742.524
Contents of personal injury protection benefits; deductibles. (1) Personal injury protection
benefits required by ORS 742.520 consist of the following payments for the
injury or death of each person:
(a) All
reasonable and necessary expenses of medical, hospital, dental, surgical,
ambulance and prosthetic services incurred within two years after the date of
the person’s injury, but not more than $15,000 in the aggregate for all such
expenses of the person. Expenses of medical, hospital, dental, surgical,
ambulance and prosthetic services are presumed to be reasonable and necessary
unless the provider receives notice of denial of the charges not more than 60
calendar days after the insurer receives from the provider notice of the claim
for the services. At any time during the first 50 calendar days after the
insurer receives notice of claim, the provider shall, within 10 business days,
answer in writing questions from the insurer regarding the claim. For purposes
of determining when the 60-day period provided by this paragraph has elapsed,
counting of days shall be suspended if the provider does not supply written
answers to the insurer within 10 days and may not resume until the answers are
supplied.
(b) If the
injured person is usually engaged in a remunerative occupation and if
disability continues for at least 14 days, 70 percent of the loss of income
from work during the period of the injured person’s disability until the date
the person is able to return to the person’s usual occupation. This benefit is
subject to a maximum payment of $3,000 per month and a maximum payment period
in the aggregate of 52 weeks. As used in this paragraph, “income” includes but
is not limited to salary, wages, tips, commissions, professional fees and
profits from an individually owned business or farm.
(c) If the
injured person is not usually engaged in a remunerative occupation and if
disability continues for at least 14 days, the expenses reasonably incurred by
the injured person for essential services that were performed by a person who
is not related to the injured person or residing in the injured person’s
household in lieu of the services the injured person would have performed
without income during the period of the person’s disability until the date the
person is reasonably able to perform such essential services. This benefit is
subject to a maximum payment of $30 per day and a maximum payment period in the
aggregate of 52 weeks.
(d) All
reasonable and necessary funeral expenses incurred within one year after the
date of the person’s injury, but not more than $5,000.
(e) If the
injured person is a parent of a minor child and is required to be hospitalized
for a minimum of 24 hours, $25 per day for child care, with payments to begin
after the initial 24 hours of hospitalization and to be made for as long as the
person is unable to return to work if the person is engaged in a remunerative
occupation or for as long as the person is unable to perform essential services
that the person would have performed without income if the person is not
usually engaged in a remunerative occupation, but not to exceed $750.
(2) With respect
to the insured person and members of that person’s family residing in the same
household, an insurer may offer forms of coverage for the benefits required by
subsection (1)(a), (b) and (c) of this section with deductibles of up to $250. [Formerly
743.805; 1991 c.768 §7; 2003 c.813 §2; 2005 c.341 §1; 2009 c.66 §1; 2015 c.5 §4]
Notes of Decisions
Dowell v. Oregon Mut. Ins. Co., 388 P.3d 1050 (Or. 2017).
· cites it 171× “PIP benefits “consist of payments for expenses, loss of income and loss of essential services as provided in ORS 742.524.” ORS 742.520(3). An insurer must pay PIP benefits “promptly after proof of loss has been submitted to the insurer.”
Strawn v. Farmers Ins. Co. of Oregon, 258 P.3d 1199 (Or. 2011).
· cites it 16× “520(1) (mandating PIP coverage for "[e]very motor vehicle liability policy issued for delivery in this state" for private passenger motor vehicles).”
Ivanov v. Farmers Ins., 185 P.3d 417 (Or. 2008).
· cites it 30× “Instead, Farmers argued that: (1) under ORS 742.524, insureds such as plaintiffs, whose PIP claims had been timely denied, had the burden of proving that their claims were medically necessary before their challenge to Farmers' claims review process could proceed to a trier of…”
Dowell v. Oregon Mut. Ins., 343 P.3d 283 (Or. Ct. App. 2015).
· cites it 28× “” ORS 742.524(1)(a). Plaintiff argues that the phrase “expenses of medical * * * services” in ORS 742.”
Strawn v. Farmers Ins., 209 P.3d 357 (Or. Ct. App. 2009).
· cites it 15× “We note that Farmers’ fifth assignment of error also raises a number of issues that appear to go beyond the question of whether “reasonableness” under ORS 742.524(1) is a jury matter. In fact, plaintiffs have moved to strike Farmers’ fifth assignment of error for that reason.”
Ivanov v. Farmers Ins., 140 P.3d 1189 (Or. Ct. App. 2006).
· cites it 8× “See ORS 742.524(l)(a) (1999) (defining PIP benefits as all “reasonable and necessary expenses of medical, hospital, dental, surgical, ambulance and prosthetic services incurred within one year after the date of the person’s injury, but not more than $10,000 in the aggregate for…”
Strawn v. Farmers Ins., 256 P.3d 100 (Or. 2011).
· cites it 2× “ORS 742.524(1)(a). Plaintiff Mark Strawn filed a class action against Farmers, alleging that Farmers's claims handling processwhich reduced payments for covered medical services to the eightieth percentile of similar bills contained in a medical billing databasebreached its…”
Eggiman v. Mid-Century Ins., 895 P.2d 333 (Or. Ct. App. 1995).
· cites it 4× “It is true that the PIP statutes, including ORS 742.524(1), do not expressly impose a duty to preauthorize.”
Spearman v. Progressive Classic Ins., 366 P.3d 839 (Or. Ct. App. 2016).
· cites it 2× “524(1) provides that PIP benefits include the following: “(a) All reasonable and necessary expenses of medical, hospital, dental, surgical, ambulance and prosthetic services incurred within one year after the date of the person’s injury, but not more than $15,000 in the…”
Grisby v. Progressive Preferred Ins., 142 P.3d 531 (Or. Ct. App. 2006).
· cites it 4× “520(3) ("[PIP] benefits consist of payments for expenses, loss of income and loss of essential services as provided in ORS 742.524."); ORS 742.524. See generally Irvin E.”
Robinson v. Tri-Cnty. Metro. Transp. Dist., 370 P.3d 864 (Or. Ct. App. 2016).
“PIP is no-fault coverage for wage loss and medical bills, ORS 742.524, whereas UM and UIM is coverage dependent on the fault of the uninsured or underinsured motorist, ORS 742.”
— Or. Rev. Stat. § 742.524(1) — 10 cases
Dowell v. Oregon Mut. Ins. Co., 388 P.3d 1050 (Or. 2017).
“PIP benefits “consist of payments for expenses, loss of income and loss of essential services as provided in ORS 742.524.” ORS 742.520(3). An insurer must pay PIP benefits “promptly after proof of loss has been submitted to the insurer.”
Strawn v. Farmers Ins. Co. of Oregon, 258 P.3d 1199 (Or. 2011).
“520(1) (mandating PIP coverage for "[e]very motor vehicle liability policy issued for delivery in this state" for private passenger motor vehicles).”
Ivanov v. Farmers Ins., 185 P.3d 417 (Or. 2008).
“Instead, Farmers argued that: (1) under ORS 742.524, insureds such as plaintiffs, whose PIP claims had been timely denied, had the burden of proving that their claims were medically necessary before their challenge to Farmers' claims review process could proceed to a trier of…”
Strawn v. Farmers Ins., 209 P.3d 357 (Or. Ct. App. 2009).
“We note that Farmers’ fifth assignment of error also raises a number of issues that appear to go beyond the question of whether “reasonableness” under ORS 742.524(1) is a jury matter. In fact, plaintiffs have moved to strike Farmers’ fifth assignment of error for that reason.”
Spearman v. Progressive Classic Ins., 366 P.3d 839 (Or. Ct. App. 2016).
“524(1) provides that PIP benefits include the following: “(a) All reasonable and necessary expenses of medical, hospital, dental, surgical, ambulance and prosthetic services incurred within one year after the date of the person’s injury, but not more than $15,000 in the…”
— Or. Rev. Stat. § 742.524(1)(a) — 14 cases
Dowell v. Oregon Mut. Ins. Co., 388 P.3d 1050 (Or. 2017).
“PIP benefits “consist of payments for expenses, loss of income and loss of essential services as provided in ORS 742.524.” ORS 742.520(3). An insurer must pay PIP benefits “promptly after proof of loss has been submitted to the insurer.”
Strawn v. Farmers Ins. Co. of Oregon, 258 P.3d 1199 (Or. 2011).
“520(1) (mandating PIP coverage for "[e]very motor vehicle liability policy issued for delivery in this state" for private passenger motor vehicles).”
Strawn v. Farmers Ins., 209 P.3d 357 (Or. Ct. App. 2009).
“We note that Farmers’ fifth assignment of error also raises a number of issues that appear to go beyond the question of whether “reasonableness” under ORS 742.524(1) is a jury matter. In fact, plaintiffs have moved to strike Farmers’ fifth assignment of error for that reason.”
Ivanov v. Farmers Ins., 185 P.3d 417 (Or. 2008).
“Instead, Farmers argued that: (1) under ORS 742.524, insureds such as plaintiffs, whose PIP claims had been timely denied, had the burden of proving that their claims were medically necessary before their challenge to Farmers' claims review process could proceed to a trier of…”
Dowell v. Oregon Mut. Ins., 343 P.3d 283 (Or. Ct. App. 2015).
“” ORS 742.524(1)(a). Plaintiff argues that the phrase “expenses of medical * * * services” in ORS 742.”
— Or. Rev. Stat. § 742.524(1)(b) — 2 cases
— Or. Rev. Stat. § 742.524(1)(e) — 2 cases
Dowell v. Oregon Mut. Ins. Co., 388 P.3d 1050 (Or. 2017).
“PIP benefits “consist of payments for expenses, loss of income and loss of essential services as provided in ORS 742.524.” ORS 742.520(3). An insurer must pay PIP benefits “promptly after proof of loss has been submitted to the insurer.”
— Or. Rev. Stat. § 742.524(l)(a) — 9 cases
Dowell v. Oregon Mut. Ins. Co., 388 P.3d 1050 (Or. 2017).
“PIP benefits “consist of payments for expenses, loss of income and loss of essential services as provided in ORS 742.524.” ORS 742.520(3). An insurer must pay PIP benefits “promptly after proof of loss has been submitted to the insurer.”
Dowell v. Oregon Mut. Ins., 343 P.3d 283 (Or. Ct. App. 2015).
“” ORS 742.524(1)(a). Plaintiff argues that the phrase “expenses of medical * * * services” in ORS 742.”
Ivanov v. Farmers Ins., 185 P.3d 417 (Or. 2008).
“Instead, Farmers argued that: (1) under ORS 742.524, insureds such as plaintiffs, whose PIP claims had been timely denied, had the burden of proving that their claims were medically necessary before their challenge to Farmers' claims review process could proceed to a trier of…”
Ivanov v. Farmers Ins., 140 P.3d 1189 (Or. Ct. App. 2006).
“See ORS 742.524(l)(a) (1999) (defining PIP benefits as all “reasonable and necessary expenses of medical, hospital, dental, surgical, ambulance and prosthetic services incurred within one year after the date of the person’s injury, but not more than $10,000 in the aggregate for…”
Eggiman v. Mid-Century Ins., 895 P.2d 333 (Or. Ct. App. 1995).
“It is true that the PIP statutes, including ORS 742.524(1), do not expressly impose a duty to preauthorize.”
— Or. Rev. Stat. § 742.524(l)(b) — 2 cases
— Or. Rev. Stat. § 742.524(l)(e) — 1 case
Dowell v. Oregon Mut. Ins. Co., 388 P.3d 1050 (Or. 2017).
“PIP benefits “consist of payments for expenses, loss of income and loss of essential services as provided in ORS 742.524.” ORS 742.520(3). An insurer must pay PIP benefits “promptly after proof of loss has been submitted to the insurer.”
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