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Personal Injury Protection Benefits

742.520 Personal Injury Protection
742.522 Binding Arbitration
742.524 Contents of Personal Injury Protection Benefits

Uninsured Motorist Coverage
742.504 Required Provisions of Uninsured Motorist Coverage

Personal Injury Protection Benefits

742.520 Personal injury protection benefits for motor vehicle liability policies; applicability; definitions for ORS 742.520 to 742.542.

(1) Every motor vehicle liability policy issued for delivery in this state that covers any private passenger motor vehicle shall provide personal injury protection benefits to the person insured thereunder, members of that person's family residing in the same household, children not related to the insured by blood, marriage or adoption who are residing in the same household as the insured and being reared as the insured's own, passengers occupying the insured motor vehicle and pedestrians struck by the insured motor vehicle. "Personal injury protection benefits" means the benefits described in this section and ORB 742.524 and 742.530.

(2) Personal injury protection benefits apply to a person's injury or death resulting: (a) In the case of the person insured under the policy and members of that person's family residing in the same household, from the use, occupancy or maintenance of any motor vehicle, except the following. vehicles: (A) A motor vehicle, including a motorcycle or moped, which is owned by any of such persons and which is not covered by a motor vehicle liability insurance policy that provides personal injury protection benefits with respect to the use, occupancy and maintenance of that vehicle; (B) A motorcycle or moped which is not owned by any of such persons, but this exclusion applies only when the injury or death results front such person's operating or riding upon the motorcycle or moped; and (C) A motor vehicle not included In sub. paragraph (A) or (B) of this paragraph and not a private passenger motor vehicle. However, this exclusion applies only when the injury or death results from such persons operating or occupying the motor vehicles. (b) In the case of a passenger occupying or a pedestrian struck by the insured motor vehicle, from the use, occupancy or maintenance of the vehicles.

(3) Personal injury protection benefits consist of payments. for expenses, loss of income and loss of essential services as provided in ORS 742.524.

(4) An insurer shall pay all personal injury protection benefits promptly after proof of loss has been submitted to the insurer,

(5) The potential existence of a cause of action in tort does not relieve an insurer from the duty to pay personal injury protection benefits.

(6) Disputes between insurers and beneficianes about the amount of personal injury protection benefits, or about the denial of personal injury protection benefits, shall be decided by arbitration except that if all requirements for bringing an action in the small claims department of a justice or district court are met, the insured. may elect to file such an action rather than submitting the claim to arbitration.

(7) As used in ORS 142.520 to 742.542: (a) "Motor vehicle" means a self propelled land motor vehicle or trailer other than: (A) A farm type tractor or other self-propelled equipment designed for use principally off roads, while not upon public roads; (B) A vehicle operated on rails or crawler-treads; or (C) A vehicle located for use as a residence or premises. (b) "Motorcycle" and "moped" have the meanings given those terms in ORS 801.345 and 801.365. (c) "Occupying" means in, or upon, or entering into or alighting from. (d) "Pedestrian" means a person while not occupying a self-propelled vehicle. (e) "Private passenger motor vehicle" means a four-wheel passenger station wagon type motor vehicle not used as a public or livery conveyance, and includes any other four-wheel motor vehicle of the utility pickup body, sedan delivery or panel truck type not used for wholesale or retail delivery other than farming, a self-propelled mobile home, and a farm truck. [Formerly 743.800; 1991 c.768 ß6; 1993 c.282 ß1; 1993 c.596 ß39]

Note: The amendments to 742.520 by section 114 chapter 658, Oregon Laws 1995, become operative January 15, 1998. See sections 129 and 150, chapter 658, Oregon Laws 1995. The text that is operative on and after January 15, 1998, is set; forth for the user's convenience.

742.520

(1) Every motor vehicle liability policy issued for delivery in this state that covers any private passenger motor vehicle shall provide personal injury protection benefits - to the person insured thereunder, members of that person's family residing in the 'same household, children not related to the insured by blood, marriage or adoption who are residing in the same household as the insured and being reared as the insured's own, passengers occupying the- insured motor vehicle and pedestrians struck by the insured motor vehicle. "Personal injury protection benefits" means the benefits described in this section and ORS 742.524 and
742.530.

(2) Personal injury protection benefits apply to a person's injury or death resulting:

(a) In the case of the person insured under the policy and members of that person's family residing In the same household, from the use, occupancy or maintenance of any motor vehicle, except the following vehicles: (A) A motor vehicle including a motorcycle or moped, which is owned by any of such persons and which is not covered by a motor vehicle liability warranty policy that provides personal injury protection benefits with respect to the use, occupancy and maintenance of that vehicle; (B) A motorcycle or moped which is not owned by any of such persons; but this exclusion applies only when the injury or death results from such persons Operating or riding upon the motorcycle or moped; and (C) A motor vehicle not included in subparagraph (A) or (B) of this paragraph and not a private passenger motor vehicle. However, this exclusion applies only when the injury or death results from such person a operating or occupying the motor vehicle. (b) In the case of a passenger occupying or a pedestrian struck by the Insured motor vehicle, from the use occupancy or maintenance of the vehicle.

(3) Personal injury protection benefits consist of payments for expenses, loss of income and loss of essential services, as provided in ORS 742.524.

(4) An insurer shall pay all personal injury protection benefits promptly after proof of loss has been submitted to the insurer.

(5) The potential existence of a cause of action in tort does not relieve an insurer from the duty to pay personal injury protection benefits.

(6) Disputes between insurers and beneficiaries about the amount of personal injury protection benefits, or about the denial of personal injury protection. benefits, shall be decided by arbitration except that if all requirements for bringing an action in the small claims department of a justice or circuit court are met, the insured may elect to file such an action rather than submitting the claim to arbitration.

(7) As used in ORS 742.520 to 742.542; (a) "Motor Vehicle" means a melt-propelled land motor vehicle or, trailer; other than: (A) A farm type tractor or other self propelled land equipment designed for use principally off public roads, while not upon public roads. (B) A vehicle operated on rails or crawler-treads; or (C) A vehicle located for use as a residence or premises. (b) "Motorcycle" and "moped" have the meanings given those terms in ORS 601.345 and 801.365. (c) "Occupying" means in, or upon, or entering into or alighting from. (d) "Pedestrian" means a person while not occupying a self-propelled vehicle. (e) "Private passenger motor vehicle" means' a four-wheel passenger or station wagon type motor vehicle not used as a public or livery conveyance, and includes any other four-wheel motor vehicle of the utility pick-up body, sedan delivery or panel truck type not used for wholesale or retail delivery other than farming, a self-propelled mobile home, and a farm truck.

742.522 Binding arbitration under ORS 742.520; costs.

(1) Arbitration' under ORS 742.520 (6) is binding on the parties to the arbitration.

(2) Costs to the insured of the arbitration proceeding shall not exceed $100 and all other costs, of arbitration shall be borne by the, insurer. As used in this subsection, "costs" does not include attorney fees or expenses incurred in the production of evidence or witnesses or the making of transcripts of the arbitration proceedings. [Formerly 743.802]

742.524 Contents of personal injury protection benefits; deductibles.

(l) Personal protection benefits as required by ORS 742.520 shall consist of the following payments for the injury or death of each
person: (a) All reasonable and necessary expenses of medical, hospital, dent, al, surgical ambulance and prosthetic services incurred within one year after the date of the persons injury, but not more than $10000 in the aggregate for all such expenses 0? the person. Expenses or medical, hospital, dental, surgical, ambulance and prosthetic services shall be presumed to be reasonable and necessary unless the provider is given notice of denial of the charges not more than 60 calendar days after the insurer receives front 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 6 0-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 day's and shall not resume until the' answers are supplied. (b) If "the insured 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 $1,250 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 in lieu of the services the 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 injuries, but not more than $2,500. (e) If the injured person is a parent of a minor child and is required to be hospitalized for a minimum of 24 hours, $15 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 $450.

(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 ß7]