2019 Oregon Revised Statutes
Volume : 18 - Financial Institutions, Insurance
Chapter 742 - Insurance Policies Generally; Property and Casualty Policies
Section 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 (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 (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.
(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 (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 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.
