(1) "Director" means the Director of the Department of Consumer and Business Services of this state or the commissioner, director or superintendent of insurance in any other state.
(2) "Completed operations liability" means liability arising out of the installation, maintenance or repair of any product at a site that is not owned or controlled by any person who performs that work or by any person who hires an independent contractor to perform that work. The term also includes liability for activities that are completed or abandoned before the date of the occurrence giving rise to the liability.
(3) "Domicile," for purposes of determining the state in which a purchasing group is domiciled, means:
(a) For a corporation, the state in which the purchasing group is incorporated; and
(b) For an unincorporated entity, the state of its principal place of business.
(4) "Hazardous financial condition" means that a risk retention group, based on its present or reasonably anticipated financial conditions, although not yet financially impaired or insolvent, is unlikely to be able:
(a) To meet obligations to policyholders with respect to known claims and reasonably anticipated claims; or
(b) To pay other obligations in the normal course of business.
(5) "Insurance" means primary insurance, excess insurance, reinsurance, surplus lines insurance and any other arrangement for shifting and distributing risk that is determined to be insurance under the laws of this state.
(6) "Liability":
(a) Means legal liability for damages, including costs of defense, legal costs and fees and other claims expenses, because of injuries to other persons, damage to their property or other damage or loss to such other persons resulting from or arising out of:
(A) Any business that is for-profit or not-for-profit, or any trade, product, premises, operations or services, including professional services; or
(B) Any activity of any state or local government, or any agency or political subdivision thereof.
(b) Does not include personal risk liability and an employer’s liability with respect to its employees other than legal liability under the Federal Employers’ Liability Act (45 U.S.C. 51 et seq.).
(7) "Personal risk liability" means liability for damages because of injury to any person, damage to property or other loss or damage resulting from any personal, familial or household responsibilities or activities, rather than from responsibilities or activities referred to in subsection (6) of this section.
(8) "Plan of operation or a feasibility study" means an analysis that presents the expected activities and results of a risk retention group, and includes at a minimum:
(a) The coverages, deductibles, coverage limits, rates and rating classification systems for each line of insurance the group intends to offer;
(b) Historical and expected loss experience of the proposed members and national experience of similar exposures to the extent that this experience is reasonably available;
(c) Pro forma financial statements and projections;
(d) Appropriate opinions by a qualified independent casualty actuary, including a determination of minimum premium or participation levels required to commence operations and prevent a hazardous financial condition;
(e) Identification of management, underwriting procedures, managerial oversight methods and investment policies; and
(f) Other matters that the director requires for liability insurance companies authorized by the insurance laws of the state in which the risk retention group is chartered.
(9) "Product liability" means liability for damages because of any personal injury, death, emotional harm, consequential economic damage or property damage, including damages resulting from the loss of use of property, arising out the manufacture, design, importation, distribution, packaging, labeling, lease or sale of a product. The term does not include the liability of any person for those damages if the product involved was in the possession of such a person when the incident giving rise to the claim occurred.
(10) "Purchasing group" means any group that:
(a) Has as one of its purposes the purchase of liability insurance on a group basis;
(b) Purchases such insurance only for its group members and only to cover their similar or related liability exposure, as described in paragraph (c) of this subsection;
(c) Is composed of members whose business or activities are similar or related with respect to the liability to which members are exposed by virtue of any related, similar or common business, trade, product, services, premises or operations; and
(d) Is domiciled in any state.
(11) "Risk retention group" means any corporation or other limited liability association formed under the laws of any state:
(a) Whose primary activity consists of assuming and spreading all, or any portion of, the liability exposure of its group members;
(b) That is organized for the primary purpose of conducting the activity described in paragraph (a) of this subsection;
(c) That:
(A) Is chartered and licensed as a liability insurance company and authorized to engage in the business of insurance under the laws of any state; or
(B) Before January 1, 1985, was chartered or licensed and authorized to engage in the business of insurance under the laws of Bermuda or the Cayman Islands and, before that date, had certified to the insurance commissioner of at least one state that it satisfied the capitalization requirements of that state. However, any such group shall be considered to be a risk retention group only if it has been engaged in business continuously since that date and only for the purpose of continuing to provide insurance to cover product liability or completed operations liability, as such terms were defined in the federal Product Liability Risk Retention Act of 1981, as amended by the Risk Retention Amendments of 1986, before the date of the enactment of the federal Liability Risk Retention Act of 1986 (P.L. 99-563);
(d) That does not exclude any person from membership in the group solely to provide for members of such a group a competitive advantage over such a person;
(e) That:
(A) Has as its members only persons who have an ownership interest in the group and has as its owners only persons who are members that are provided insurance by the risk retention group; or
(B) Has as its sole member and sole owner an organization that is owned by persons who are provided insurance by the risk retention group;
(f) Whose members are engaged in businesses or activities similar or related with respect to the liability to which such members are exposed by virtue of any related, similar or common business, trade, product, services, premises or operations;
(g) Whose activities do not include the provision of insurance other than:
(A) Liability insurance for assuming and spreading all or any portion of the liability of its group members; and
(B) Reinsurance with respect to the liability of any other risk retention group, or any members of such other group, that is engaged in businesses or activities so that such group or member meets the requirement described in paragraph (f) of this subsection for membership in the risk retention group that provides such reinsurance; and
(h) The name of which includes "Risk Retention Group."
(12) "State" means any state of the United States or the District of Columbia. [1987 c.774 §99; 1993 c.744 §29]
Structure 2021 Oregon Revised Statutes
Volume : 18 - Financial Institutions, Insurance
Chapter 735 - Alternative Insurance
Section 735.005 - Definitions for ORS 735.005 to 735.145.
Section 735.065 - Required association functions; assessments.
Section 735.075 - Discretionary association functions.
Section 735.095 - Contents of plan of operation.
Section 735.150 - Definitions for ORS 735.150 to 735.190.
Section 735.152 - Application of laws.
Section 735.156 - Confidentiality of documents and materials; public disclosure.
Section 735.160 - Business name.
Section 735.166 - Investment requirements for association captive insurer.
Section 735.170 - Rating organization.
Section 735.174 - Examination; frequency; scope; payment of expenses.
Section 735.176 - Compliance with sound actuarial principles.
Section 735.178 - Suspension or revocation of certificate of authority.
Section 735.180 - Branch captive insurer as pure captive insurer; rules.
Section 735.184 - Requirements for foreign captive insurer to provide insurance in this state.
Section 735.186 - Management of assets of captive reinsurer.
Section 735.188 - Application of captive reinsurer for certificate of authority.
Section 735.190 - Incorporation of captive reinsurer.
Section 735.200 - Legislative findings; purpose.
Section 735.205 - Definitions for ORS 735.200 to 735.260.
Section 735.210 - Formation of market assistance plans; rules.
Section 735.215 - Findings prior to formation of joint underwriting association; hearing.
Section 735.245 - Conditions for policyholder surcharge.
Section 735.265 - Liquor liability insurance risk and rate classifications; rules.
Section 735.305 - Definitions for ORS 735.300 to 735.365.
Section 735.320 - Relationship to insurance guaranty fund and joint underwriting association.
Section 735.330 - Purchasing groups; notice of intent to do business; registration; exceptions.
Section 735.400 - Purposes of ORS 735.400 to 735.495.
Section 735.405 - Definitions for ORS 735.400 to 735.495.
Section 735.410 - Conditions for procuring insurance through nonadmitted insurer; rules.
Section 735.415 - Qualifications for placement of coverage with nonadmitted insurer.
Section 735.420 - Declaration of ineligibility of surplus lines insurer.
Section 735.425 - Filing by licensee after placement of surplus lines insurance.
Section 735.430 - Surplus Line Association of Oregon; fees.
Section 735.455 - Authority of licensee; rules.
Section 735.460 - Records of licensee; examination.
Section 735.465 - Monthly reports; rules.
Section 735.470 - Premium tax; collection; payment; refund; rules.
Section 735.480 - Suspension or revocation of license; refusal to renew; grounds.
Section 735.485 - Actions against surplus lines insurer.
Section 735.495 - Short title; severability.
Section 735.500 - Requirements for certification as retainer medical practice; disclosures; rules.
Section 735.510 - Notice to department of specified changes to practice.
Section 735.515 - Charges for services not covered by contract.
Section 735.530 - Definitions for ORS 735.530 to 735.552.
Section 735.532 - Registration of pharmacy benefit managers; fees; rules.
Section 735.534 - Claim reimbursement; maximum allowable costs; documentation; rules.
Section 735.540 - Definitions for ORS 735.540 to 735.552.
Section 735.542 - Pharmacy claims audits; requirements.
Section 735.544 - Pharmacy claims audits; standards for review of claims.
Section 735.546 - Pharmacy claims audits; auditors.
Section 735.548 - Pharmacy claims audits; validation of claims.
Section 735.552 - Pharmacy claims audits; exception for fraud.