Or. Admin. R. 436-050-0005

Current through Register Vol. 63, No. 6, June 1, 2024

Section 436-050-0005 - Definitions

Unless a term is defined elsewhere in these rules, the definitions of ORS chapter 656 are incorporated by reference and made a part of these rules. For the purpose of these rules, unless the context requires otherwise:

(1)"Assigned claims agent" means an entity selected by the director to process the claims of a noncomplying employer under ORS 656.054.

(2)"Audited financial statement" means a financial statement audited by an outside accounting firm.

(3)"Board" means the Workers' Compensation Board and includes its Hearings Division.

(4)"Cancel" or "cancellation," in relation to an insurance policy, means ending the policy at a date before its expiration date.

(5)"Claims processing location" means a place of business maintained or operated by an insurer, self-insured employer, self-insured employer group, or service company to process claims and make records available. "Claims processing location" does not include a post office box, commercial mail receiving agency, virtual office, or the place of residence of an employee of the insurer, self-insured employer, self-insured employer group, or service company.

(6)"Days" means calendar days unless otherwise specified.

(7)"Default" means failure of an employer, insurer, or self-insured employer to pay the moneys due to the director under ORS 656.506, 656.612, and 656.614 at such intervals as the director directs.

(8)"Director" means the director of the Department of Consumer and Business Services or the director's designee.

(9)"Division" means the Workers' Compensation Division of the Department of Consumer and Business Services.

(10)"Governmental subdivision" means a city, county, special district as defined in ORS 198.010, intergovernmental agency created under ORS 225.050, school district as defined in ORS 255.005, public housing authority created under ORS chapter 456, or regional council of governments created under ORS chapter 190.

(11)"Insurer" means the State Accident Insurance Fund Corporation or an insurer authorized under ORS chapter 731 to transact workers' compensation insurance in Oregon.

(12)"Nonrenewal" means the insurer's decision not to renew a policy at its expiration date.

(13)"Person" means an individual, partnership, corporation, joint venture, limited liability company, association, government agency, sole proprietorship, or other business entity allowed to do business in the State of Oregon.

(14)"Premium" means the monetary consideration for an insurance policy.

(15)"Premium assessments" means moneys due the director under ORS 656.612 and 656.614.

(16)"Principal" means the entity whose liability is secured by a surety bond.

(17)"Process claims" means the determination of compensability and management of workers' compensation claims by an Oregon certified claims examiner.

(18)"Proof of coverage" has the meaning provided under OAR 436-162-0005.

(19)"Reinstatement" means the continuation or reestablishing of workers' compensation insurance coverage under a workers' compensation insurance policy that was previously canceled.

(20) "Renewal" or "renew" means the issuance of a policy succeeding a previously issued policy or the issuance of a certificate or notice extending the terms of an existing policy for a specified period beyond its expiration date.

(21)"Self-insured employer" means an employer certified under ORS 656.430 as having met the qualifications of a self-insured employer under ORS 656.407.

(22)"Self-insured employer group" means five or more employers certified under ORS 656.430 as having met the qualifications of a self-insured employer under ORS 656.407.

(23)"Service company" means the contracted agent for an insurer, self-insured employer, or self-insured employer group authorized to process claims and make payment of compensation on behalf of the insurer, self-insured employer, or self-insured employer group.

(24)"State" means the state of Oregon.

(25)"Written" means information communicated in writing, and includes electronic records.

Or. Admin. R. 436-050-0005

WCB 2-1976(Admin)(Temp), f. & ef. 4-12-76; WCB 3-1976(Admin), f. & ef. 6-15-76; WCD 3-1980(Admin), f. & ef. 4-2-80; WCD 4-1982(Admin), f. 2-10-82, ef. 2-15-82; WCD 10-1982(Admin), f. 9-30-82, ef. 10-1-82; WCD 1-1983(Admin), f. 6-30-83, ef. 7-1-83; WCD 7-1983(Admin), f. 12-22-83, ef. 12-27-83; WCD 5-1985(Admin), f. 12-10-85, cert. ef. 1-1-86; Renumbered from 436-051-0005; WCD 9-1985(Admin), f. 12-12-85, ef. 1-1-86; WCD 9-1987, f. 12-18-87, ef. 1-1-88; WCD 7-1989, f. 12-22-89, cert. ef. 1-1-90; WCD 25-1990, f. 11-29-90, cert. ef. 12-26-90; WCD 2-1994, f. 4-1-94, cert. ef. 5-1-94; WCD 9-1996, f. 3-11-96, cert. ef. 4-1-96; WCD 5-2001, f. 6-22-01, cert. ef. 7-1-01; WCD 12-2003, f. 12-4-03, cert. ef. 1-1-04; WCD 3-2007(Temp), f. 5-31-07, cert. ef. 6-1-07 thru 11-27-07; WCD 7-2007, f. 11-1-07, cert. ef. 11-28-07; WCD 1-2008, f. 6-13-08, cert. ef. 7-1-08; WCD 4-2008, f. 9-17-08, cert. ef. 7-1-09; WCD 6-2012, f. 10-4-12, cert. ef. 1-1-13; WCD 5-2016, f. 11-28-16, cert. ef. 1/1/2017; WCD 7-2018, amend filed 06/07/2018, effective 7/1/2018; WCD 20-2018, amend filed 11/15/2018, effective 1/1/2019; WCD 10-2019, amend filed 12/17/2019, effective 1/1/2020; WCD 18-2021, amend filed 12/13/2021, effective 1/1/2022

Statutory/Other Authority: ORS 656.726(4)

Statutes/Other Implemented: ORS 656.726(4)