New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 15 - GROUP SELF-INSURANCE › Subchapter 2 - JOINT INSURANCE FUNDS FOR LOCAL GOVERNMENTAL UNITS PROVIDING PROPERTY AND LIABILITY COVERAGES › Section 11:15-2.2 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise.
"Actuary" means a person who is a Fellow in good standing of the Casualty Actuarial Society with three years recent experience in loss reserving; an Associate in good standing of the Casualty Actuarial Society with five years recent experience in loss reserving; or a Member in good standing of the American Academy of Actuaries who has been approved as qualified for signing casualty loss reserve opinions by the Casualty Practice Council of the American Academy of Actuaries and who has seven years recent experience in loss reserving.
"Administrator" means a person, partnership, corporation or other legal entity engaged by the joint insurance fund commissioners or executive committee, as defined herein, to act as executive director to carry out the policies established by the joint insurance fund commissioners or executive committee and to otherwise administer and provide day-to-day management of the joint insurance fund. The administrator may also be the lead agency, an employee of the fund, a fund member, or an independent contractor.
"Automobile and equipment liability" means liability resulting from the use or operation of motor vehicles, equipment or apparatus owned by or controlled by the local unit or owned by or under the control of any subdivisions thereof including its departments, boards, agencies, commissions or other entities which the local unit may provide coverage for under 40A:10-2.
"Blanket bond coverage" means coverage of certain county or municipal officers and employees for faithful performance and discharge of their duties as provided under 40A:5-34.1.
"Chairman" means the chairman of the fund commission, elected by the commission pursuant to 40A:10-37.
"Commissioner" means the Commissioner of the Department of Banking and Insurance.
"Department" means the New Jersey Department of Banking and Insurance.
"Employers' liability" means the legal liability of a public employer to pay damages because of bodily injury or death by accident or disease at any time resulting therefrom sustained by an employee arising out of and in the course of his employment by the public employer, which is not covered by a workers' compensation law.
"Environmental impairment liability fund" means a joint insurance fund formed for the sole purpose of insuring against bodily injury and property damage claims arising from environmental liability and legal representation therefor to the extent and for coverages set forth in this subchapter.
"Excess carrier" means an insurer that provides excess insurance or reinsurance to a fund.
"Excess insurance" means insurance, purchased from an insurance company authorized or admitted in the State of New Jersey or deemed eligible by the Commissioner as a surplus lines insurer, or from any other entity authorized to provide such coverage in this State pursuant to law, covering losses in excess of an amount established between the joint insurance fund and the insurer up to the limits of coverage set forth in the insurance contract on a specific per occurrence, or per accident, or annual aggregate basis.
"Executive committee" means the committee of insurance fund commissioners, as provided in 40A:10-36 et seq.
"Fiscal year" or "fund year" means the calendar year January 1 through December 31.
"General liability" means any and all liability which may be insured under the laws of the State of New Jersey, excluding workers' compensation and employers' liability.
"Hazardous financial condition" means that, based on its present or reasonably anticipated financial condition, a fund, although not yet financially impaired or insolvent, is unlikely to be able:
1. To meet obligations to claimants with respect to known claims and reasonably anticipated claims; or
2. To pay other obligations in the normal course of business.
"Indemnity and trust agreement" means a written contract signed by the members of the joint insurance fund under which each agrees to jointly and severally assume and discharge the liabilities of each and every party to such agreement arising from their participation in the fund.
"Insolvent fund" means a joint insurance fund which has been determined by a court of competent jurisdiction to be unable to pay its outstanding lawful obligations as they mature in the regular course of business, as may be shown either by an excess of its required reserves and other liabilities over its assets or by its not having sufficient assets to reinsure all of its outstanding liabilities after paying all accrued claims owed by it, or for which, or for the assets of which, a receiver or liquidator, however entitled, has been appointed by a court of competent jurisdiction and authority, after the effective date of this subchapter.
"Insurer" means any corporation, association, partnership, reciprocal exchange, interinsurer, Lloyd's insurer or other person engaged in the business of insurance pursuant to Subtitle 3 of Title 17 of the Revised Statutes.
"Intertrust fund transfer" means an actual transfer of funds from one claim or loss retention fund account in a fiscal year to another account within the same fiscal year.
"Interyear fund transfer" means the transfer of funds from a claim or loss retention trust account for a fiscal year, to a claim or loss retention trust account of similar risk or liability for a different fiscal year.
"Joint insurance fund" or "Fund" means a group organized by two or more local units of government to establish an insurance fund for the purposes of insuring and/or self-insuring against liability, property damage, and workers' compensation, or for the sole purpose of insuring against bodily injury and property damage claims arising from environmental impairment liability and legal representation therefor, to the extent and for coverages approved by the Commissioner pursuant to the authority of 40A:10-36 et seq. and this subchapter.
"Joint insurance fund commissioners" means local unit representatives chosen to represent those units in the fund, as provided in 40A:10-36 et seq.
"Lead agency" means a member of the joint insurance fund responsible for the custody and maintenance of the assets of the fund and such other duties as may be designated by the joint insurance fund commissioners. The duties performed by a lead agency may include duties that may be performed by an administrator or servicing organization.
"Local unit of government" or "local unit" means a county, municipality, county vocational school (pursuant to 18A:18B-8 and 40A:10-50 ), county college (pursuant to 18A:64A-25.4 0 and 40A:10-51 ), any contracting unit as defined in 40A:11-2, boards of education of certain school districts, to the extent permitted pursuant to 40A:10-52 through 57, and non-profit housing entities as defined by and subject to the limitations and requirements of 40A:10-36.3, when such entities choose to establish a joint insurance fund with other non-profit housing entities pursuant to 40A:10-36.3 and in accordance with N.J.A.C. 11:15-6, or to join a joint insurance fund pursuant to 40A:10-36.3 et seq. and in accordance with 11:15-2.3.
"Net current surplus" or "surplus" means that amount of monies in a trust account established pursuant to 11:15-2.6(b)10  that is in excess of all costs, earned investment income, refunds made pursuant to 11:15-2.2 1, incurred losses and loss adjustment expenses and incurred but not reported reserves, including the associated loss adjustment expenses attributed to the fund net of any recoverable per occurrence or aggregate excess insurance or reinsurance for a particular year.
"Producer" means any person engaged in the business of an insurance agent, insurance broker or insurance consultant as defined in N.J.S.A. 17:22A-1 et seq.
"Property damage" means any loss or damage, however caused, on property, motor vehicles, equipment or apparatus owned by the local unit or owned by or under the control of any of its departments, boards, agencies, commissions, or other entities which the local unit may provide coverage for under 40A:10-2.
"Secretary" means the secretary of the fund commission elected by the commission pursuant to 40A:10-37.
"Servicing organization" means an individual, partnership, association or corporation, other than the administrator, that has contracted with the fund to provide, on the fund's behalf, any function as designated by the fund commissioners including, but not limited to, actuarial services, claims administration, cost containment services, loss prevention/safety engineering services, legal services, auditing services, financial services, compilation and maintenance of the fund's underwriting file, coordination and preparation of coverage documents, risk selection and pricing, excess insurance or reinsurance producer services, which include producer negotiations on behalf of the fund for excess insurance or reinsurance from an insurer, member assessment and fee development, report preparation pursuant to 40A:10-36 et seq. and this subchapter, and such other duties as designated by the fund.
"Unpaid claims" or "unpaid losses" means case reserves and reserves for incurred but not reported claims attributed to the fund net of any recoverable per occurrence or aggregate excess insurance or reinsurance for a particular year.
"Workers' compensation law" means the provisions of 34:15-7 et seq.