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contact for claims processing location information forms: |
On-line form |
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Mail-in form |
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All Insurers:
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Insurers must register
with the Oregon Workers' Compensation Division within 30 days after obtaining a certificate
of authority from the Oregon Insurance Division and beginning to write workers' compensation
insurance policies for Oregon subject employers under Oregon Administrative Rule 436-050-0110
(1) and (2). In order to register with WCD, insurers must submit the Notification
of Place of Business form.
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Insurers
using Service Companies:
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If an insurer uses a service
company, in addition to completing the Notification of Place of Business form,
it must also submit a service agreement as required by ORS
Chapter 731.475. A power of attorney (or letter of authorization) must also
be submitted if the agreement does not grant the service company authority to act for
the insurer in workers' compensation claims and/or coverage proceedings under ORS
Chapter 656.
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Service
Companies (Third Party Administrators):
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Service
companies handling claims for Oregon workers must be incorporated in or authorized
to do business in Oregon and have a location in Oregon for processing claims. The service
company (TPA) must employ only "certified" claims examiners to process workers'
compensation claims and the company must have a general lines adjuster license from
the Insurance Division. (The general lines adjuster license is not the same license
a TPA is required to have in order to adjust life and health policies.) Service companies
handling only claims for self-insured employers are not required to have a general
lines adjuster license; however, before they may adjust claims for insurers, they must
meet the full licensing requirements.
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Service
Company (TPA) Notification of Place of Business In Oregon - Registration
Form |
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Claims
examiner certification or call the WCD Benefits & Certifications Unit at
(503)947-7585 |
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Independent
Claims Adjuster license or call Insurance Division Licensing at 503-947-7215. |
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Please
send completed documents to:
Mail to:
Oregon Workers' Compensation Division
Compliance Section, Insurer Registration
350 Winter Street NE
PO Box 14480
Salem, OR 97309-0405
Fax: 503-934-6048
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