Notice to Interested Persons of Rulemaking
Except when acting in an emergency to adopt a temporary rule in accordance with ORS 183.335(5), the Director of the Department of Consumer and Business Services will give prior notice of the proposed adoption, amendment, or repeal of an administrative rule by the Insurance Division:
(1) By causing notice of the proposed action to be published once, in the Secretary of State's Bulletin referred to in ORS 183.360, at least 21 days prior to the effective date of the rule.
(2) By mailing copies of the notice to persons on the Director's mailing list established by the Insurance Division pursuant to ORS 183.335(7), at least 28 days prior to the effective date of the rule.
(3) By mailing or delivering copies of the notice to the Associated Press, the Daily Journal of Commerce and the Business Journal.
(4) By mailing copies of the notice to organizations and publications that may provide notice to persons who may have an interest, such as the following, depending on the subject matter of the proposal:
(a) Authorized insurers;
(b) Independent Insurance Agents of Oregon;
(c) Oregon Association of Insurance and Financial Advisors;
(d) National Association of Independent Insurers;
(e) American Insurance Association;
(f) Alliance of American Insurers;
(g) American Council of Life Insurers;
(h) America's Health Insurance Plans;
(i) Professional Insurance Agents of Oregon/Idaho;
(j) Oregon Association of Health Underwriters;
(k) Reinsurance Association of America;
(L) Insurance Information Institute;
(m) National Council on Compensation Insurance; and
(n) Insurance Services Office.
Stat. Auth.: ORS 183.341
Stats. Implemented: ORS 183.341
Hist.: IC 63, f. & ef. 12-5-75; IC 5-1982, f. 1-29-82, ef. 2-1-82; ID 4-1996, f. 2-28-96, cert. ef. 3-1-96; ID 19-2006, f. & cert. ef. 9-26-06
Model Rules of Procedure Governing Rulemaking
The Model Rules of Procedure, OAR 137-001-0005 to 137-005-0070, in effect on January 31, 2012, as promulgated by the Attorney General of the State of Oregon under the Administrative Procedures Act, are adopted as the rules of procedure for the Insurance Division.
[ED. NOTE: The full text of the Attorney General’s Model Rules of Pro?cedures is available from the Office of the Attorney General or the Insurance Division.]
Stat. Auth.: ORS 183.341
Stats. Implemented: ORS 183.025, 183.090 & 183.310 - 183.550
Hist.: IC 2-1981, f. & ef. 11-20-81; IC 7-1983, f. & ef. 9-28-83; IC 3-1986, f. & ef. 3-5-86; IC 16-1988, f. & cert. ef. 10-12-88; ID 19-1990, f. & cert. ef. 12-13-90; ID 3-1992, f. & cert. ef. 2-13-92; ID 2-1994, f. & cert. ef. 3-23-94; ID 8-1995, f. & cert. ef. 12-8-95; ID 7-1998, f. & cert. ef. 4-15-98; ID 10-2000, f. & cert. ef. 11-3-00; ID 3-2002, f. & cert. ef. 1-24-02; ID 3-2004, f. & cert. ef. 5-7-04; ID 8-2006, f. & cert. ef. 4-27-06; ID 7-2012, f. & cert. ef. 3-27-12
Persons Represented by Authorized Representative
(1) A party or limited party participating in a contested case hearing in which an insured appears under ORS 737.505 may be represented by authorized representative of the party or limited party.
(2) On or before the first appearance in a contested case by an authorized representative, the authorized representative must provide the presiding officer a letter from the party or limited party that authorizes the representative to appear on behalf of the party or limited party.
(3) The presiding officer may limit an authorized representative's presentation of evidence, examination and cross-examination of witnesses or presentation of factual arguments to ensure the orderly and timely development of the hearing record. The presiding officer may not allow an authorized representative to present any legal argument.
(4) As used in this rule:
(a) Authorized representative means a member of a partnership that is a party or limited party in the contested case, an authorized officer or regular employee of a corporation, association or organized group that is a party or limited party in the contested case, or an authorized officer or employee of a governmental authority other than a state agency, that is a party or limited party in the contested case;
(b) Legal argument includes any argument on:
(A) The jurisdiction of the Department to hear the contested case;
(B) The constitutionality of a statute or rule or the application of a constitutional requirements; or
(C) The application of court precedent to the facts of the contested case.
(c) Legal argument does not include any argument on:
(A) The application of the facts to the statutes or rules that directly apply to the issues in the contested case;
(B) Comparison of prior actions of the Department;
(C) The literal meaning of the statutes or rules that directly apply to the issues in the contested case; or
(D) The admissibility of evidence or the correctness of procedures being followed.
(5) When an authorized representative represents a party of limited party in a hearing, the presiding officer shall advise the representative of the manner in which objections may be made and the manner in which matters may be preserved for appeal. The advice is of a procedural nature and does not change applicable law on waiver or applicable law on the duty to make timely objection. When an objection may involve a legal argument, the presiding officer shall provide reasonable opportunity for the authorized for the authorized representative to consult legal counsel and shall permit the legal counsel to file written legal argument within a reasonable time after conclusion of the hearing.
Stat. Auth.: ORS 821
Stats. Implemented: ORS 183.457(1)(d) & ORS 183.457(2)(b)
Hist.: IC 6-1988, f. & cert. ef. 3-30-88
Annual Complaint Report
The Director shall publish an annual statistical report on complaints against insurers as required under ORS 731.264, according to the method established in this rule. Each report shall contain the number, percentage, type and disposition of complaints against each insurer that were closed by the Department of Consumer and Business Services during the reporting period. The report shall be based on the records of the Department of Consumer and Business Services. The report shall be structured as a cross tabulation of complaints closed during the reporting period, by complaint type and disposition, against each insurer with respect to whom one or more complaints were closed during the period for which the report is made.
Stat. Auth.: ORS 731
Stats. Implemented: ORS 731.264(3)
Hist.: ID 3-1989(Temp), f. & cert. ef. 2-28-89; ID 11-1989, f. & cert. ef. 11-20-89; ID 19-2006, f. & cert. ef. 9-26-06
Disclosure of Information about Complaints Regarding Unlawful Claims Settlement Practices
(1) Subject to subsections (2) through (4), the director shall provide to a person who submits a request, records associated with complaints submitted to the director, for which:
(a) The director has confirmed the complaint to be about an alleged unlawful practice described in ORS 746.230;
(b) The complaint:
(A) Has been closed and the complainant has been provided a closing letter; or
(B) Has been open for more than 120 days;
(c) The complaint was submitted after January 1, 2017; and
(d) The complaint was submitted during a period in which disclosure of complaint information was authorized under ORS 731.264(3).
(2) For each complaint subject to disclosure, the director shall provide:
(a) The complaint intake form;
(b) Any narrative description submitted by the complainant with the initial complaint;
(c) Any request for information submitted by the director to an insurer on behalf of the complainant in order to resolve the complaint; and
(d) Any closing letter provided to the complainant by the director, which summarizes:
(A) The complaint;
(B) Steps the director took to investigate and resolve the complaint; and
(C) Any findings and conclusions reached by the director.
(3) Before providing records to a requestor, the director:
(a) Shall remove any information that could be used to identify any individual;
(b) Shall remove any information for which disclosure is prohibited under applicable federal or state law;
(c) May remove any information exempt from public records requests under ORS 192.410 to 192.505; and
(d) May require the requestor to pay any fees listed in OAR 440-005-0025 and 440-005-0030, unless waived under ORS192.440.
(4) The director shall not provide complaint records:
(a) Unless a request is submitted to the director in writing;
(b) If a request is made with regard to a particular person, unless the request is made with regard to an insurer; nor
(c) If the director determines that release of such records would clearly and convincingly cause harm to the public interest in the particular instance. If such a determination is made, the director shall provide to the requestor, a written explanation of why the records will not be disclosed.
Stat. Auth.: ORS 731.264, 2016 Or Laws
ch 62 (Enrolled Senate Bill 1591)
Stats. Implemented: ORS 731.264
Hist.: ID 1-2017, f. & cert. ef. 1-10-17
State Archives • 800 Summer St. NE • Salem, OR 97310