742.536 Notice
of claim or legal action to insurer; insurer to elect manner of recovery of
benefits furnished; lien of insurer.
(1) If an authorized motor vehicle liability insurer has furnished personal
injury protection benefits, or an authorized health insurer has furnished
benefits, to a person who was injured in a motor vehicle accident and the
injured person makes a claim, or brings legal action, for damages for injuries
against any other person, the injured person shall give notice of the claim or
legal action to the insurer by personal service or by registered or certified
mail. Service of a copy of the summons and complaint or copy of other process
served in connection with the legal action is sufficient notice to the insurer,
in which case a return showing service of the notice must be filed with the
clerk of the court but is not a part of the record except to give notice.
(2) An insurer
may elect to seek reimbursement as provided in this section for benefits the
insurer has furnished to the injured person out of any recovery the injured
person obtains from a claim or legal action if the insurer has not been a party
under ORS 742.534 to an interinsurer reimbursement proceeding with respect to
benefits the insurer furnished to the injured person and the insurer is
entitled by the terms of the insurer’s policy to the benefit of this section.
The insurer shall give written notice of an election under this subsection by
personal service or by registered or certified mail within 30 days after
receiving the notice or knowledge of the claim or legal action to the person
who made the claim or brought the legal action and to the person against whom
the injured person made a claim or brought legal action. In the case of a legal
action, a return showing service of the notice of election must be filed with
the clerk of the court but is not a part of the record except to give notice to
the claimant and the defendant of the lien of the insurer.
(3) If the
insurer serves a written notice of the insurer’s election under subsection (2)
of this section and, if applicable, files a return showing service:
(a) Subject to
ORS 742.544, an insurer has a lien, for not more than the amount of benefits
the insurer furnished, against an injured person’s recovery in an action for
damages, less a proportionate amount of not more than 100 percent of the
expenses, costs and attorney fees the injured person incurred in connection
with the recovery. The proportionate amount must be calculated as the ratio between
the amount of the lien before a reduction under this paragraph and the amount
of the recovery.
(b) The injured
person shall include the benefits the insurer furnished as damages in a claim
or legal action.
(c) In the case
of a legal action, the action must be taken in the name of the injured person.
(4) As used in
this section, “makes a claim” means delivers a written demand for a specific
amount of damages that meets requirements reasonably established by the
director’s rule. [Formerly 743.828; 2019 c.460 §1]
Notes of Decisions
Mid-Century Ins.. v. Turner, 182 P.3d 855 (Or. Ct. App. 2008).
· cites it 21× “534, ORS 742.536, and ORS 742.538. Accordingly, we affirm.”
Cavanaugh Ex Rel. Cavanaugh v. Providence Health Plan, 699 F. Supp. 2d 1209 (D. Or. 2010).
· cites it 37× “s the Court, among other things, to [djeclare that (a) Providence’s lack of success in enforcing its rights against plaintiff directly against the motor vehicle carriers identified in paragraph 5 of plaintiffs complaint in no way impaired Providence’s right to collect from…”
Gaucin v. Farmers Ins., 146 P.3d 370 (Or. Ct. App. 2006).
· cites it 14× “534, ORS 742.536, and ORS 742.538, are the only sources of authorization for PIP reimbursement.”
State Farm Mut. Auto. Ins. v. Hale, 168 P.3d 285 (Or. Ct. App. 2007).
· cites it 13× “In January 2003, defendant’s attorney wrote to plaintiff, advising it of defendant’s intention of filing a claim against Knotts and, citing ORS 742.536, 1 stating “please advise this office within thirty (30) days from the date of this letter which *22 method of reimbursement of…”
Providence Health Plan v. Winchester, 288 P.3d 13 (Or. Ct. App. 2012).
· cites it 17× “534, ORS 742.536, and ORS 742.538, provide methods for insurers to seek reimbursement of their expenditures and that those provisions preempt any language in defendant’s policy with Providence that purports to give Providence another method of recovery.”
Delcastillo v. Norris, 104 P.3d 1158 (Or. Ct. App. 2005).
· cites it 3× “Because the entire judgment would have gone to reimburse plaintiffs PIP hen 1 pursuant to ORS 742.536, 2 plaintiff personally would have retained nothing from the offer of judgment.”
State v. Jordan, 274 P.3d 289 (Or. Ct. App. 2012).
“” See ORS 742.536 (provides for an insurer’s lien for benefits furnished for a person injured in a motor vehicle accident against amounts recovered by the injured person from third parties).”
Providence Health Plan v. Charriere, 666 F. Supp. 2d 1169 (D. Or. 2009).
· cites it 5× “ages for injuries sustained in a motor vehicle accident by a person for whom personal injury protection benefits have been furnished by another such insurer, or for whom benefits have been furnished by an authorized health insurer, shall reimburse such other insurer for the…”
Strawn v. Farmers Ins., 209 P.3d 357 (Or. Ct. App. 2009).
“Thus, we reject Farmers’ premise that plaintiffs were required to prove that they actually paid the medical expenses that Farmers denied as unreasonable. 7 Next, Farmers contends that certain plaintiffs were not injured because they received compensation from third-party…”
Wynia v. Fick, 986 P.2d 625 (Or. Ct. App. 1999).
· cites it 7× “534 and ORS 742.536. 3 Under those three statutes, a PIP provider has four *370 methods through which to recover benefits that it has paid.”
Garrett v. State Farm Mut. Ins., 829 P.2d 713 (Or. Ct. App. 1992).
· cites it 2× “ages for injuries sustained in a motor vehicle accident by a person for whom personal injury protection benefits have been furnished by another such insurer, or for whom benefits have been furnished by an authorized health insurer, shall reimburse such other insurer for the…”
Bell v. Morales, 142 P.3d 76 (Or. Ct. App. 2006).
· cites it 5× “536(2); by a lien on an insured’s cause of action, ORS 742.536; or otherwise, based on the insurer’s right of subrogation, ORS 742.”
— Or. Rev. Stat. § 742.536(1) — 3 cases
Cavanaugh Ex Rel. Cavanaugh v. Providence Health Plan, 699 F. Supp. 2d 1209 (D. Or. 2010).
“s the Court, among other things, to [djeclare that (a) Providence’s lack of success in enforcing its rights against plaintiff directly against the motor vehicle carriers identified in paragraph 5 of plaintiffs complaint in no way impaired Providence’s right to collect from…”
Providence Health Plan v. Winchester, 288 P.3d 13 (Or. Ct. App. 2012).
“534, ORS 742.536, and ORS 742.538, provide methods for insurers to seek reimbursement of their expenditures and that those provisions preempt any language in defendant’s policy with Providence that purports to give Providence another method of recovery.”
— Or. Rev. Stat. § 742.536(2) — 5 cases
Gaucin v. Farmers Ins., 146 P.3d 370 (Or. Ct. App. 2006).
“534, ORS 742.536, and ORS 742.538, are the only sources of authorization for PIP reimbursement.”
Providence Health Plan v. Winchester, 288 P.3d 13 (Or. Ct. App. 2012).
“534, ORS 742.536, and ORS 742.538, provide methods for insurers to seek reimbursement of their expenditures and that those provisions preempt any language in defendant’s policy with Providence that purports to give Providence another method of recovery.”
Bell v. Morales, 142 P.3d 76 (Or. Ct. App. 2006).
“536(2); by a lien on an insured’s cause of action, ORS 742.536; or otherwise, based on the insurer’s right of subrogation, ORS 742.”
— Or. Rev. Stat. § 742.536(3) — 1 case
— Or. Rev. Stat. § 742.536(3)(a) — 3 cases
State Farm Mut. Auto. Ins. v. Hale, 168 P.3d 285 (Or. Ct. App. 2007).
“In January 2003, defendant’s attorney wrote to plaintiff, advising it of defendant’s intention of filing a claim against Knotts and, citing ORS 742.536, 1 stating “please advise this office within thirty (30) days from the date of this letter which *22 method of reimbursement of…”
Providence Health Plan v. Winchester, 288 P.3d 13 (Or. Ct. App. 2012).
“534, ORS 742.536, and ORS 742.538, provide methods for insurers to seek reimbursement of their expenditures and that those provisions preempt any language in defendant’s policy with Providence that purports to give Providence another method of recovery.”
— Or. Rev. Stat. § 742.536(3)(b) — 1 case
Bell v. Morales, 142 P.3d 76 (Or. Ct. App. 2006).
“536(2); by a lien on an insured’s cause of action, ORS 742.536; or otherwise, based on the insurer’s right of subrogation, ORS 742.”
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