2015 ORS 742.407¹
Insurer may not refuse to defend or pay claim based on provider’s disclosure of adverse event or provider’s participation in mediation

(1) As used in this section:

(a) "Adverse event" means a negative consequence of patient care that is unanticipated, is usually preventable and results in or presents a significant risk of patient injury.

(b) "Claim" means a written demand for restitution for an injury alleged to have been caused by the medical negligence of a health practitioner or licensed health care facility.

(c) "Health practitioner" means a person described in ORS 31.740 (When award of punitive damages against health practitioner prohibited) (1).

(d) "Patient’s family" includes:

(A) A parent, sibling or child by marriage, blood, adoption or domestic partnership.

(B) A foster parent or foster child.

(2) An insurer may not decline or refuse to defend or indemnify a health practitioner or a health care facility with respect to a claim, for any reason that is based on:

(a) The disclosure to the patient or the patient’s family by the health practitioner or facility of an adverse event or information relating to the cause of an adverse event;

(b) A notice of adverse health care incident filed under section 2, chapter 5, Oregon Laws 2013; or

(c) Participation in a discussion or mediation under section 3 or 5, chapter 5, Oregon Laws 2013.

(3) A policy or contract of insurance or indemnity may not include a provision or term excluding or limiting coverage based on:

(a) The disclosure to a patient or the patient’s family by a health practitioner or facility of an adverse event or information relating to the cause of an adverse event;

(b) A notice of adverse health care incident filed under section 2, chapter 5, Oregon Laws 2013; or

(c) Participation in a discussion or mediation under section 3 or 5, chapter 5, Oregon Laws 2013.

(4) An insurer may establish requirements and policy provisions for coverage of payments of compensation made under section 3, chapter 5, Oregon Laws 2013, or as a result of a mediation under section 5, chapter 5, Oregon Laws 2013. Requirements and policy provisions established under this subsection may not be intended to or have the effect of preventing meaningful participation in discussions and mediations under sections 3 and 5, chapter 5, Oregon Laws 2013.

(5) An insurer may not provide or be required to provide information related to an adverse health care incident as defined in section 1, chapter 5, Oregon Laws 2013, for credentialing purposes. [Formerly 743.056]

Note: The amendments to 742.407 (Insurer may not refuse to defend or pay claim based on provider's disclosure of adverse event or provider's participation in mediation) (formerly 743.056) by section 16, chapter 5, Oregon Laws 2013, become operative December 31, 2023. See section 22, chapter 5, Oregon Laws 2013. The text that is operative on and after December 31, 2023, is set forth for the user’s convenience.

742.407 (Insurer may not refuse to defend or pay claim based on provider's disclosure of adverse event or provider's participation in mediation). (1) As used in this section:

(a) "Adverse event" means a negative consequence of patient care that is unanticipated, is usually preventable and results in or presents a significant risk of patient injury.

(b) "Claim" means a written demand for restitution for an injury alleged to have been caused by the medical negligence of a health practitioner or licensed health care facility.

(c) "Health practitioner" means a person described in ORS 31.740 (When award of punitive damages against health practitioner prohibited) (1).

(d) "Patient’s family" includes:

(A) A parent, sibling or child by marriage, blood, adoption or domestic partnership.

(B) A foster parent or foster child.

(2) An insurer may not decline or refuse to defend or indemnify a health practitioner or a health care facility with respect to a claim, for any reason that is based on the disclosure to the patient or the patient’s family by the health practitioner or facility of an adverse event or information relating to the cause of an adverse event.

(3) A policy or contract of insurance or indemnity may not include a provision or term excluding or limiting coverage based on the disclosure to a patient or the patient’s family by a health practitioner or facility of an adverse event or information relating to the cause of an adverse event.

Note: 742.407 (Insurer may not refuse to defend or pay claim based on provider's disclosure of adverse event or provider's participation in mediation) was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 742 or any series therein. See Preface to Oregon Revised Statutes for further explanation.


1 Legislative Counsel Committee, CHAPTER 742—Insurance Policies Generally; Property and Casualty Policies, https://­www.­oregonlegislature.­gov/­bills_laws/­ors/­ors742.­html (2015) (last ac­cessed Jul. 16, 2016).
 
2 OregonLaws.org contains the con­tents of Volume 21 of the ORS, inserted along­side the per­tin­ent statutes. See the preface to the ORS An­no­ta­tions for more information.
 
3 OregonLaws.org assembles these lists by analyzing references between Sections. Each listed item refers back to the current Section in its own text. The result reveals relationships in the code that may not have otherwise been apparent.