Oregon Administrative Rules
Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION
Division 43 - WORKERS'COMPENSATION INSURANCE RATING SYSTEM AND AUDIT PROCEDURES
Section 836-043-0230 - Committee Operating Rules

Universal Citation: OR Admin Rules 836-043-0230

Current through Register Vol. 63, No. 9, September 1, 2024

(1) The term of each Committee shall commence on June 1 and expire on May 31 of the following year.

(2) The Committee shall meet either in person or by teleconference at the beginning of each term for purposes of electing the First Vice-chairperson and Second Vice-chairperson. The Chairperson shall be responsible for organizing the agenda of each meeting and each hearing, and for the conduct of each hearing. The First Vice-chairperson shall be responsible for arranging facilities, providing notice as required, and arranging for administrative support services. The Chairperson or Vice-chairperson, may delegate any of its administrative functions to other Committee officers.

(3) The Committee shall meet as needed and in accordance with the provisions of state law.

(a) Upon receipt of a grievance to the Recording Secretary, the Committee shall schedule a hearing to be convened within 90 days;

(b) Written notice of hearing shall be provided to the appellant, the insurer and the NWD within 20 days after receipt of the grievance, but not less than ten days prior to the hearing;

(c) The written notice of hearing shall contain notice of discovery rights pursuant to ORS 737.505(1) and notice of the right to be represented by counsel or have other advisors present;

(d) Hearings shall not be held unless a quorum is present either in person or by teleconference. A quorum shall consist of a simple majority. The decision of the Committee shall be by majority vote of those voting members present at the hearing;

(e) If a member has a conflict of interest with respect to a hearing scheduled before the Committee, the member shall declare such conflict of interest and either abstain from voting, or obtain the agreement of the aggrieved party that such abstention is not required. A conflict of interest shall exist when:
(A) A member has a familial relationship with the aggrieved party; or

(B) An insured member is a direct competitor of the aggrieved party; or

(C) An insured member is a part of an affiliated group, any member of which is a direct competitor of the aggrieved party; or

(D) A member is associated with the aggrieved party and comes within the definition of a controlled group as specified in Section 851(c)(3) of the Internal Revenue Code; or

(E) A member has any other material conflicting interest which could call into question that member's ability to render an unbiased decision.

(f) A conflict of interest may be waived if, after full disclosure of the facts raising such a conflict, all parties to the appeal agree to such waiver;

(g) The NCCI representative(s) on the Committee shall not be deemed to have a conflict of interest with respect to any appeal brought before the Committee based solely upon such representa-tives' affiliation with NCCI.

(4) Each decision shall be provided in writing and shall state the reason(s) for the decision. The decision shall be sent within 30 days of the hearing to all parties and to the Director:

(a) The votes of each member shall not be recorded on the decision;

(b) This decision shall be prepared by the First Vice-chairman of the Committee;

(c) This decision shall provide conspicuous notice of the appeal rights to a de novo administrative law contested case hearing before the Director pursuant to ORS 737.505(3). The NCCI shall have the right to appeal this decision at such a contested case hearing.

(5) Review of decisions of the Committee shall be accorded pursuant to ORS 737.505.

(6) Except for executive sessions held to discuss appropriate issues, all Committee meetings shall be open to any NCCI member or subscriber, insured and the general public. Executive Sessions are open to any NCCI member.

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

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

Disclaimer: These regulations may not be the most recent version. Oregon may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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