Moore v. Allstate Ins. Co.

“Nothing in McBride suggests that ORS 742.524(1) mandates payment of PIP benefits within 60 days of an insurer receiving the bills” and the “60-day requirement in ORS 742.524(1)(a) operates to create a rebuttable presumption that the medical bills are reasonable and necessary”, which can be rebutted by a defendant. McBride v. State Farm Mutual Automobile Ins. Co., 282 Or App 675 (2016).

Plaintiff appealed a limited judgment in favor of Allstate. Plaintiff assigned error to the trial court’s grant of Allstate’s motion for summary judgment. On appeal, Plaintiff reprised her argument that Allstate breached its promise to pay or deny medical bills within 60 days of receiving them which ORS 742.524(1)(a) required. In response, Allstate argued that failing to pay or deny PIP benefits within 60 days does not constitute a breach of its duty under the policy. “Nothing in McBride suggests that ORS 742.524(1) mandates payment of PIP benefits within 60 days of an insurer receiving the bills” and the “60-day requirement in ORS 742.524(1)(a) operates to create a rebuttable presumption that the medical bills are reasonable and necessary,” which can be rebutted by a defendant. McBride v. State Farm Mutual Automobile Ins. Co., 282 Or App 675 (2016). The Court held that the trial court did not err because Plaintiff failed to submit to an EUO before filing the cause of action and because it was reasonable for Allstate to require the EUO. Affirmed.