Or. Admin. Code § 836-080-0220

Current through Register Vol. 63, No. 12, December 1, 2024

Section 836-080-0220 - Misrepresentation and Other Prohibited Claim Practices

An insurer shall not:

(1) Fail to fully disclose to a first party claimant all pertinent benefits, coverages and other provisions of an insurance policy under which the claim is asserted.

(2) Conceal from a first party claimant any insurance policy benefits, coverages or other provisions that are pertinent to the claim.

(3) Deny a claim on the grounds of the claimant's failure to exhibit the relevant property without proof of the insurer's demand and the claimant's unfounded refusal.

(4) Except where there is such time limit specified in the policy, make statements, written or otherwise, that require a claimant to give written notice of loss or proof of loss within a specified time and that seek to relieve the insurer of its obligations if the time limit is not complied with, unless the failure to comply with the specified time limit prejudices the insurer's rights.

(5) Request a first party claimant to sign a release that extends beyond the subject matter that gave rise to the claim payment.

(6) Issue checks or drafts in partial settlement of a loss or claim under a specific policy coverage that contain language releasing the insurer or its insured from its total liability.

Or. Admin. Code § 836-080-0220

IC 2-1980, f. 5-8-80, ef. 6-1-80

Stat. Auth.: ORS 731

Stats. Implemented: ORS 746.230(1)(a), ORS 746.230(f), ORS 746.230(j) & ORS 746.230(m)