Or. Admin. R. 836-043-0210

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

Section 836-043-0210 - Definitions

As used in; OAR 836-043-0200 to 836-043-0240, unless the context requires otherwise:

(1) "Aggrieved Person" means any person adversely affected by application of a rating system or by any decision of the Committee.

(2) "Classification" means a grouping of insurance risks according to a classification system used by an insurer.

(3) "Classification System" means a schedule of classifications and a rule or set of rules used by an insurer for determining the classification applicable to an insured.

(4) "Committee" means the Oregon Workers' Compensation Rating System Review and Advisory Committee established by OAR 836-043-0200 to 836-043-0240.

(5) "Experience Rating" means modification of workers' compensation insurance premium according to the Experience Rating Plan Manual of the National Council on Compensation Insurance filed with the Director.

(6) "Hearing" or "Hearings" means an informal and reasonable means whereby any person aggrieved by the application of NCCI's rating system or an authorized representative of the person may be heard by the Oregon Workers' Compensation Rating System Review and Advisory Committee to review the manner in which such rating system has been applied in connection with the insurance afforded the person. This hearing does not constitute a contested case hearing within the meaning of ORS 183.310.

(7) "Insured" means an employer who has been issued a workers' compensation insurance policy by an insurer. An insured may designate, in writing, a representative to present their appeal before the Committee. The Small Business Ombudsman of the Department of Insurance and Finance may be a representative.

(8) "Insurer" means any insurer authorized to transact workers' compensation insurance and includes the State Accident Insurance Fund Corporation.

(9) "Member" means a member of the Oregon Workers' Compensation Rating System Review and Advisory Committee of the Director of the Department of Insurance and Finance.

(10) "National Council on Compensation Insurance" or "NCCI" is the rating organization that has been licensed by the Director for workers' compensation insurance, of which organization authorized workers' compensation insurers must be members pursuant to ORS 737.560.

(11) "Northwestern Division" or "NWD" is a branch of the National Council on Compensation Insurance providing related services for Oregon.

(12) "Premium" means the contractual consideration charged to an insured for insurance for a specific period of time regardless of the timing of actual charges.

(13) "Rate" means a monetary amount applied to the units of exposure basis assigned to a classification and used by an insurer to determine the premium for an insured, prior to any adjustment or adjustments resulting from the application of any rating plan.

(14) "Rating Plan" means a rule or set of rules used by an insurer to calculate premium for an insured, and the parameter values used in such calculation, after application of classification premium rates to units of exposure.

(15) "Rating System" means a collection of rating plans to be used by an insurer, rules for determining which rating plans are applicable to an insured, a classification system and other rules used by an insurer for determining contractual consideration for an insured.

(16) "Retrospective Rating" means a method of adjustment of workers' compensation insurance premium according to the insurer's rating plan for the policy of an insured based on losses incurred during the period covered by the policy.

(17) "Workers' Compensation Insurance" means insurance providing an employer coverage from the obligations of an employer arising from illness or injury to workers whether such obligation is imposed by ORS Chapter 656 of this state, similar laws of the United States, or agreements between states.

Or. Admin. R. 836-043-0210

ID 11-1992, f. 6-9-92, cert. ef. 6-15-92

Publications: The publication(s) referred to or incorporated by reference in this rule are available from the agency.

Stat. Auth.: ORS 731.244, ORS 737.310(13) & ORS 737.526(1)

Stats. Implemented: ORS 737.310(13) & ORS 737.526