742.525
Provider charges.
(1) Except as provided in subsection (2) of this section, a provider shall
charge a person who receives personal injury protection benefits or that person’s
insurer the lesser of:
(a) An amount
that does not exceed the amount the provider charges the general public; or
(b) An amount
that does not exceed the fee schedules for medical services published pursuant
to ORS 656.248 for expenses of medical, hospital, dental, surgical and
prosthetic services.
(2) For expenses
of hospital services that are subject to the adjusted cost-to-charge ratio
specified for a hospital in the hospital fee schedule published pursuant to ORS
656.248, a provider of hospital services shall charge a person who receives
personal injury protection benefits or that person’s insurer the greater of:
(a) The amount of
the hospital charges multiplied by the adjusted cost-to-charge ratio specified
for the hospital; or
(b) Ninety
percent of the hospital charges. [2003 c.813 §4; 2005 c.341 §4; 2011 c.707 §1]
Notes of Decisions
Dowell v. Oregon Mut. Ins. Co., 388 P.3d 1050 (Or. 2017).
· cites it 4× “, ORS 742.525, ORS 742.528. An insurer may deny a PIP claim for medical expenses; however, the “potential existence of a cause of action in tort does not relieve an insurer from the duty to pay [PIP] benefits.”
Strawn v. Farmers Ins., 209 P.3d 357 (Or. Ct. App. 2009).
“” By the time the court entered that judgment, ORS 742.525 had been enacted. Or Laws 2003, ch 813, § 4.”
Koenig v. State Farm Mut. Auto. Ins. Co., 500 P.3d 68 (Or. Ct. App. 2021).
· cites it 2× “And, if bills are disputed on the ground that they may not be causally related to the accident, the PIP insurer is in peril of owing the insured attorney fees if those expenses are later shown to be so related.”
State v. Roskelley, 561 P.3d 125 (Or. Ct. App. 2024).
“See ORS 742.525(1)(b) (providing that PIP claimants shall be charged “an amount that does not exceed the fee schedules for medical services published pursuant to ORS 656.”
Dowell v. Oregon Mut. Ins. Co. (Or. 2017).
· cites it 2× “, ORS 742.525, ORS 742.528. An insurer may deny a PIP claim for medical expenses; however, the “potential existence of a cause of action in tort does not relieve an insurer from the duty to pay [PIP] benefits.”
— Or. Rev. Stat. § 742.525(1)(b) — 4 cases
Dowell v. Oregon Mut. Ins. Co., 388 P.3d 1050 (Or. 2017).
“, ORS 742.525, ORS 742.528. An insurer may deny a PIP claim for medical expenses; however, the “potential existence of a cause of action in tort does not relieve an insurer from the duty to pay [PIP] benefits.”
Koenig v. State Farm Mut. Auto. Ins. Co., 500 P.3d 68 (Or. Ct. App. 2021).
“And, if bills are disputed on the ground that they may not be causally related to the accident, the PIP insurer is in peril of owing the insured attorney fees if those expenses are later shown to be so related.”
State v. Roskelley, 561 P.3d 125 (Or. Ct. App. 2024).
“See ORS 742.525(1)(b) (providing that PIP claimants shall be charged “an amount that does not exceed the fee schedules for medical services published pursuant to ORS 656.”
Dowell v. Oregon Mut. Ins. Co. (Or. 2017).
“, ORS 742.525, ORS 742.528. An insurer may deny a PIP claim for medical expenses; however, the “potential existence of a cause of action in tort does not relieve an insurer from the duty to pay [PIP] benefits.”
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