742.544
Reimbursement for benefits paid.
(1)(a) As used in this subsection, “total amount of the recovery” means the
amount that a person injured in a motor vehicle accident recovers from:
(A) Underinsured
motorist benefits described in ORS 742.502 (2);
(B) Liability
insurance coverage the injured person receives from other parties involved in
the motor vehicle accident;
(C) Personal
injury protection benefits or health insurance benefits; and
(D) Any other
payment by or on behalf of the party that caused the motor vehicle accident.
(b) An insurer
may not receive a reimbursement or subrogation for personal injury protection
benefits or health benefits the insurer provided to a person injured in a motor
vehicle accident from any recovery the injured person obtains in an action for
damages except to the extent that:
(A) The injured
person first receives full compensation for the injured person’s injuries; and
(B) The
reimbursement or subrogation is paid only from the total amount of the recovery
in excess of the amount that fully compensates for the injured person’s
injuries.
(2) For purposes
of this section, the following rebuttable presumptions apply:
(a) The amount of
any judgment that an injured person obtains is the amount necessary to fully
compensate for the injured person’s injuries.
(b) An injured
person has received full compensation for the injured person’s injuries if the
amount of the recovery is less than the coverage available to the injured
person from the sum of benefits paid under another person’s motor vehicle
liability policy, under an underinsured motorist policy described in ORS
742.502 (2), as personal injury protection payments and from any other source
of payment from or on behalf of the party whose fault caused the injuries.
(c) An injured
person has not received full compensation for the injured person’s injuries if
the injured person recovers an amount that is equal to the coverage available
to the injured person from the sum of benefits paid under another person’s
motor vehicle liability policy, under an underinsured motorist policy described
in ORS 742.502 (2), as personal injury protection payments and from any other
source of payment from or on behalf of the party whose fault caused the
injuries.
(3) An insurer
may not deny or refuse to provide benefits that are otherwise available to an
injured person because of the potential the injured person has to make a claim
or bring an action against another person or enter into a settlement with
another person.
(4) A person with
whom an injured person enters into a settlement or from whom the injured person
obtains a judgment in connection with a claim or action may not name an insurer
that seeks a reimbursement or subrogation under ORS 742.536 or 742.538 as a payee
on a check, draft or other form of payment in satisfaction of the claim or
judgment.
(5) An insurer
may not delay, withhold or reduce benefits to an injured person because of an
act or omission for which a third party is or may be liable or as a means of
enforcing or attempting to enforce a claim for reimbursement or subrogation.
(6) An insurer
that receives a reimbursement for benefits the insurer provided to an injured
person shall apply the amount of the reimbursement as a credit against any
lifetime maximum benefit set forth for the injured person in the policy,
benefit plan or contract under which the insurer paid the benefits.
(7) A provision
in a policy, benefit plan or contract that permits reimbursement or subrogation
other than as provided in this section is void and unenforceable.
(8) This section
does not:
(a) Prohibit
insurers from coordinating benefits;
(b) Limit an
insurer’s right to seek reimbursement or subrogation to recover, without
reduction, amounts the insurer paid for property damage;
(c) Limit an
insurer that provided coverage against underinsured motorists from pursuing a
claim against a party at fault; or
(d) Require a
person to repay more than the amount of personal injury protection benefits
that the person actually received. [1993 c.709 §9; 2015 c.5 §5; 2019 c.460 §4]
Notes of Decisions
Farmers Ins. v. Conner, 182 P.3d 878 (Or. Ct. App. 2008).
· cites it 33× “We explained that the parties and the trial court had operated under the belief that ORS 742.544 provided a substantive entitlement to an insurer for the reimbursement of PIP benefits — a proposition that we rejected in Gaucin v.”
Gaucin v. Farmers Ins., 146 P.3d 370 (Or. Ct. App. 2006).
· cites it 33× “The trial court ruled that defendant was entitled to reimbursement by virtue of ORS 742.544. 1 Plaintiff argues that ORS 742.”
North Pac. Ins. v. Hamilton, 957 P.2d 165 (Or. Ct. App. 1998).
· cites it 59× “They also argued that "[t]o the extent that the policy * * * provides for reimbursement of PIP payments, that provision is unenforceable as contrary to the provisions of ORS 742.544." ORS 742.544 provides that PIP providers can be reimbursed for money that they have paid in PIP…”
Providence Health Plan v. Winchester, 288 P.3d 13 (Or. Ct. App. 2012).
· cites it 6× “534 provides: “(1) Except as provided in ORS 742.544, every authorized motor vehicle liability insurer whose insured is or would be held legally liable for damages for injuries sustained in a motor vehicle accident by a person for whom personal injury protection benefits have…”
Farmers Ins. Co. of Oregon v. Conner, 174 P.3d 1058 (Or. Ct. App. 2007).
· cites it 39× “Farmers argued that it was entitled to reimbursement pursuant to ORS 742.544, which provides: “(1) A provider of personal injury protection benefits shall be reimbursed for personal injury protection payments made on behalf of any person only to the extent that the total amount…”
Mid-Century Ins.. v. Turner, 182 P.3d 855 (Or. Ct. App. 2008).
“534 — which is often referred to as the “direct reimbursement” or “interinsurer reimbursement” statute— provided: “(1) Except as provided in ORS 742.544, every authorized motor vehicle liability insurer whose insured is or would be held legally liable for damages for injuries…”
Bell v. Morales, 142 P.3d 76 (Or. Ct. App. 2006).
· cites it 2× “2 Furthermore, a PIP insurer may be reimbursed for PIP benefits by an injured person “only to the extent that the total amount of [PIP] benefits paid exceeds the economic damages * * * suffered by that person,” ORS 742.544(1), and “[n]othing in this section requires a person to…”
Providence Health Plan v. Charriere, 666 F. Supp. 2d 1169 (D. Or. 2009).
“It provides: (1) Except as provided in ORS 742.544 [addressing reimbursement to a provider of personal injury protection benefits and not at issue here], every authorized motor vehicle liability insurer whose insured is or would be held legally liable for damages for injuries…”
Wynia v. Fick, 986 P.2d 625 (Or. Ct. App. 1999).
“534 provides: “(1) Except as provided in ORS 742.544, every authorized motor vehicle liability insurer whose insured is or would be held legally liable for damages for injuries sustained in a motor vehicle accident by a person for whom personal injury protection benefits have…”
Horlacher v. Mid-Century Ins., 923 P.2d 1317 (Or. Ct. App. 1996).
· cites it 20× “Plaintiff argued that ORS 742.544 applied and prevented defendant from offsetting PIP payments made to her after the effective date of the statute.”
Hughes v. City of Portland, 296 P.3d 642 (Or. Ct. App. 2013).
“Subsection (1) of that statute provides, in part: “Except as provided in ORS 742.544, every authorized motor vehicle liability insurer whose insured is or would be held legally liable for damages for injuries sustained in a motor vehicle accident by a person for whom personal…”
— Or. Rev. Stat. § 742.544(1) — 6 cases
Gaucin v. Farmers Ins., 146 P.3d 370 (Or. Ct. App. 2006).
“The trial court ruled that defendant was entitled to reimbursement by virtue of ORS 742.544. 1 Plaintiff argues that ORS 742.”
Farmers Ins. v. Conner, 182 P.3d 878 (Or. Ct. App. 2008).
“We explained that the parties and the trial court had operated under the belief that ORS 742.544 provided a substantive entitlement to an insurer for the reimbursement of PIP benefits — a proposition that we rejected in Gaucin v.”
North Pac. Ins. v. Hamilton, 957 P.2d 165 (Or. Ct. App. 1998).
“They also argued that "[t]o the extent that the policy * * * provides for reimbursement of PIP payments, that provision is unenforceable as contrary to the provisions of ORS 742.544." ORS 742.544 provides that PIP providers can be reimbursed for money that they have paid in PIP…”
Bell v. Morales, 142 P.3d 76 (Or. Ct. App. 2006).
“2 Furthermore, a PIP insurer may be reimbursed for PIP benefits by an injured person “only to the extent that the total amount of [PIP] benefits paid exceeds the economic damages * * * suffered by that person,” ORS 742.544(1), and “[n]othing in this section requires a person to…”
— Or. Rev. Stat. § 742.544(1)(a) — 1 case
North Pac. Ins. v. Hamilton, 957 P.2d 165 (Or. Ct. App. 1998).
“They also argued that "[t]o the extent that the policy * * * provides for reimbursement of PIP payments, that provision is unenforceable as contrary to the provisions of ORS 742.544." ORS 742.544 provides that PIP providers can be reimbursed for money that they have paid in PIP…”
— Or. Rev. Stat. § 742.544(2) — 2 cases
Gaucin v. Farmers Ins., 146 P.3d 370 (Or. Ct. App. 2006).
“The trial court ruled that defendant was entitled to reimbursement by virtue of ORS 742.544. 1 Plaintiff argues that ORS 742.”
Bell v. Morales, 142 P.3d 76 (Or. Ct. App. 2006).
“2 Furthermore, a PIP insurer may be reimbursed for PIP benefits by an injured person “only to the extent that the total amount of [PIP] benefits paid exceeds the economic damages * * * suffered by that person,” ORS 742.544(1), and “[n]othing in this section requires a person to…”
— Or. Rev. Stat. § 742.544(b) — 1 case
North Pac. Ins. v. Hamilton, 957 P.2d 165 (Or. Ct. App. 1998).
“They also argued that "[t]o the extent that the policy * * * provides for reimbursement of PIP payments, that provision is unenforceable as contrary to the provisions of ORS 742.544." ORS 742.544 provides that PIP providers can be reimbursed for money that they have paid in PIP…”
— Or. Rev. Stat. § 742.544(l)(a) — 1 case
North Pac. Ins. v. Hamilton, 957 P.2d 165 (Or. Ct. App. 1998).
“They also argued that "[t]o the extent that the policy * * * provides for reimbursement of PIP payments, that provision is unenforceable as contrary to the provisions of ORS 742.544." ORS 742.544 provides that PIP providers can be reimbursed for money that they have paid in PIP…”
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