ORS 746.600
Definitions for ORS 746.600 to 746.690


As used in ORS 746.600 (Definitions for ORS 746.600 to 746.690) to 746.690 (Obtaining information under false pretenses prohibited):

(1)

Intentionally left blank —Ed.

(a)

“Adverse underwriting decision” means any of the following actions with respect to insurance transactions involving insurance coverage that is individually underwritten:

(A)

A declination of insurance coverage.

(B)

A termination of insurance coverage.

(C)

Failure of an insurance producer to apply for insurance coverage with a specific insurer that the insurance producer represents and that is requested by an applicant.

(D)

In the case of life or health insurance coverage, an offer to insure at higher than standard rates.

(E)

In the case of insurance coverage other than life or health insurance coverage:
(i)
Placement by an insurer or insurance producer of a risk with a residual market mechanism, an unauthorized insurer or an insurer that specializes in substandard risks.
(ii)
The charging of a higher rate on the basis of information that differs from that which the applicant or policyholder furnished.
(iii)
An increase in any charge imposed by the insurer for any personal insurance in connection with the underwriting of insurance. For purposes of this sub-subparagraph, the imposition of a service fee is not a charge.

(b)

“Adverse underwriting decision” does not mean any of the following actions, but the insurer or insurance producer responsible for the occurrence of the action must nevertheless provide the applicant or policyholder with the specific reason or reasons for the occurrence:

(A)

The termination of an individual policy form on a class or statewide basis.

(B)

A declination of insurance coverage solely because the coverage is not available on a class or statewide basis.

(C)

The rescission of a policy.

(2)

“Affiliate of” a specified person or “person affiliated with” a specified person means a person who directly, or indirectly, through one or more intermediaries, controls, or is controlled by, or is under common control with, the person specified.

(3)

“Applicant” means a person who seeks to contract for insurance coverage, other than a person seeking group insurance coverage that is not individually underwritten.

(4)

“Consumer” means an individual, or the personal representative of the individual, who seeks to obtain, obtains or has obtained one or more insurance products or services from a licensee that are to be used primarily for personal, family or household purposes, and about whom the licensee has personal information.

(5)

“Consumer report” means any written, oral or other communication of information bearing on a natural person’s creditworthiness, credit standing, credit capacity, character, general reputation, personal characteristics or mode of living that is used or expected to be used in connection with an insurance transaction.

(6)

“Consumer reporting agency” means a person that, for monetary fees or dues, or on a cooperative or nonprofit basis:

(a)

Regularly engages, in whole or in part, in assembling or preparing consumer reports;

(b)

Obtains information primarily from sources other than insurers; and

(c)

Furnishes consumer reports to other persons.

(7)

“Control” means, and the terms “controlled by” or “under common control with” refer to, the possession, directly or indirectly, of the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting securities, by contract other than a commercial contract for goods or nonmanagement services, or otherwise, unless the power of the person is the result of a corporate office held in, or an official position held with, the controlled person.

(8)

“Covered entity” means:

(a)

A health insurer;

(b)

A health care provider that transmits any health information in electronic form to carry out financial or administrative activities in connection with a transaction covered by ORS 746.607 (Use and disclosure of personal information) or by rules adopted under ORS 746.608 (Rules); or

(c)

A health care clearinghouse.

(9)

“Credit history” means any written or other communication of any information by a consumer reporting agency that:

(a)

Bears on a consumer’s creditworthiness, credit standing or credit capacity; and

(b)

Is used or expected to be used, or collected in whole or in part, as a factor in determining eligibility, premiums or rates for personal insurance.

(10)

“Customer” means a consumer who has a continuing relationship with a licensee under which the licensee provides one or more insurance products or services to the consumer that are to be used primarily for personal, family or household purposes.

(11)

“Declination of insurance coverage” or “decline coverage” means a denial, in whole or in part, by an insurer or insurance producer of an application for requested insurance coverage.

(12)

“Health care” means care, services or supplies related to the health of an individual.

(13)

“Health care operations” includes but is not limited to:

(a)

Quality assessment, accreditation, auditing and improvement activities;

(b)

Case management and care coordination;

(c)

Reviewing the competence, qualifications or performance of health care providers or health insurers;

(d)

Underwriting activities;

(e)

Arranging for legal services;

(f)

Business planning;

(g)

Customer services;

(h)

Resolving internal grievances;

(i)

Creating deidentified information; and

(j)

Fundraising.

(14)

“Health care provider” includes but is not limited to:

(a)

A psychologist, occupational therapist, regulated social worker, professional counselor or marriage and family therapist licensed or otherwise authorized to practice under ORS chapter 675 or an employee of the psychologist, occupational therapist, regulated social worker, professional counselor or marriage and family therapist;

(b)

A physician or physician assistant licensed under ORS chapter 677, an acupuncturist licensed under ORS 677.759 (License required) or an employee of the physician, physician assistant or acupuncturist;

(c)

A nurse or nursing home administrator licensed under ORS chapter 678 or an employee of the nurse or nursing home administrator;

(d)

A dentist licensed under ORS chapter 679 or an employee of the dentist;

(e)

A dental hygienist or denturist licensed under ORS chapter 680 or an employee of the dental hygienist or denturist;

(f)

A speech-language pathologist or audiologist licensed under ORS chapter 681 or an employee of the speech-language pathologist or audiologist;

(g)

An emergency medical services provider licensed under ORS chapter 682;

(h)

An optometrist licensed under ORS chapter 683 or an employee of the optometrist;

(i)

A chiropractic physician licensed under ORS chapter 684 or an employee of the chiropractic physician;

(j)

A naturopathic physician licensed under ORS chapter 685 or an employee of the naturopathic physician;

(k)

A massage therapist licensed under ORS 687.011 (Definitions) to 687.250 (Enforcement) or an employee of the massage therapist;

(L)

A direct entry midwife licensed under ORS 687.405 (“Direct entry midwifery” defined) to 687.495 (Collection of data on birth and fetal death outcomes) or an employee of the direct entry midwife;

(m)

A physical therapist licensed under ORS 688.010 (Definitions for ORS 688.010 to 688.201) to 688.201 (Disposition of receipts) or an employee of the physical therapist;

(n)

A medical imaging licensee under ORS 688.405 (Definitions for ORS 688.405 to 688.605) to 688.605 (Duty to report violation) or an employee of the medical imaging licensee;

(o)

A respiratory care practitioner licensed under ORS 688.815 (License to practice respiratory care) or an employee of the respiratory care practitioner;

(p)

A polysomnographic technologist licensed under ORS 688.819 (Polysomnographic technologist license) or an employee of the polysomnographic technologist;

(q)

A pharmacist licensed under ORS chapter 689 or an employee of the pharmacist;

(r)

A dietitian licensed under ORS 691.405 (Definitions for ORS 691.405 to 691.485) to 691.485 (Board of Licensed Dietitians) or an employee of the dietitian;

(s)

A funeral service practitioner licensed under ORS chapter 692 or an employee of the funeral service practitioner;

(t)

A health care facility as defined in ORS 442.015 (Definitions);

(u)

A home health agency as defined in ORS 443.014 (Definitions for ORS 443.014 to 443.105);
(v)
A hospice program as defined in ORS 443.850 (Definitions for ORS 443.850 to 443.869);

(w)

A clinical laboratory as defined in ORS 438.010 (Definitions for ORS 438.010 to 438.510);
(x)
A pharmacy as defined in ORS 689.005 (Definitions);

(y)

A diabetes self-management program as defined in ORS 743.694; and

(z)

Any other person or entity that furnishes, bills for or is paid for health care in the normal course of business.

(15)

“Health information” means any oral or written information in any form or medium that:

(a)

Is created or received by a covered entity, a public health authority, a life insurer, a school, a university or a health care provider that is not a covered entity; and

(b)

Relates to:

(A)

The past, present or future physical or mental health or condition of an individual;

(B)

The provision of health care to an individual; or

(C)

The past, present or future payment for the provision of health care to an individual.

(16)

“Health insurer” means an insurer who offers:

(a)

A health benefit plan as defined in ORS 743B.005 (Definitions);

(b)

A short term health insurance policy, the duration of which does not exceed three months including renewals;

(c)

A student health insurance policy;

(d)

A Medicare supplemental policy; or

(e)

A dental only policy.

(17)

“Homeowner insurance” means insurance for residential property consisting of a combination of property insurance and casualty insurance that provides coverage for the risks of owning or occupying a dwelling and that is not intended to cover an owner’s interest in rental property or commercial exposures.

(18)

“Individual” means a natural person who:

(a)

In the case of life or health insurance, is a past, present or proposed principal insured or certificate holder;

(b)

In the case of other kinds of insurance, is a past, present or proposed named insured or certificate holder;

(c)

Is a past, present or proposed policyowner;

(d)

Is a past or present applicant;

(e)

Is a past or present claimant; or

(f)

Derived, derives or is proposed to derive insurance coverage under an insurance policy or certificate that is subject to ORS 746.600 (Definitions for ORS 746.600 to 746.690) to 746.690 (Obtaining information under false pretenses prohibited).

(19)

“Individually identifiable health information” means any oral or written health information that is:

(a)

Created or received by a covered entity or a health care provider that is not a covered entity; and

(b)

Identifiable to an individual, including demographic information that identifies the individual, or for which there is a reasonable basis to believe the information can be used to identify an individual, and that relates to:

(A)

The past, present or future physical or mental health or condition of an individual;

(B)

The provision of health care to an individual; or

(C)

The past, present or future payment for the provision of health care to an individual.

(20)

“Institutional source” means a person or governmental entity that provides information about an individual to an insurer, insurance producer or insurance-support organization, other than:

(a)

An insurance producer;

(b)

The individual who is the subject of the information; or

(c)

A natural person acting in a personal capacity rather than in a business or professional capacity.

(21)

“Insurance producer” or “producer” means a person licensed by the Director of the Department of Consumer and Business Services as a resident or nonresident insurance producer.

(22)

“Insurance score” means a number or rating that is derived from an algorithm, computer application, model or other process that is based in whole or in part on credit history.

(23)

Intentionally left blank —Ed.

(a)

“Insurance-support organization” means a person who regularly engages, in whole or in part, in assembling or collecting information about natural persons for the primary purpose of providing the information to an insurer or insurance producer for insurance transactions, including:

(A)

The furnishing of consumer reports to an insurer or insurance producer for use in connection with insurance transactions; and

(B)

The collection of personal information from insurers, insurance producers or other insurance-support organizations for the purpose of detecting or preventing fraud, material misrepresentation or material nondisclosure in connection with insurance underwriting or insurance claim activity.

(b)

“Insurance-support organization” does not mean insurers, insurance producers, governmental institutions or health care providers.

(24)

“Insurance transaction” means any transaction that involves insurance primarily for personal, family or household needs rather than business or professional needs and that entails:

(a)

The determination of an individual’s eligibility for an insurance coverage, benefit or payment; or

(b)

The servicing of an insurance application, policy or certificate.

(25)

“Insurer” has the meaning given that term in ORS 731.106 (“Insurer.”).

(26)

“Investigative consumer report” means a consumer report, or portion of a consumer report, for which information about a natural person’s character, general reputation, personal characteristics or mode of living is obtained through personal interviews with the person’s neighbors, friends, associates, acquaintances or others who may have knowledge concerning such items of information.

(27)

“Licensee” means an insurer, insurance producer or other person authorized or required to be authorized, or licensed or required to be licensed, pursuant to the Insurance Code.

(28)

“Loss history report” means a report provided by, or a database maintained by, an insurance-support organization or consumer reporting agency that contains information regarding the claims history of the individual property that is the subject of the application for a homeowner insurance policy or the consumer applying for a homeowner insurance policy.

(29)

“Nonaffiliated third party” means any person except:

(a)

An affiliate of a licensee;

(b)

A person that is employed jointly by a licensee and by a person that is not an affiliate of the licensee; and

(c)

As designated by the director by rule.

(30)

“Payment” includes but is not limited to:

(a)

Efforts to obtain premiums or reimbursement;

(b)

Determining eligibility or coverage;

(c)

Billing activities;

(d)

Claims management;

(e)

Reviewing health care to determine medical necessity;

(f)

Utilization review; and

(g)

Disclosures to consumer reporting agencies.

(31)

Intentionally left blank —Ed.

(a)

“Personal financial information” means:

(A)

Information that is identifiable with an individual, gathered in connection with an insurance transaction from which judgments can be made about the individual’s character, habits, avocations, finances, occupations, general reputation, credit or any other personal characteristics; or

(B)

An individual’s name, address and policy number or similar form of access code for the individual’s policy.

(b)

“Personal financial information” does not mean information that a licensee has a reasonable basis to believe is lawfully made available to the general public from federal, state or local government records, widely distributed media or disclosures to the public that are required by federal, state or local law.

(32)

“Personal information” means:

(a)

Personal financial information;

(b)

Individually identifiable health information; or

(c)

Protected health information.

(33)

“Personal insurance” means the following types of insurance products or services that are to be used primarily for personal, family or household purposes:

(a)

Private passenger automobile coverage;

(b)

Homeowner, mobile homeowners, manufactured homeowners, condominium owners and renters coverage;

(c)

Personal dwelling property coverage;

(d)

Personal liability and theft coverage, including excess personal liability and theft coverage; and

(e)

Personal inland marine coverage.

(34)

“Personal representative” includes but is not limited to:

(a)

A person appointed as a guardian under ORS 125.305 (Order of appointment), 419B.372 (Guardianship as incident of custody), 419C.481 (Guardianship and legal custody of adjudicated youth committed to Oregon Youth Authority) or 419C.555 (Authority to appoint guardian) with authority to make medical and health care decisions;

(b)

A person appointed as a health care representative under ORS 127.505 (Definitions for ORS 127.505 to 127.660) to 127.660 (Short title) or 127.700 (Definitions for ORS 127.700 to 127.737) to 127.737 (Certain other laws applicable to declaration) to make health care decisions or mental health treatment decisions;

(c)

A person appointed as a personal representative under ORS chapter 113; and

(d)

A person described in ORS 746.611 (Personal representative of deceased person).

(35)

“Policyholder” means a person who:

(a)

In the case of individual policies of life or health insurance, is a current policyowner;

(b)

In the case of individual policies of other kinds of insurance, is currently a named insured; or

(c)

In the case of group policies of insurance under which coverage is individually underwritten, is a current certificate holder.

(36)

“Pretext interview” means an interview wherein the interviewer, in an attempt to obtain personal information about a natural person, does one or more of the following:

(a)

Pretends to be someone the interviewer is not.

(b)

Pretends to represent a person the interviewer is not in fact representing.

(c)

Misrepresents the true purpose of the interview.

(d)

Refuses upon request to identify the interviewer.

(37)

“Privileged information” means information that is identifiable with an individual and that:

(a)

Relates to a claim for insurance benefits or a civil or criminal proceeding involving the individual; and

(b)

Is collected in connection with or in reasonable anticipation of a claim for insurance benefits or a civil or criminal proceeding involving the individual.

(38)

Intentionally left blank —Ed.

(a)

“Protected health information” means individually identifiable health information that is transmitted or maintained in any form of electronic or other medium by a covered entity.

(b)

“Protected health information” does not mean individually identifiable health information in:

(A)

Education records covered by the federal Family Educational Rights and Privacy Act (20 U.S.C. 1232g);

(B)

Records described at 20 U.S.C. 1232g(a)(4)(B)(iv); or

(C)

Employment records held by a covered entity in its role as employer.

(39)

“Residual market mechanism” means an association, organization or other entity involved in the insuring of risks under ORS 735.005 (Definitions for ORS 735.005 to 735.145) to 735.145 (Immunity from legal action in carrying out duties), 737.312 (Agreements among insurers for assignment of risks) or other provisions of the Insurance Code relating to insurance applicants who are unable to procure insurance through normal insurance markets.

(40)

“Termination of insurance coverage” or “termination of an insurance policy” means either a cancellation or a nonrenewal of an insurance policy, in whole or in part, for any reason other than the failure of a premium to be paid as required by the policy.

(41)

“Treatment” includes but is not limited to:

(a)

The provision, coordination or management of health care; and

(b)

Consultations and referrals between health care providers. [1981 c.649 §4; 1987 c.490 §50; 2001 c.191 §50; 2001 c.377 §25; 2003 c.87 §6; 2003 c.364 §151; 2003 c.590 §§2,4; 2003 c.599 §§5,7; 2003 c.788 §1a; 2005 c.253 §§6,7; 2005 c.489 §§1,2; 2009 c.442 §48; 2009 c.833 §31; 2011 c.703 §47; 2011 c.715 §22; 2013 c.129 §39; 2013 c.698 §24; 2017 c.152 §15]

Source: Section 746.600 — Definitions for ORS 746.600 to 746.690, https://www.­oregonlegislature.­gov/bills_laws/ors/ors746.­html.

746.005
Trade practices exempted from prohibitions
746.015
Discrimination
746.018
Discrimination in issuance of burglary, theft, robbery or casualty policies prohibited
746.021
Discrimination under health benefit plans
746.023
Discrimination against living donors or body part donors with respect to life insurance, health insurance or long term care insurance
746.025
Securities or other contracts as inducement to insurance
746.035
Inducements not specified in policy
746.045
Prohibition on rebates
746.055
Title insurance commissions, rebates and discounts
746.065
Personal or controlled insurance
746.075
Misrepresentation generally
746.085
Regulating replacement of life insurance
746.100
Misrepresentation in insurance applications or transactions
746.110
False, deceptive or misleading statements
746.115
Advertisements in languages other than English
746.120
Illegal dealing in premiums
746.125
Limitation on coverage of eye care services
746.130
Insurance connected to sale or rental of property
746.135
Genetic tests and information
746.137
Reimbursement of private emergency responder’s actual expenses in emergency response
746.140
Sale of life insurance with securities
746.145
Workers’ compensation insurance
746.147
Workers’ compensation insurance
746.150
Other insurance
746.155
Applicability of ORS 746.145 and 746.150
746.160
Practices injurious to free competition
746.195
Insurance on property securing loan or credit
746.201
Depository institution to obtain required property insurance when borrower does not
746.213
Definitions for ORS 746.213 to 746.219
746.215
Regulation of depository institutions with regard to insurance sales or solicitations
746.217
Disclosures to customers
746.219
Investigatory powers
746.220
Debtor’s option in furnishing credit life or credit health insurance
746.230
Unfair claim settlement practices
746.233
Unfair claim settlement practices with respect to prior authorizations of health care items or services
746.240
Undefined trade practices injurious to public prohibited
746.260
Driving record not to be considered in issuance of motor vehicle insurance
746.265
Purposes for which abstract of nonemployment driving record may be considered
746.270
Use of past investment or predicted future investment experience in sale of variable life insurance policies
746.275
Definitions for ORS 746.275 to 746.300
746.280
Designation of particular motor vehicle repair shop by insurer prohibited
746.285
Notice of prohibition in motor vehicle repair shops
746.287
Insurer requirement of installation of aftermarket crash part in vehicle
746.289
Insurer offer of crash part warranty
746.290
Notice of prohibition in policies and by adjusters
746.292
Motor vehicle repair shops
746.295
Proof and amount of loss under motor vehicle liability policies
746.300
Liability of insurers and motor vehicle repair shops for damages
746.305
Rules
746.308
Violation of provisions regarding totaled vehicles as violation of Insurance Code
746.310
Representing or aiding unauthorized insurer prohibited
746.320
Service of process equivalent to personal service on unauthorized foreign or alien insurer
746.330
Judgment by default after service of process under ORS 746.320
746.340
Conditions to be met by defendant unauthorized insurer before filing motions or pleadings
746.350
Attorney fee allowable to prevailing party
746.360
Exceptions to application of unauthorized insurer service of process law
746.370
Records of insureds
746.405
Definitions for ORS 746.405 to 746.530
746.422
Inquiries from director to premium finance company
746.425
Applicability of ORS 746.405 to 746.530
746.465
Records required of premium finance companies
746.470
Prohibition against interfering with premium financing recommendation
746.475
Premium finance agreements
746.485
Regulation of service charge for premium financing
746.495
Delinquency charges regulated
746.505
Cancellation of policy by premium finance company
746.515
Return of unearned premiums on cancellation
746.525
Agreement effective as security interest
746.530
Attorney fees
746.600
Definitions for ORS 746.600 to 746.690
746.605
Purpose
746.606
Information privacy standards for health insurers
746.607
Use and disclosure of personal information
746.608
Rules
746.609
Exemptions for health insurers
746.610
Application of ORS 746.600 to 746.690
746.611
Personal representative of deceased person
746.612
No right of action
746.615
Pretext interviews prohibited
746.620
Notice of insurance information practices
746.625
Marketing and research surveys
746.630
Authorization for disclosure of certain information
746.632
Genetic information used for treatment
746.635
Investigative consumer reports
746.640
Access to recorded personal information
746.645
Correction, amendment or deletion of recorded personal information
746.650
Reasons for adverse underwriting decisions
746.655
Information concerning previous adverse underwriting decisions
746.660
Basing adverse underwriting decision on previous adverse decision
746.661
Use of credit history or insurance score
746.662
Filing of insurance scoring models
746.663
Cancellation or nonrenewal of personal insurance policies based on credit history or insurance score
746.665
Limitations and conditions on disclosure of certain information
746.668
Relationship of ORS 746.620, 746.630 and 746.665 to federal Fair Credit Reporting Act
746.670
Investigatory powers
746.675
Service of process on out-of-state insurance-support organizations
746.680
Remedies
746.685
Liability for disclosure of information
746.686
Use of prior claim or inquiry in determination to issue or renew homeowner insurance policy
746.687
Cancellation of homeowner insurance policy
746.688
Use of loss history reports
746.690
Obtaining information under false pretenses prohibited
746.991
Penalties
Green check means up to date. Up to date