that provision restricting or abridging rights of insured carry explanatory
title is applicable to multi-peril insurance policy containing fire coverage.
Fleming v. United Services Automobile Association, 330 Or 62, 996 P2d 501
(2000)
Explanatory
title may be printed in mixed uppercase and lowercase type so long as all
letters are at least as large as eight-point capital letters. Indiana Lumbermens Mutual Insurance Co. v. West Oregon Wood
Products, Inc., 268 F3d 639 (9th Cir. 2001)
742.449 to 742.466
NOTES OF DECISIONS
Where
Financial Responsibility Law requires motor vehicle insurance policies to
insure against all liability arising out of motor vehicle “ownership,
operation, use or maintenance,” insurer’s named driver policy which insurer
sold to insured in connection with insured’s vehicle must be construed as
providing coverage by law and insurer is responsible for insured’s defense.
Viking Ins. Co. v. Perotti, 308 Or 623, 784 P2d 1081
(1989)
742.450
(formerly
486.541, then 743.776)
See
also annotations under ORS 486.541 in permanent edition.
NOTES OF DECISIONS
This
section, together with ORS 806.070, does not mandate omnibus coverage to limits
set forth in ORS 806.070. Shell Oil Co. v. Employers Ins. of Wausau, 69 Or App
179, 684 P2d 622 (1984)
Financial
responsibility laws generally are to ensure that drivers can respond in damages
for liability and especially to ensure that motor vehicle accident victims are
compensated for injuries. State Farm Fire and Casualty Co. v. Jones, 306 Or
415, 759 P2d 271 (1988)
Car
insurance policy violated Financial Responsibility Law where it excluded
liability coverage for permissive user’s injury of insured while driving
insured’s car. State Farm Fire and Casualty Co. v. Jones, 306 Or 415, 759 P2d
271 (1988)
Automobile
insurance policy must cover not only named insured but also must provide
coverage for all persons who operate insured vehicle with consent of insured.
Viking Ins. Co. v. Petersen, 308 Or 616, 784 P2d 437 (1989)
Family
exclusion provision of policy is ineffective only as to statutorily required
minimum amounts; insurer may limit additional coverage by any exclusion not
otherwise prohibited by law. Collins v. Farmers Ins. Co., 312 Or 337, 822 P2d
1146 (1991)
“Statement”
excluding person from policy coverage may be embodied as recital in insurance
application form. Progressive Insurance v. National American Insurance Co., 201
Or App 301, 118 P3d 836 (2005)
LAW REVIEW CITATIONS: 44 WLR 253 (2008)
742.454
(formerly
486.546, then 743.778)
NOTES OF DECISIONS
Words
“need not insure” differentiate between risks statute enumerates and risks that
policies required by law do not need to insure; injuries to family members are
not among risks that liability policies “need not insure” and therefore
policies issued under Financial Responsibility Law must insure such injuries.
Dowdy v. Allstate Ins. Co., 68 Or App 709, 685 P2d 444 (1984), Sup Ct review
denied
LAW REVIEW CITATIONS: 44 WLR 253 (2008)
742.456
(formerly
486.551, then 743.779)
See
also annotations under ORS 486.551 in permanent edition.
NOTES OF DECISIONS
Under
this section, insurance carrier’s liability is absolute with respect to
policies issued as proof of financial responsibility, and insurer was not
entitled to raise defense of insured’s non-cooperation where policy was issued
for this purpose. Rowley v. Dairyland Ins. Co., 44 Or
App 333, 605 P2d 1356 (1980)
742.460
(formerly
486.561, then 743.782)
See
annotations under ORS 486.561 in permanent edition.
742.464
(formerly
486.566, then 743.785)
NOTES OF DECISIONS
Under
this section, insurer who failed to file notice of cancellation required by ORS
806.270 was liable only for required statutory coverage and not for excess
amount of lapsed policy. Oregon Automobile Ins. Co. v. Thorbeck,
283 Or 271, 583 P2d 543 (1978)
Legislative
intent in using word “coverage” in this section is to encompass not only risk
insured against but also monetary amount of insurance. Oregon Automobile Ins.
Co. v. Thorbeck, 283 Or 271, 583 P2d 543 (1978)
Family
exclusion provision of policy is ineffective only as to statutorily required
minimum amounts; insurer may limit additional coverage by any exclusion not
otherwise prohibited by law. Collins v. Farmers Ins. Co., 312 Or 337, 822 P2d
1146 (1991)
742.468
NOTES OF DECISIONS
Exclusion
from definition of motor vehicle liability policies only applies to listed
policies initially issued after effective date of statute. Savage v. Grange
Mutual Insurance Co., 158 Or App 86, 970 P2d 695 (1999), Sup Ct review
denied
742.500 to 742.506
(formerly
743.786 to 743.795)
NOTES OF DECISIONS
These
statutes apply to umbrella policies that insure against loss arising from use
of automobile. American Economy Ins. Co. v. Canamore,
114 Or App 348, 834 P2d 542 (1992), Sup Ct review denied
LAW REVIEW CITATIONS: 24 WLR 948 (1988)
742.500
(formerly
743.786)
LAW REVIEW CITATIONS: 8 WLJ 83 (1972)
742.502
(formerly
743.789)
See
also annotations under ORS 743.789 in permanent edition.
NOTES OF DECISIONS
Insurer’s
notification of availability of increased uninsured motorist coverage satisfied
requirement of “offer” under this section. Beck v. Powell, 113 Or App 318, 832
P2d 1254 (1992), Sup Ct review denied
Underinsured
motorist limits can be calculated without conflict with ORS 742.542. Yokum v. Farmers Ins. Co., 117 Or App 546, 844 P2d 937
(1993), Sup Ct review denied
Underinsured
motorist coverage applies only where dollar amount of tortfeasor’s
policy is exceeded, notwithstanding that recovery limitations imposed by law
may prevent full recovery of damages. Dasteur v.
American Economy Ins. Co., 127 Or App 686, 874 P2d 85 (1994), Sup Ct review
denied
Whether
car is underinsured is determined by comparing per accident policy limitations,
not per person policy limitations. Windsor Ins. Co. v. Judd, 321 Or 379, 898
P2d 761 (1995)
Where
policy was initially issued prior to effective date of 1993 amendments to this
section, appropriate remedy for insurer’s failure to make required offering of
uninsured motorist coverage is to read into insurance contract coverage insurer
should have offered. Savage v. Grange Mutual Insurance Co., 158 Or App 86, 970
P2d 695 (1999), Sup Ct review denied
Failure
of insurer to offer increased uninsured motorist insurance at time of policy
issuance dictates imputing increased coverage, notwithstanding policyholder
election at subsequent time to decline increased coverage. Buccino
v. California Casualty Insurance Co., 159 Or App 654, 978 P2d 441 (1999), Sup
Ct review denied
For
single-limit policy, amount recoverable by insured as underinsured or uninsured
motorist benefit is subject to offset only by those amounts paid by other
sources on account of injury to that individual insured. Grijalva
v. Safeco Insurance Co., 329 Or 36, 985 P2d 784 (1999)
Statutory
exclusion of insured vehicles from definition of uninsured vehicle in ORS
742.504 is applicable to underinsured motorist coverage. Wright v. State Farm
Mutual Automobile Insurance Co., 332 Or 1, 22 P3d 744 (2001)
Where
multiple claimants obtain recovery under liability policy, provisions of this
section allowing recovery equal to amount by which underinsured motorist insurance
exceeds claimant’s recovery supersede requirement of this section that damages
or death arise from vehicle insured for less than amount of underinsured
motorist coverage. Takano v. Farmers Insurance Co., 184 Or App 479, 56 P3d 491
(2002), Sup Ct review denied
Under
2001 version of statute, whether tortfeasor was
underinsured was determined by comparing insurance policy limit of tortfeasor with policy limit of insured. Mid-Century
Insurance Co. v. Perkins, 209 Or App 613, 149 P3d 265 (2006), aff’d 344 Or 196, 179 P3d 633 (2008), modified
345 Or 373, 195 P3d 59 (2008)
Under
2001 version of this section, phrase “Uninsured motorist coverage benefits”
means uninsured motorist liability limits in policy of insured, not total
amount of damages incurred. Vogelin v. American
Family Mutual Insurance Co., 346 Or 490, 213 P3d 1216 (2009)
Provision
that subjects underinsurance coverage to model policy terms requires model
policy terms to apply equally to uninsured motorist and underinsured motorist
coverage unless application of terms is inconsistent with mandate to provide
underinsured motorist coverage. Vogelin v. American
Family Mutual Insurance Co., 346 Or 490, 213 P3d 1216 (2009)
Insurer
may offset tortfeasor liability payment against
policy limit for uninsured motorist liability. Vogelin
v. American Family Mutual Insurance Co., 346 Or 490, 213 P3d 1216 (2009)
LAW REVIEW CITATIONS: 34 WLR 327 (1998);
44 WLR 253 (2008)
742.504
(formerly
743.792)
See
also annotations under ORS 743.792 in permanent edition.
NOTES OF DECISIONS
In general
A
tortfeasor whose insurance policy is disclaimed
subsequent to an accident for failure to notify his insurer of the accident is
an uninsured motorist under this section. General Acc. Fire and Life Assur. Corp., Ltd. v. Shasky, 266
Or 312, 512 P2d 987 (1973)
A
tortfeasor is not uninsured because his liability
insurance is insufficient in amount to compensate for all injuries. Lund v.
Mission Ins. Co., 270 Or 461, 528 P2d 78 (1974)
An
endorsement excluding coverage while the insured automobile was operated by a
person under 25 years of age did not preclude the passenger injured by the
negligence of the uninsured motorist from recovering under the uninsured
motorist provisions of the policy even though the driver of the insured vehicle
was under the age of 25. Hartford Acc. and Indem. Co.
v. Dairyland Ins. Co., 274 Or 145, 545 P2d 113 (1976)
In
the absence of a specific agreement, this section does not apply to establish a
two-year statute of limitations; if the policy is silent, the normal six-year
statute of limitations for contract actions applies. North River Ins. v. Kowaleski, 275 Or 531, 551 P2d 1286 (1976); Kalhar v. Transamerica Ins. Co., 129 Or App 38, 877 P2d 656
(1994), Sup Ct review denied
Where
insured brought action against insurance company alleging that insurer, in bad
faith, prejudiced his claim for uninsured motorist coverage, this section and
insurance contract provided that arbitration was condition precedent to
litigation. Mendelson v. State Farm Mutual Auto Ins.
Co., 285 Or 269, 590 P2d 726 (1979)
This
section authorizes insurer to exclude from uninsured motorist coverage an
insured who occupies a vehicle as to which insured has procured liability
insurance satisfying financial responsibility law. State Farm Mut. Ins. Co. v. Whitlock, 59 Or App 303, 650 P2d 1042
(1982), Sup Ct review denied
Vehicle
fitting any categories of this section is “the insured motor vehicle” for
purposes of PIP. Utah Home Fire Ins. Co. v. Colonial Ins. Co., 300 Or 564, 715
P2d 1112 (1986)
Requirement
that named insured be person designated in schedule does not mean that
principal shareholder of insured corporation is covered by policy that only
names corporation. Meyer v. American Economy Ins. Co., 103 Or App 160, 796 P2d
1223 (1990), Sup Ct review denied
Plaintiff’s
injuries were not covered when plaintiff was run over by uninsured thief
stealing plaintiff’s insured vehicle. Cole v. Farmer Ins. Co., 108 Or App 277,
814 P2d 188 (1991)
Benefits
were not payable under uninsured motorist policy until policy limits of other tortfeasors had been exhausted. Stembridge
v. West American Ins. Co., 109 Or App 552, 823 P2d 418 (1991); Estate of Salma S. Serang v. Amer. States
Ins. Co., 127 Or App 405, 873 P2d 367 (1994)
“Insured
vehicle” does not include nonowned vehicle driven by
named insured, if one of the passengers owns vehicle. Farmers Ins. Co. v. Paepier, 110 Or App 77, 822 P2d 140 (1991), Sup Ct review
denied
Nothing
in language “furnished for regular use” requires that vehicle must be totally
under insured’s control and available for both personal and business use. North
Pacific Ins. Co. v. Anderson, 110 Or App 269, 821 P2d 444 (1991)
Arbitration
proceedings described in this section do not violate right to jury trial
because claimant or insurer is not required to arbitrate claim and can demand
jury trial. Carrier v. Hicks, 316 Or 341, 851 P2d 581 (1993)
Insured
satisfies entitlement to recovery by establishing that other motorist was
uninsured and is legally liable for damages to insured and amount of damages. Kalhar v. Transamerica Ins. Co., 129 Or App 38, 877 P2d 656
(1994), Sup Ct review denied
“Occupying”
is limited to processes that directly cause, continue or terminate physical
relationship between person and car. Marcilionis v.
Farmers Ins. Co., 318 Or 640, 871 P2d 470 (1994)
Provision
making damage determination through mandatory arbitration binding on party not
requesting arbitration violated constitutional right to jury. Lind v. Allstate
Insurance Co., 134 Or App 395, 895 P2d 327 (1995), modified 136 Or App
532, 902 P2d 603 (1995), Sup Ct review denied
Validity
of policy provision is based on comparison between coverage under policy and
coverage under hypothetical policy consisting totally of statutory model
provisions. Vega v. Farmers Ins. Co., 323 Or 291, 918 P2d 95 (1996)
Only
permissible variation from model statutory provisions is to exclude or soften
provisions favorable to insurer or to add extraneous terms that are neutral or
favorable to insured. Vega v. Farmers Ins. Co., 323 Or 291, 918 P2d 95 (1996)
Total
underinsured motorist coverage benefits are calculated by deducting amount
recovered from other automobile liability policies from base amount of
uninsured motorist coverage. Pitchford v. State Farm
Mutual Auto. Ins. Co., 147 Or App 9, 934 P2d 616 (1997), Sup Ct review
denied
Filing
action that is subject to court-mandated arbitration is not election to settle
matter by arbitration. Douglass v. Allstate Ins. Co., 152 Or App 216, 953 P2d
770 (1998), Sup Ct review denied
Because
recovery of damages against government is limited by [former] ORS 30.270,
injured party is not “legally entitled to recover” excess damages through
uninsured motorist insurance claim. Surface v. American Spirit Insurance Cos.,
154 Or App 696, 962 P2d 717 (1998), aff’d 335
Or 356, 67 P3d 938 (2003)
Offset
of paid-out workers’ compensation benefits against amount due from underinsured
motorist insurance applies regardless of whether workers’ compensation
beneficiaries and insurance beneficiaries are identical. Estate of Linda Greenslitt v. Farmers Insurance Co., 156 Or App 75, 964 P2d
1129 (1998)
Where
action is victim’s claim against insurer under policy issued to victim, whether
injury was intentional is viewed from perspective of victim, not person
inflicting harm. Fox v. Country Mutual Insurance Co., 327 Or 500, 964 P2d 997
(1998)
Injury
is “caused by accident” if injury itself was not intentionally inflicted, even
though caused by intentional act. Fox v. Country Mutual Insurance Co., 327 Or
500, 964 P2d 997 (1998)
Defendant’s
successful assertion of contributory negligence defense does not make plaintiff
insured “person or organization alleged to be legally responsible for bodily
injury.” Safeco Insurance Co. v. Laskey, 162 Or App
1, 985 P2d 878 (1999)
For
single-limit policy, amount recoverable by insured as underinsured or uninsured
motorist benefit is subject to offset only by those amounts paid by other
sources on account of injury to that individual insured. Grijalva
v. Safeco Ins. Co., 329 Or 36, 985 P2d 784 (1999)
Insured’s
acceptance of settlement offer from tortfeasor’s
liability insurer precludes recovering uninsured motorist benefits based on
liability insurer’s earlier denial of coverage. Fox v. Country Mutual Insurance
Co., 169 Or App 54, 7 P3d 677 (2000), Sup Ct review denied
Requirement
that suit against uninsured motorist be “filed” within specified time does not
incorporate requirement for service of process. Lindsey v. Farmers Insurance
Co., 170 Or App 458, 12 P3d 571 (2000)
“This
coverage” refers to underinsured motorist coverage provided by individual
policy, not aggregate coverage under multiple policies issued by same insurer. VanWormer v. Farmers Insurance Co., 171 Or App 450, 15 P3d
612 (2000)
Relevant
factors for determining whether person using uninsured vehicle is member of
household of insured are: 1) whether parties live under one roof; 2) length of
time parties have lived together; 3) whether residence is intended to be permanent
or temporary; and 4) whether parties are financially independent. State Farm
Mutual Automobile Insurance Co. v. McCormick, 171 Or App 657, 17 P3d 1083
(2000), Sup Ct review denied
“Amount
paid” under workers’ compensation law means net amount that insured received
after any recoupment by workers’ compensation insurer. Harlow v. Allstate
Insurance Co., 177 Or App 122, 33 P3d 363 (2001)
For
purposes of deducting payments from other sources, amount payable under terms
of “this coverage” is amount insured would be legally entitled to recover from
owner or operator of uninsured or underinsured vehicle on account of bodily
injury, not policy limit on insurer liability. Bergmann v. Hutton, 337 Or 596,
101 P3d 353 (2004)
Person
is “severally liable together with” underinsured motorist if person is
independently liable to insured for same injuries caused by underinsured
motorist. Kerry v. Quicehuatl, 213 Or App 589, 162
P3d 1033 (2007), Sup Ct review denied
Where
policy fails to clearly notify insured of requirement imposed on insured by
statute, policy language is less favorable to insured than statutory language.
Wilson v. Tri-County Metropolitan Transportation District of Oregon, 343 Or 1,
161 P3d 933 (2007)
Under
2001 version of statute, “operator” of uninsured vehicle means person who
exercises actual physical control over vehicle. Rogozhnikov
v. Essex Insurance Co., 222 Or App 565, 195 P3d 400 (2008)
Period
during which insured is disabled does not toll time limitation for accrual of
cause of action. Wright v. State Farm Mutual Automobile Ins. Co., 223 Or App
357, 196 P3d 1000 (2008)
Where
matter concerns employer and worker, and where neither party has requested
order from Workers’ Compensation Board, trial court has subject matter
jurisdiction over issue of reimbursement of underinsured motorist benefits.
Longstreet v. Liberty Northwest Insurance Corporation, 238 Or App 396, 245 P3d
656 (2010)
Insurance
contract that contains mutual agreement to arbitrate dispute is not required to
institute formal arbitration proceedings. Bonds v. Farmers Insurance Co., 349
Or 152, 240 P3d 1086 (2010)
To
formally institute arbitration proceedings, insured or insurer must expressly
communicate to other party that initiating party is beginning process of arbitrating
dispute. Bonds v. Farmers Insurance Co., 349 Or 152, 240 P3d 1086 (2010)
Party
does not formally institute arbitration proceedings when party has consented to
arbitrate upon occurrence of certain event and, upon occurrence of that event,
does not expressly advise or acknowledge to other party that event has
occurred. Bonds v. Farmers Insurance Co., 349 Or 152, 240 P3d 1086 (2010)
Phantom vehicle
Corroboration,
as used in phantom vehicle provision, means evidence that supplements,
strengthens and confirms testimony of injured claimant; it does not mean that
claimant’s prima faciecase rests solely on corroborating
evidence. Farmers Ins. Exch. v. Colton, 264 Or 210, 504 P2d 1041 (1972)
Where
insured acted with reasonable diligence and under circumstances of case, he was
excused from strict compliance with notice requirements of this section.
Farmers Ins. Exch. v. Colton, 264 Or 210, 504 P2d 1041 (1972)
The
requirement of corroborative “facts of an accident” means observation, with
corroborated testimony thereof, of facts from which inferences may be drawn
that accident was caused by phantom vehicle. Farmers Ins. Exch. v. Colton, 264
Or 210, 504 P2d 1041 (1972)
Even
though individual’s policy does not contain phantom vehicle coverage, this section
requires that policy be construed as though it contained phantom vehicle
coverage required by statute. Farmers Ins. Exch. v. Colton, 264 Or 210, 504 P2d
1041 (1972)
Testimony
of witness who released right to claim against insurer prior to testifying was
not legally insufficient as corroborative evidence. To v. State Farm Mutual
Ins., 319 Or 93, 873 P2d 1072 (1994)
LAW REVIEW CITATIONS: 54 OLR 328 (1975);
31 WLR 737 (1995); 34 WLR 327 (1998); 44 WLR 253 (2008)
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)
742.520
(formerly
743.800)
NOTES OF DECISIONS
Insurance
policy clause required by this section, providing for payment of 70 percent of
injured person’s lost wages during period of disability, was inapplicable where
injured person was killed instantaneously, because there was no period of “disability”
within meaning of policy. Perez v. State Farm Mutual Auto Ins. Co., 43 Or App
19, 602 P2d 284 (1979), aff’d 289 Or 295, 613
P2d 23 (1980)
Where
liability policy issued to plaintiff’s father covered private passenger vehicle
registered to father, fact that plaintiff was injured riding motorcycle did not
disqualify him from PIP coverage. Garrow v.
Pennsylvania Gen. Ins. Co., 40 Or App 23, 594 P2d 415 (1979), aff’d 288 Or 215, 603 P2d 1175 (1979)
Where,
at time of accident, insured father’s married son and his wife and child were
living in father’s house and paying $100 per month room and board, son was
member of father’s family, residing in father’s household as required for
coverage under this section. Garrow v. Pennsylvania
Gen. Ins. Co., 40 Or App 23, 594 P2d 415 (1979), aff’d
288 Or 215, 603 P2d 1175 (1979)
Language
of this section and [former] ORS 743.805 indicates that legislature was aware
of family exclusion provision and chose to regulate it only to limited extent.
State Farm v. Baughman, 57 Or App 576, 646 P2d 102 (1982)
Under
definitions of “pedestrian” and “occupying” of this section, defendant who was
ejected from car, rendered immobile and struck by plaintiff’s insured, was “pedestrian.”
State Farm Ins. v. Berg, 70 Or App 410, 689 P2d 959 (1984), Sup Ct review
denied
Where
passenger was occupying motor vehicle insured as temporary substitute vehicle
in driver’s policy, personal injury protection benefits afforded to passenger
under driver’s liability policy while passenger was riding in her own vehicle
were primary insurance, while personal injury protection benefits afforded to
passenger under her own broad form named operator policy were excess insurance.
Utah Home Fire Ins. Co. v. Colonial Ins. Co., 300 Or 564, 715 P2d 1112 (1986)
ORS
12.155, which requires person making advance payment before determining tort
liability to give written notice of when applicable statute of limitations will
run, is not applicable to Personal Injury Protection payments made under this
section. Smith v. Riker, 88 Or App 579, 746 P2d 247 (1987), Sup Ct review
denied
Breach
of good faith duty to pre-authorize treatment is denial of benefits subject to
mandatory arbitration provision. Eggiman v.
Mid-Century Insurance Co., 134 Or App 381, 895 P2d 333 (1995)
Injury
results from use of motor vehicle if injury is direct or indirect consequence
or effect of motor vehicle use. Carrigan v. State
Farm Mutual Automobile Ins. Co., 326 Or 97, 949 P2d 705 (1997)
ATTY. GEN. OPINIONS: Use of PIP benefits
for uninsured pedestrian eligible for medical assistance and covered under
Motor Vehicle Accident Fund, (1982) Vol. 43, p 1
LAW REVIEW CITATIONS: 31 WLR 737 (1995)
742.522
NOTES OF DECISIONS
Nonrecovery of attorney fees and costs does not apply to
fees and costs incurred in litigating previously arbitrated personal injury
protection claim. Kramm v. Mid-Century Ins. Co., 153
Or App 325, 956 P2d 1036 (1998)
Application
of pre-1997 version of ORS 742.520 so as to make arbitration binding on nondemanding party denied constitutional right to jury in
civil cases. Foltz v. State Farm Mutual Auto. Ins. Co., 326 Or 294, 952
P2d 1012 (1998)
LAW REVIEW CITATIONS: 31 WLR 737 (1995)
742.524
(formerly
743.805)
NOTES OF DECISIONS
Language
of this section and [former] ORS 743.800 indicates that legislature was aware
of family exclusion provision and chose to regulate it only to limited extent.
State Farm v. Baughman, 57 Or App 576, 646 P2d 1022 (1982)
742.526
(formerly
743.810)
NOTES OF DECISIONS
Personal
injury protection benefits may be offset by benefits collected from another
source if the insurance policy so provides. Southwestern Ins. Co. v. Winn, 274
Or 695, 548 P2d 1311 (1976)
Where
insurer made personal injury protection payments to insureds
who subsequently received workers compensation awards for same injury, former
statute did not authorize imposition of equitable trust to recover these
payments. Farmers Ins. Co. v. Ownby, 40 Or App 15,
594 P2d 834 (1979)
When
damages incurred by insured are greater than personal injury benefits
designated by this section as “primary,” insurer is liable for “excess” damages
to the limits of its coverage and protection benefits are triggered for payment
that excess insurance coverage must be greater than primary insurance coverage.
Porter v. Utah Home Fire Ins. Co., 58 Or App 729, 650 P2d 130 (1982)
Policy
which covers vehicle involved in collision or accident is primary as against
policy not covering vehicle. Utah Home Fire Ins. Co. v. Colonial Ins., 300 Or
564, 715 P2d 1112 (1986)
Where
plaintiff presently has no entitlement to underinsured motorist benefits under
her own insurance contract, personal injury protection insurance benefits under
defendant’s insured’s contract are not excess over underinsured motor coverage.
Farley v. Farmers Insurance Co. of Oregon, 83 Or App 99, 730 P2d 598 (1986)
Medical
assistance payments made by the state under ORS chapter 414 are “governmental
benefits” within the meaning of this section and thus personal injury
protection benefits are limited to expenses that exceed any medical assistance
payments. Farmers Insurance Co. of Oregon v. Wickham, 86 Or App 100, 739 P2d 30
(1987)
742.534
(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)
742.538
(formerly
743.830)
NOTES OF DECISIONS
Former
similar statute did not authorize imposition of trust by insurer against
workers compensation carrier who made payments to insured or against insurers
who received payments as neither were “motorists legally responsible.” Farmers
Insurance Co. v. Ownby, 40 Or App 15, 594 P2d 834
(1979)
Provision
allowing insurer to require that insured bring action to recover amount of
insurance benefits paid does not permit insured to bring second action on claim
against tortfeasor. Wynia
v. Fick, 162 Or App 365, 986 P2d 625 (1999), Sup Ct review
denied
Use
of process under ORS 742.534 does not bar claim filed pursuant to this section
for moneys that cannot be claimed under ORS 742.534. Providence Health Plan v. Charriere, 666 F. Supp. 2d 1169 (D. Or. 2009)
LAW REVIEW CITATIONS: 27 WLR 562 (1991)
742.542
(formerly
743.835)
NOTES OF DECISIONS
Insurer
is allowed to subtract personal injury protection benefits paid to its insured
from the amount due under the uninsured motorist coverage whether or not the
insured is fully compensated for his or her loss. Monaco v. U.S. Fid. and Guar.
Co., 275 Or 183, 550 P2d 422 (1976)
Judgment
for general damages does not have to be reduced by amount of Personal Injury
Protection payments made by defendants to plaintiff’s insurer. McIntire v.
Gray, 39 Or App 861, 593 P2d 1273 (1979), Sup Ct review denied
Statute
is clear and unambiguous and allows only offset of PIP benefits against
uninsured motorist coverage insured receives from own insurer. Staiger v. Burkhart, 68 Or App 548, aff’d
299 Or 49, 698 P2d 487 (1985)
Plaintiff’s
uninsured motorist coverage limits cannot be reduced by amount of personal
injury protection benefits paid by insured’s insurer. Yokum
v. Farmers Ins. Co., 117 Or App 546, 844 P2d 937 (1993), Sup Ct review
denied
Underinsured
motorist limits can be calculated under ORS 742.502 without conflict with this
section. Yokum v. Farmers Ins. Co., 117 Or App 546,
844 P2d 937 (1993), Sup Ct review denied
Limitation
on insurer reimbursement entitles insured to policy benefits for personal
injury protection and uninsured/underinsured motorist coverage up to level of
damages. Farmers Insurance Co. v. Conner, 219 Or App 337, 182 P3d 878 (2008),
Sup Ct review denied
“Underinsured
motorist coverage policy limits” refers to total amount insured is entitled to
recover under policy’s underinsured motorist coverage, not to amount of
benefits owed under policy. Farmers Insurance Co. v. Conner, 219 Or App 337,
182 P3d 878 (2008), Sup Ct review denied
ATTY. GEN. OPINIONS: Repayment of War
Veterans Fund moneys transferred to General Fund, (1988) Vol
46, p 78, clarified (1989) Vol 46, p 245
LAW REVIEW CITATIONS: 34 WLR 327 (1998);
44 WLR 253 (2008)
742.544
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 (2008)
742.564
NOTES OF DECISIONS
Where
insured agreed to termination, policy that insured receive notice of
cancellation of coverage sufficient to entitle insured to procure other
insurance was inapplicable. Nelson v. Oregon Insurance Guaranty Assn., 102 Or
App 125, 794 P2d 1 (1990), Sup Ct review denied