737.318
Premium audit program for workers’ compensation insurance; rules; penalties. (1) A workers’ compensation
insurer shall maintain a premium audit program to aid in achieving equitable
premium charges to Oregon employers and for the collection of credible
statewide data for ratemaking.
(2) The Director
of the Department of Consumer and Business Services shall prescribe by rule a
premium audit program system for workers’ compensation insurance.
(3) The premium
audit system shall include provisions for:
(a) Employer
education of the audit reporting function of the rating system;
(b) A continuing
test audit program providing for auditing of all insurers;
(c) A continuous
monitoring of the audit program system pursuant to ORS 737.235;
(d) An appeal
process pursuant to ORS 737.505 for employers to question the results of a
premium audit. This process must include written notification to the employer
that is included in the final premium audit billing that informs the employer
of appeal rights to the director under ORS 737.505, of the requirement that a
written request to initiate an appeal must be received by the director not
later than the 60th day after the employer receives the final premium audit
billing and of any other information the director may request by rule; and
(e) Civil
penalties pursuant to ORS 731.988 for violations of prescribed standards of the
premium audit system.
(4)
Notwithstanding ORS 737.505, the provisions of this section apply to all
premium audit disputes between employers and insurers in existence on July 20,
1987, regardless of the policy year involved or the date of the final audit
billing. [1987 c.884 §8; 1999 c.1020 §5]
Notes of Decisions
Cited in
15
cases, 1991–2014 · leading case:
Boone v. Wright, 822 P.2d 719 (Or. Ct. App. 1991).
Boone v. Wright, 822 P.2d 719 (Or. Ct. App. 1991).
· cites it 2× “505, the provisions of this section apply to all premium audit disputes between employers and insurers in existence on July 20, 1987, regardless of the policy year involved or the date of the final audit billing." The legislature did not enact that kind of provision here.”
Salem Decorating Ctr., Inc. v. Nat'l Council on Comp. Ins., 840 P.2d 739 (Or. Ct. App. 1992).
· cites it 2× “ORS 737.318 specifically authorizes the director of DIF to develop and administer a premium audit program and appeal process: “(1) A workers’ compensation insurer shall maintain a premium audit program to aid in achieving equitable premium charges to Oregon employers and for the…”
Bruer's Contract Cutting v. Nat'l Council On Comp. Ins., 841 P.2d 690 (Or. Ct. App. 1992).
· cites it 2× “DIF reviewed ORS 737.318 3 and concluded: *489 “The statutory language does not specifically provide for successive hearings on the same issue, but the language does imply that such hearings were contemplated at the time of legislative enactment.”
Pease v. Nat'l Council on Comp. Ins., 830 P.2d 605 (Or. Ct. App. 1992).
· cites it 2× “505(4) provides: “Appeals to the director pursuant to ORS 737.318 with regard to a final premium audit billing must be made within 60 days after receipt of the billing.”
Cobra Constr. v. Nat'l Council on Comp. Ins., 812 P.2d 19 (Or. Ct. App. 1991).
· cites it 2× “505(4): “Appeals to the director pursuant to ORS 737.318 with regard to a final premium audit billing must be made within 60 days after receipt of the billing.”
— Or. Rev. Stat. § 737.318(3)(d) — 3 cases
— Or. Rev. Stat. § 737.318(4) — 1 case
Boone v. Wright, 822 P.2d 719 (Or. Ct. App. 1991).
“505, the provisions of this section apply to all premium audit disputes between employers and insurers in existence on July 20, 1987, regardless of the policy year involved or the date of the final audit billing." The legislature did not enact that kind of provision here.”
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