Unfair Claims Settlement Practices Act

The Oregon Supreme Court has long held the legislature did not create a private right of action under the Unfair Claims Settlement Practices Act (ORS 746.230). Policyholders could bring a tort claim against their insurance company only if the insurer was subject to a standard of care independent of the insurance policy.[i]  But the Court’s mood changed last month in Moody v. Oregon Community Credit Union, 371 Or 772 (2023).

Moody’s facts are not complex.  Plaintiff Christine Moody’s husband, Troy, was accidentally shot and killed by a friend during a camping trip. Christine sought life insurance benefits, and the insurer denied Christine’s claim based on a policy exclusion for deaths caused by or resulting from the insured being “under the influence of any narcotic or other controlled substance.”  Troy evidently had marijuana in his system when he died.

Christine sued the insurer, alleging claims for breach of contract, breach of an implied contractual covenant of good faith and fair dealing, and negligence. She sought both economic damages and emotional distress damages. In her negligence claim, Christine alleged the Unfair Claims Settlement Practices Act provided an independent standard of care outside the terms of the insurance contract.  She asserted the insurer violated several claims handling practices, such as failing “to pay the insurance benefits without conducting a reasonable investigation based on all available information” and “[n]ot attempting, in good faith, to promptly and equitably settle a claim in which the insurer’s liability has become reasonably clear.”  Christine further alleged that the insurer “knew, or in the exercise of reasonable care as a corporation engaged in the business of marketing and selling insurance, should have known, that one or more of its foregoing acts or omissions would create an unreasonable risk of harm to the beneficiaries of its insured, including [Christine].” Finally, because of the insurer’s negligence, she had suffered “the noneconomic loss of increased emotional distress and anxiety caused by having fewer financial resources to navigate the loss of a bread-winning spouse.”Continue Reading The Mood Swings on Insurer Bad-Faith in Oregon: An Analysis of the Oregon Supreme Court Decision in Moody v. Oregon Community Credit Union