reglab/statecodes huggingface dataset:
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 5 - PERSONAL INJURY PROTECTION DISPUTE RESOLUTION › Section 11:3-5.12 - Prohibition of conflicts of interest

Current through Register Vol. 56, No. 14, July 15, 2024
(a) No administrator or employee thereof, dispute resolution professional, medical review organization or reviewing health care provider shall have any personal or financial interest, direct or indirect, or engage in any business or transaction which is in conflict with the proper conduct of his or her duties under this subchapter.
(b) No administrator or employee thereof, dispute resolution professional, medical review organization or reviewing health care provider shall act in such capacity in any matter wherein he or she has a direct or indirect personal or financial interest that might reasonably be expected to impair his or her objectivity or independence of judgment.
(c) No administrator or employee thereof, dispute resolution professional, medical review organization or reviewing health care provider shall accept any gift, favor, service or other thing of value under circumstances from which it might be reasonably inferred that such gift, service or other thing of value was given or offered for the purpose of influencing him or her in the conduct of duties under this subchapter.
(d) No dispute resolution professional shall accept from any person, whether directly or indirectly and whether by him or herself or through a spouse or any family member or through any partner or associate or controlled business, any gift, favor, service, employment or offer of employment or any other thing of value which he or she knows or has reason to believe is offered with the intent to influence the performance of his or her duties as a dispute resolution professional.
(e) No dispute resolution professional shall make any determination in any PIP dispute in which he or she directly or indirectly or through a spouse, family member or by partner or associate or controlled business has any personal or financial interest.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 6 - INSURANCE IDENTIFICATION CARDS › Section 11:3-6.1 - Scope

Current through Register Vol. 56, No. 14, July 15, 2024
In accordance with
39:3-29.1
, this subchapter concerns the issuance, design, and content of insurance identification cards for motor vehicles issued by insurers in this State. This subchapter shall not apply to policies covering motor vehicles registered with the U.S. Department of Transportation pursuant to 49 CFR Parts 300-399.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 6 - INSURANCE IDENTIFICATION CARDS › Section 11:3-6.2 - 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:
"Electronic insurance identification card or E-card" means the display of an electronic image on a cellular phone or any other type of portable electronic device if the device has sufficient functionality and display capability to enable the user to display the required information as clearly as a paper insurance identification card issued by the insurer.
"Insurance identification card" means proof of insurance coverage by means of a paper card or an electronic image that meets the requirement of this subchapter.
"Insurer" or "insurance company" means any person or persons, corporation, association, partnership, company, reciprocal exchange, risk retention group, or other legal entity authorized or admitted to transact private passenger automobile insurance, motor vehicle liability, or physical damage insurance in this State. Insurer does not include an entity that is self-insured pursuant to 39:6-52.
"Motor vehicle" means a vehicle as described in
39:1-1
, required to be registered with the New Jersey Motor Vehicle Commission, but does not include trailers or semi-trailers.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 6 - INSURANCE IDENTIFICATION CARDS › Section 11:3-6.4 - Additional requirements for paper permanent insurance identification cards

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The front of the card shall include the information provided in
11:3-6.3(e)
1 through 10. The address for Notification of Commencement of Medical Treatment required by
11:3-6.3(e)
11 may be printed on the reverse of the card.
(b) The card shall meet the following specifications:
1. The minimum size shall be three inches by five inches, and the maximum size shall be 5 1/2 inches by 8 1/2 inches; and
2. The weight shall not be lighter than 20 pounds white bond.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 6 - INSURANCE IDENTIFICATION CARDS › Section 11:3-6.5 - Requirements for paper temporary evidence of insurance

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The paper temporary evidence of insurance document shall include the information required by
11:3-6.3(e)
, except as noted below:
1. The heading on the document shall read: "State of New Jersey Temporary Evidence of Insurance";
2. There are no requirements for the weight or size of the paper for the document and it can be sent to the insured by facsimile or e-mail, or downloaded from an insurer's website;
3. The policy number shall be indicated, if available. Otherwise, the application or binder number is acceptable; and
4. The document shall contain the following statement: "This Temporary Evidence of Insurance expires 20 days after the effective date shown above."
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 7 - AUTOMOBILE REPARATION REFORM ACT › Section 11:3-7.1 - Purpose

Current through Register Vol. 56, No. 14, July 15, 2024
This subchapter implements certain provisions of the Automobile Reparation Reform Act, 39:6A-1 et seq., including the Commissioner's authority to establish the amounts and terms of additional personal injury protection benefits that must be made available to insureds electing a standard automobile insurance policy pursuant to 39:6A-4.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 7 - AUTOMOBILE REPARATION REFORM ACT › Section 11:3-7.2 - General requirements applicable to additional personal injury protection benefits

Current through Register Vol. 56, No. 14, July 15, 2024
(a) In addition to the personal injury protection benefits that insurers must provide pursuant to 39:6A-4 or 39:6A-3.1, insurers shall make available to the named insured, and, at his or her option, to any resident relatives in the name insured's household who are not named insureds on another standard or basic policy, additional income continuation benefits, essential services benefits, death benefits and funeral expense benefits pursuant to 39:6A-10 and this subchapter.
(b) The additional benefit indicated in each option that an insurer may offer for income continuation benefits and essential services benefits represents the aggregate of the basic and additional personal injury protection benefits.
(c) Any additional income continuation benefits that an insurer may offer shall be limited to 75 percent of the insured's weekly income.
(d) The limits which are applicable to any additional personal injury protection benefits that an insurer may offer shall apply on a per person, per accident basis.
(e) Each insurer shall make available as an option additional income continuation benefits for as long as the disability persists.
1. Each insurer shall furnish rates for such benefits upon the request of the insured.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 7 - AUTOMOBILE REPARATION REFORM ACT › Section 11:3-7.3 - Personal injury protection policy forms or endorsements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All policy forms or endorsements that provide personal injury protection benefits required by 39:6A-4 shall specify that such benefits shall be afforded by the insurer of the injured person subject to any deductibles or exclusions elected by the policyholder pursuant to 39:6A-4.3. The required personal injury protection benefits are set forth below:
1. Medical expense benefits;
2. Income continuation benefits;
3. Essential services benefits;
4. Death benefits; and
5. Funeral expense benefits.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 7 - AUTOMOBILE REPARATION REFORM ACT › Section 11:3-7.4 - Minimum schedule of additional personal injury protection coverage benefits

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Every rate filer's schedule of rates for additional personal injury protection benefits, other than medical expense benefits, shall provide at least the benefit schedules set forth in Table 1 in (b) below.
(b) The additional personal injury protection coverage table follows:
Table 1
Income
Essential Services
Option
Weekly
Total
Per Day
Total
Death
Funeral Expense
1
$ 100
$ 10,400
$ 12
$ 8,760
$ 10,000
$ 2,000
2
125
13,000
20
14,600
10,000
2,000
3
175
18,200
20
14,600
10,000
2,000
4
250
26,000
20
14,600
10,000
2,000
5
400
41,600
20
14,600
10,000
2,000
6
500
52,000
20
14,600
10,000
2,000
7
600
62,400
20
14,600
10,000
2,000
8
700
72,800
20
14,600
10,000
2,000
9
100
unlimited
12
8,760
10,000
2,000
10
125
unlimited
20
14,600
10,000
2,000
11
175
unlimited
20
14,600
10,000
2,000
12
250
unlimited
20
14,600
10,000
2,000
13
400
unlimited
20
14,600
10,000
2,000
14
500
unlimited
20
14,600
10,000
2,000
15
600
unlimited
20
14,600
10,000
2,000
16
700
unlimited
20
14,600
10,000
2,000
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 7 - AUTOMOBILE REPARATION REFORM ACT › Section 11:3-7.5 - Notice Requirement

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Additional personal injury protection benefits that are required to be offered by an insurer shall be offered by the insurer at least annually as part of the Coverage Selection Form required pursuant to 39:6A-23 and N.J.A.C. 11:3-15.
1. The buyer's guide and coverage selection form specified at 39:6A-23 and any rules promulgated thereunder shall meet the requirements of (a) above.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 7 - AUTOMOBILE REPARATION REFORM ACT › Section 11:3-7.6 - Cancellation of automobile coverage for nonpayment of premium

Current through Register Vol. 56, No. 14, July 15, 2024
(a) This rule applies to all automobile policies delivered or issued for delivery in this State, insuring a single individual or husband and wife resident of the same household, as named insured, and under which the insured vehicles therein designated are of the following types only:
1. A motor vehicle of the private passenger or station wagon type that is not used as a public or livery conveyance for passengers, not rented to others; or
2. Any other four-wheel motor vehicle with a load capacity of 1,500 pounds or less which is not customarily used in the occupation, profession or business of insured, other than farming or ranching, provided, however, that this rule shall not apply to any policy insuring more than four automobiles, or to any policy covering garage, automobile sales agency, repair shop, service station or public parking place operation hazards.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 8 - ACCEPTANCE, RENEWAL, NONRENEWAL AND CANCELLATION OF AUTOMOBILE INSURANCE POLICIES › Section 11:3-8.1 - Scope

Current through Register Vol. 56, No. 14, July 15, 2024
This subchapter applies to all automobiles as defined in N.J.S.A. 39:6A-2a, excluding those owned by business entities or insured through any statutorily mandated residual market mechanism, and to all policies or contracts of insurance insuring such automobiles.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 8 - ACCEPTANCE, RENEWAL, NONRENEWAL AND CANCELLATION OF AUTOMOBILE INSURANCE POLICIES › Section 11:3-8.2 - 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.
"Acceptance criteria" means the written standards by which an insurer accepts or rejects new business, and/or renews or nonrenews existing business as set forth in 11:3-8.1 2.
"Commissioner" means the Commissioner of the New Jersey Department of Banking and Insurance.
"Department" means the New Jersey Department of Banking and Insurance.
"Ineligible person" means a person who does not meet the definition of an eligible person in 11:3-34.4(a).
"Information" means any facts, documents, information and representations that are intentionally disclosed, or not disclosed, by an insured, applicant or covered person to an insurer or its representative that would materially affect the coverage, the premium or the benefits under a policy of insurance.
"Insurance score" means a number or rating, including that which is derived from an algorithm, computer application, model or other process, that is based in whole or part on credit information.
"Insurer" includes a group of affiliated companies.
"Nonrenewal" means the termination of coverage at the end of the policy period. Nonrenewal occurs when a notice of nonrenewal is sent to the insured in accordance with these rules.
"Producer" means any person or business entity, licensed pursuant to N.J.S.A. 17:22A-1 et seq., that earns $ 10,000 or more in commissions from an insurer in the prior calendar year.
"Renew" means to issue and deliver at the end of the policy period a policy superseding a policy previously issued and delivered, or to issue and deliver a certificate or notice extending the term of a policy beyond its policy period or term, by the same individual insurance company, or by another of a group of affiliated companies pursuant to a rating plan, filed and approved in accordance with N.J.A.C. 11:3-19A.
"Tier rating plan" means a rating system used by an insurer that provides different rates for different risks to those insureds who qualify in accordance with the insurer's approved tier placement criteria, which have been filed and approved in accordance with N.J.A.C. 11:3-19A.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 8 - ACCEPTANCE, RENEWAL, NONRENEWAL AND CANCELLATION OF AUTOMOBILE INSURANCE POLICIES › Section 11:3-8.3 - Standards for renewal

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Every insurer shall make an offer to the insured named policyholder subject to this subchapter to renew such policy upon its expiration date, unless a valid notice of nonrenewal has been sent by the insurer to the insured in accordance with this subchapter.
(b) Each renewal offer shall be in the usual form of either a renewal policy, a certificate, or a renewal offer or bill. A renewal offer or bill shall indicate the date by which the renewal premium is due. The renewal bill or offer shall be mailed or delivered by the insurer to the insured not more than 45 days and not less than 30 days prior to the date the renewal premium is due.
1. Payment by the insured in accordance with the terms stated in the billing notice or in accordance with terms agreed to with the company or producer shall constitute acceptance of the renewal offer by the insured. Where acceptance of the policy renewal is made by payment of the renewal premium on or before the expiration date of the policy, the premium shall be deemed to have been received timely if it was mailed prior to the due date and received by the insurer within three business days after the due date. The date of mailing may be determined by the postmark on the envelope.
i. As an alternative to retaining the payment envelope as proof of the date of mailing, an insurer may presume that receipt of the mailed renewal premium payment within three business days after the due date conclusively establishes that the payment was mailed prior to the due date.
ii. An insurer may file changes to its rating system to charge a late fee of not more than $ 25.00 when the renewal premium was received after the due date but is deemed timely as provided in (b)1i above.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 8 - ACCEPTANCE, RENEWAL, NONRENEWAL AND CANCELLATION OF AUTOMOBILE INSURANCE POLICIES › Section 11:3-8.4 - Standards for nonrenewals-eligible persons

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Subject to the limitation set forth in 11:3-8.7, an insurer may issue a notice of nonrenewal to a named insured who is an eligible person, in the following instances:
1. In accordance with N.J.S.A. 17:29C-7.1f, when the policyholder or other person insured under the policy either has:
i. Provided false or misleading information in connection with an application or renewal of coverage, or as part of a claim for benefits; or
ii. Failed to provide the minimum information necessary to accurately rate the policy or renewal;
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 8 - ACCEPTANCE, RENEWAL, NONRENEWAL AND CANCELLATION OF AUTOMOBILE INSURANCE POLICIES › Section 11:3-8.5 - Standards for nonrenewals-ineligible persons

Current through Register Vol. 56, No. 14, July 15, 2024
(a) An insurer may issue a notice of nonrenewal to any ineligible person pursuant to 11:3-34.4.
(b) For the purpose of determining whether a person is an eligible person pursuant to 11:3-34.4, an insurer shall consider those accidents and violations accrued only in the experience period set forth in its acceptance criteria for renewal business established in accordance with 11:3-8.1 2.
(c) An insurer may issue a notice of nonrenewal to insureds who are ineligible persons for failure to meet the insurer's acceptance criteria in an amount not to exceed two percent of the insurer's in force voluntary market policies in each rating territory.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 8 - ACCEPTANCE, RENEWAL, NONRENEWAL AND CANCELLATION OF AUTOMOBILE INSURANCE POLICIES › Section 11:3-8.6 - Issuance of nonrenewal notices

Current through Register Vol. 56, No. 14, July 15, 2024
(a) A notice of nonrenewal shall not be valid unless it is mailed or delivered by the insurer to the insured no less than 60 days and no more than 90 days prior to the expiration of the current policy, except that the Commissioner may direct by Order that a notice of nonrenewal must be mailed or delivered up to 90 days prior to the expiration of the current policy. No such order shall be applicable to nonrenewal notices issued within 30 days after the date of the order. A notice of nonrenewal shall not be valid unless it specifies the reason(s) underlying the action being taken. Nonrenewal notices based on the insured's failure to meet the insurer's acceptance criteria shall identify the specific acceptance criteria that the insured being non-renewed has failed to fulfill. Non-renewal notices shall identify the specific facts relied upon by the insurer in determining to non-renew the insured, including dates and other facts necessary to identify the incident(s), which form the basis for the insurer's determination to nonrenew the policy.
1. In the event action is being taken under 11:3-8.4(a)2  or 3, or which would be subject to 11:3-8.5(c), the notice shall also specify that the action is being taken in accordance with 11:3-8.4(a)2  or 3 or is subject to 11:3-8.5(c), as applicable, and shall be consecutively numbered in each territory.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 8 - ACCEPTANCE, RENEWAL, NONRENEWAL AND CANCELLATION OF AUTOMOBILE INSURANCE POLICIES › Section 11:3-8.7 - Limitations on nonrenewal

Current through Register Vol. 56, No. 14, July 15, 2024
(a) No insurer shall nonrenew a policy based on 11:3-8.4(a)1  i without having first conducted an investigation and reported the matter in accordance with the insurer's Fraud Detection and Prevention Plan.
(b) No insurer shall nonrenew a policy for failure to complete and return a renewal questionnaire without having first given written notice to the policyholder one full policy cycle prior to the issuance of the notice of nonrenewal that:
1. At the next renewal, the insurer shall send the policyholder a renewal questionnaire, which must be completed and returned; and
2. Failure to complete and return that renewal questionnaire may result in the nonrenewal of the policy.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 8 - ACCEPTANCE, RENEWAL, NONRENEWAL AND CANCELLATION OF AUTOMOBILE INSURANCE POLICIES › Section 11:3-8.8 - Suspension of nonrenewals

Current through Register Vol. 56, No. 14, July 15, 2024
Notwithstanding the provisions of this subchapter, if the plan for automobile insurance established pursuant to 17:29D-1 is not accepting new applications for coverage pursuant to 17:29D-1(d), no insurer transacting automobile insurance in this State shall refuse to renew any private passenger automobile insurance policy in this State.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 8 - ACCEPTANCE, RENEWAL, NONRENEWAL AND CANCELLATION OF AUTOMOBILE INSURANCE POLICIES › Section 11:3-8.9 - Records

Current through Register Vol. 56, No. 14, July 15, 2024
Insurance companies shall maintain records of nonrenewals for not less than five years which shall include a copy of the notice of nonrenewal, data concerning the allowable number of nonrenewals in each territory computed in accordance with 11:3-8.4(a)2  and 8.5(c), and data concerning the actual number of newly insured automobiles and nonrenewals in each territory for each category, computed in accordance with 11:3-8.4(a)3. Such records and data shall be made available to the Department upon request.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 8 - ACCEPTANCE, RENEWAL, NONRENEWAL AND CANCELLATION OF AUTOMOBILE INSURANCE POLICIES › Section 11:3-8.10 - Standards for cancellation

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Pursuant to 17:29C-7, a notice of cancellation shall be effective only when based on one or more of the following reasons:
1. Nonpayment of premium;
2. The driver's license or motor vehicle registration of the named insured has been suspended or revoked during the policy period;
3. The driver's license or motor vehicle registration of another named insured or person insured under the policy who either resides in the same household or customarily operates an automobile insured under the policy has been suspended or revoked during the policy term for one or more of the following reasons:
i. Conviction of operating a motor vehicle under the influence of alcohol or drugs (39:4-50 );
ii. Conviction of refusal to submit to a chemical test (39:4-50.4a );
iii. Conviction of vehicular homicide (2C:11-2 );
iv. Conviction of operating a motor vehicle while driving privilege is suspended (39:3-40 ), except for convictions under N.J.S.A. 39:3-40i;
v. Conviction of operating a motor vehicle without liability insurance (39:6B-2 );
vi. Conviction of misrepresentation of insurance coverage (39:6A-15 );
vii. Accumulation of motor vehicle penalty points pursuant to 39:5-30.5;
viii. By a court upon conviction of one of the following motor vehicle violations: racing on a highway (39:5C-1 ); failure to pass to right of vehicle proceeding in opposite direction (39:4-84 ); tailgating (39:4-89 ); reckless driving (39:4-96 ); exceeding a speed limit by 30 MPH or more (39:4-99 ); improperly passing a school bus (39:4-128.1 ); or leaving the scene of an accident in which personal injury occurred (39:4-129 ); or
ix. Where evidence exists that the suspended or revoked operator has been driving the vehicle during the period of suspension or revocation;
4. The named insured knowingly provided materially false or misleading information in connection with any application for insurance, renewal of insurance, or in connection with the filing of a claim for benefits under an insurance policy; or
5. An insurer determines, within 60 days of issuance of the policy, that the named insured does not meet the acceptance criteria of the insurer in effect on the date of application.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 8 - ACCEPTANCE, RENEWAL, NONRENEWAL AND CANCELLATION OF AUTOMOBILE INSURANCE POLICIES › Section 11:3-8.11 - Issuance of cancellation notices

Current through Register Vol. 56, No. 14, July 15, 2024
(a) No notice of cancellation issued pursuant to 11:3-8.1 0(a)1, non-payment of premium, shall be effective unless it is mailed or delivered by the insurer in accordance with 17:29C-8 to the named insured at least 15 days prior to the effective date of the cancellation.
(b) No notice of cancellation issued pursuant to 11:3-8.1 0(a)2 through 5 shall be effective unless it is mailed or delivered by the insurer in accordance with 17:29C-8 to the named insured at least 20 days prior to the effective date of the cancellation.
(c) All cancellation notices shall include the reason for the cancellation or shall state or be accompanied by a statement that upon written request of the named insured, mailed or delivered to the insurer not less than 15 days prior to the effective date of the cancellation, the insurer will specify the reason for the cancellation.
(d) No cancellation notice shall be effective unless (d)3 below and either (d)1 or 2 below are satisfied:
1. The notice is sent by certified mail; or
2. The notice is sent by regular mail and at the time of the mailing of the notice, the insurer has obtained from the U.S. Postal Service a date-stamped proof of mailing showing the name and address of the insured; and
3. The insurer retains a duplicate copy of the mailed cancellation notice that is certified to be a true copy.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 8 - ACCEPTANCE, RENEWAL, NONRENEWAL AND CANCELLATION OF AUTOMOBILE INSURANCE POLICIES › Section 11:3-8.12 - Acceptance criteria

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Acceptance criteria are the written standards by which an insurer accepts or rejects new business, and/or renews or nonrenews existing business. An insurer shall have separate acceptance criteria for new and renewal business.
(b) An insurer is prohibited from using any of the following in its acceptance criteria:
1. Any factor set forth in the New Jersey Law Against Discrimination, 10:5-12 (
l
), except in the case of disability set forth in (b)4 below;
2. The territory in which the applicant or insured resides;
3. The occupation, education or insurance score of the applicant or insured; provided that, as it relates to occupation, this paragraph shall not be construed to prohibit the operation of an insurer that has been approved by the Department to limit coverage to persons who are members or employees of members of certain groups, clubs or organizations, such as trade associations or the military (so-called membership companies) when membership is a condition for insurance and is uniformly and consistently applied on a Statewide basis;
4. Any mental or physical impairment of the insured unless such disability impairs the ability to operate an automobile safely;
5. Criteria based on whether the insured or a member of the insured's household purchases or continues to purchase other insurance or services from the insurer or its affiliates, agents or other companies, except that this provision shall not prohibit a rate discount; and
6. Criteria based upon a policyholder's application for coverage required to be provided by law, such as minimum limits of liability set forth in 17:28-1.1, or criteria requiring the purchase of coverage not otherwise required by law, such as physical damage coverage.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 8 - ACCEPTANCE, RENEWAL, NONRENEWAL AND CANCELLATION OF AUTOMOBILE INSURANCE POLICIES › Section 11:3-8.13 - Separability

Current through Register Vol. 56, No. 14, July 15, 2024
If any provision of this subchapter or its application to any person or circumstances is held invalid, the remainder of this subchapter and its application to other persons or circumstances shall not be affected.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 8 - ACCEPTANCE, RENEWAL, NONRENEWAL AND CANCELLATION OF AUTOMOBILE INSURANCE POLICIES › Section 11:3-8.14 - Penalties

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Any person violating the provisions of this subchapter shall be subject to such penalties as may be authorized by law.
(b) In addition to any such penalties, the Commissioner may, after notice and hearing, suspend or revoke the rights of any insurer or group of insurers under 11:3-8.4.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 8 - ACCEPTANCE, RENEWAL, NONRENEWAL AND CANCELLATION OF AUTOMOBILE INSURANCE POLICIES › Appendix - APPENDIX

Current through Register Vol. 56, No. 14, July 15, 2024
CERTIFICATION OF COMPLIANCE WITH 11:3-8.1 2
I hereby certify _________(Name of Insurance Company)__________ is in compliance with the above-captioned rule and is not using any of the prohibited "Acceptance Criteria" as set forth in 11:3-8.1 2(b).
______________________________________________
Signature
_______________________________________________
Print Name
_______________________________________________
Title
_______________________________________________
Telephone Number
_______________________________________________
Date
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 9 - RATING INFORMATION; AUTOMOBILE INSURANCE ON PRIVATE PASSENGER CARS › Section 11:3-9.1 - Rating information; private passenger cars; automobile insurance

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Every automobile insurance policy subject to New Jersey rates and providing coverage for an individually owned (or jointly owned by husband and wife; or two or more relatives resident of the household) private passenger automobile and/or any motor vehicle rates as a private passenger automobile shall be accompanied by rating information applicable to the premium determination. Such information must include the criteria pertaining to any individual driver classification plan used by the company and shall recite any rules that apply to the chargeability of accidents and convictions.
(b) If the declaration page or extension certificate or similar documents to the insured identifies the insured's car by a code, or other abbreviation, the rating information may be supplied by a rating information form that interprets the code number or abbreviation.
(c) Every company shall develop a rating information format adapted to the classification system approved for and used by the company in this State. Such format shall be submitted to the Commissioner of Banking and Insurance for approval initially within 30 days of the effective date of this regulation, and subsequently within 15 days of any revision of the classification system approved for the company. Filings of the rating information format by a rating organization shall be applicable to members and subscribers of such organization unless such companies deviate from the rating organization's classification system.
(d) This regulation shall be effective August 31, 1973. Use of approved forms will be required on all new and renewal business with effective dates January 1, 1974 and thereafter.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 10 - AUTO PHYSICAL DAMAGE CLAIMS › Section 11:3-10.2 - 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:
"Actual cash value", unless otherwise specifically defined by law or policy, means the lesser of the amounts for which the insured or the designated representative can reasonably be expected to:
1. Repair the motor vehicle to its condition immediately prior to the loss; or
2. Replace the motor vehicle with a substantially similar vehicle. The amount shall include all moneys paid or payable as sales taxes on the motor vehicle repaired or replaced. This paragraph shall not be construed to prevent an insurer from issuing a policy where the amount of damages to be paid in the event of a total loss is a specified dollar amount.
"Agreed price" or "figure" means the amount agreed to by the insurer and the insured, or their representatives, as the reasonable cost to replace the motor vehicle or to repair damages to the motor vehicle resulting from the loss, without considering any deductible or deductions.
"Designated representative" means a person designated by the insured to represent the insured in negotiations with the insurer in an attempt to settle the claim. The designated representative may be any person authorized by the insured who may act legally in his or her behalf.
"Motor vehicle" shall have the meaning ascribed in 39:1-1.
"Substantially similar vehicle" means a vehicle of the same make, model, year and condition, including all major options of the insured vehicle. Mileage must not exceed that of the insured vehicle by more than 4,000 miles. Mileage differences of more than 4,000 miles may, at the option of the insured, be exchanged for the presence or absence of options or a cash adjustment.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 10 - AUTO PHYSICAL DAMAGE CLAIMS › Section 11:3-10.4 - Adjustment of total losses

Current through Register Vol. 56, No. 14, July 15, 2024
(a) If the insurer elects to make a cash settlement, it must bear in mind at all times that the insured's position is that of a retail consumer and the settlement value arrived at must be reasonable and fair for a person in that position. Written, itemized valuations showing all options and deductions shall be included in the insurer's claim file and presented to the insured no later than the date of payment. If the insurer elects to make a cash settlement, its offer, subject to applicable additions or deductions, must be one of the following plus applicable sales tax:
1. The average of the retail values for substantially similar motor vehicles as listed in the editions current for the date of loss of two valuation manuals approved by the Commissioner.
i. The average figure arrived at may be reduced or increased by considering all factors, including, but not limited to, mileage tables and the presence or absence of extras.
ii. If the destroyed vehicle included an option which is listed in one manual but not in the other, the value of the option shall not be averaged. The insured shall receive full value for the option by carrying over the amount listed to the other manual. The option carryover shall apply only in those instances where the option has not been considered by the used vehicle guide either as a separate item or included in the vehicle's base value.
iii. If a manual is submitted for approval by the Commissioner its accuracy must meet objective criteria for the values of substantially similar vehicles of at least 85 percent of all makes and models for the last 15 years and shall include all major options. A sufficient number of vehicles shall be used for each year, make and model to represent a cross-section sufficient to determine fair market values. At the time of request for approval, the source of the manual's data must be revealed to the Commissioner in a manner that can be verified by the Department. Manuals approved for use on or after January 1, 1976 are "Automobile Red Book" and "Older Car/Truck Red Book" published by Maclean Hunter Market Reports, Inc. and the "N.A.D.A. Official Used Car Guide" and "N.A.D.A. Official Older Car Guide" published by the National Automobile Dealers Used Car Guide Company.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 10 - AUTO PHYSICAL DAMAGE CLAIMS › Section 11:3-10.5 - Unreasonable delay

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Unless a clear justification exists, physical damage claims will have a maximum payment period of 30 calendar days. A payment period is the period between the date of the receipt of the notice of loss by the insurer, and:
1. The date the settlement check is mailed; or
2. The date on which the damaged vehicle is returned to use when the insurer elects to repair or have repaired the insured vehicle; or
3. The date on which the damaged vehicle is replaced by the insurer.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 10 - AUTO PHYSICAL DAMAGE CLAIMS › Section 11:3-10.6 - Loss of use

Current through Register Vol. 56, No. 14, July 15, 2024
In the event of the theft of the entire vehicle the insurer at the time of notification shall advise the insured of his or her right under the policy to be reimbursed for transportation expenses. The notification must be confirmed in writing immediately after receipt of notice of theft. All conditions and benefits related to this coverage as stated in the policy must be contained in the notification to the insured.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 10 - AUTO PHYSICAL DAMAGE CLAIMS › Section 11:3-10.7 - Subrogation agreements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) If an insured has received payment under his or her physical damage coverage that is subject to a deductible, the insured shall share, pro rata, with the insurer any net recovery received by the insurer from third parties.
(b) Net recovery shall be the total recovery less the insurer's allocated loss adjustment expenses attributable to such recovery. The formula for computing net recovery and the insured's share of recovery of the deductible may be stated as follows:
Data in image
(c) Unless the insurer returns its insured's full deductible the insured shall attempt to effect full recovery in clear liability cases and shall not enter into any intercompany agreements that provide for the acceptance of lesser amounts on a formula basis.
(d) If an insurer has paid a physical damage claim that is subject to a deductible and it elects not to pursue its subrogation claim where the probability of recovery exists, the insurer shall so notify its insured in writing within 60 calendar days after it has paid the claim, except that the notification shall be given at least 30 days prior to the running of any applicable statute of limitations or period required for notice of claim. If an insurer does not notify its insured within the time periods prescribed above and the statute of limitations or period required for notice or claim has expired, the insurer shall forthwith remit to its insured the full amount of the insured's deductible.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 10 - AUTO PHYSICAL DAMAGE CLAIMS › Section 11:3-10.8 - Repair estimates

Current through Register Vol. 56, No. 14, July 15, 2024
If the insurer requires that its insured obtain more than one estimate of motor vehicle damage, the reasonable cost of such additional estimates, if any, shall be borne by the insurer unless the estimator does the work.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 10 - AUTO PHYSICAL DAMAGE CLAIMS › Section 11:3-10.9 - Referral of insured to the at-fault party

Current through Register Vol. 56, No. 14, July 15, 2024
There shall be no attempt to discourage an insured from filing a physical damage claim, nor shall an insurer encourage its insured to assert a claim against a third party in lieu of filing a physical damage claim under the insured's policy.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 10 - AUTO PHYSICAL DAMAGE CLAIMS › Section 11:3-10.10 - Examinations by the New Jersey Department of Banking and Insurance

Current through Register Vol. 56, No. 14, July 15, 2024
To ensure compliance with this rule, the Department of Banking and Insurance personnel will investigate the market performance of insurers. To enable Department personnel to reconstruct an insurer's activities pursuant to the provisions of this rule, each insurer must maintain a complete file on each claim settled pursuant to this rule. The claim file shall contain all communications, transactions, notes and work papers relating to the claim. With respect to automobile damage claims, the file also shall include the name, address, telephone number and license number of any auto body repair facility that has been utilized by the insurer in the adjustment of the loss or repair of the automobile. All papers in the file must be accurately dated by the insurer.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 11 - MOPED INSURANCE › Section 11:3-11.1 - Required coverages for mopeds

Current through Register Vol. 56, No. 14, July 15, 2024
(a) No policy insuring against loss resulting from liability imposed by law for bodily injury, death and property damage sustained by any person arising out of the ownership, operation or use of a motorized bicycle as defined in 39:1-1, as amended, shall be issued in the State to the owner (or parent or guardian of an owner under 18 years of age) of any motorized bicycle principally garaged or operated in this State unless it includes coverage for the owner and operator in the following minimum amounts or limits.
1. Bodily injury;
i. An amount or limit of $ 15,000, exclusive of interest and costs, on account of injury to, or death of, one person, in any one accident; and
ii. An amount or limit, subject to such limit for any one person so injured or killed, of $ 30,000, exclusive of interest and costs, on account of injury to or death of more than one person, in any one accident.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 12 - AUTOMOBILE RATE FILERS: FLATTENING OF PREMIUM TAXES AND ASSESSMENTS MADE FOR UNSATISFIED CLAIM AND JUDGMENT FUND › Section 11:3-12.1 - Purpose

Current through Register Vol. 56, No. 14, July 15, 2024
The New Jersey Automobile Insurance Reform Act of 1982 ( 17:29A-33 et al.) requires that each insurer calculate and collect, on a flat and uniform basis per insured automobile statewide, the taxes which are paid pursuant to 54:18A-1 et seq. This subchapter provides rules for the implementation of these requirements.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 12 - AUTOMOBILE RATE FILERS: FLATTENING OF PREMIUM TAXES AND ASSESSMENTS MADE FOR UNSATISFIED CLAIM AND JUDGMENT FUND › Section 11:3-12.2 - Scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) This subchapter applies to every insurer authorized to transact the business of automobile insurance in the State and every rating organization engaged in the business of rate-making for such insurers.
(b) The provisions of this subchapter are not intended to supersede or amend any other law or regulation.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 12 - AUTOMOBILE RATE FILERS: FLATTENING OF PREMIUM TAXES AND ASSESSMENTS MADE FOR UNSATISFIED CLAIM AND JUDGMENT FUND › Section 11:3-12.3 - 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 meaning unless the context clearly indicates otherwise.
"Commissioner" means the Commissioner of Banking and Insurance.
"Filer" means a rating organization or any insurer making its own rates.
"Insurer" means any person or persons, corporation, association, partnership, or company authorized by the laws of this State to transact the business of insurance in this State.
"Rating organization" means every person or persons, corporation, partnership, company, society, or association engaged in the business of rate-making for two or more insurers.
"Taxes" mean those taxes required to be paid pursuant to 54:18A-1 et seq.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 12 - AUTOMOBILE RATE FILERS: FLATTENING OF PREMIUM TAXES AND ASSESSMENTS MADE FOR UNSATISFIED CLAIM AND JUDGMENT FUND › Section 11:3-12.4 - Tax; general provisions

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Pursuant to 17:29A-33 et seq., each automobile filer shall calculate and collect taxes for its insureds on a flat uniform fee basis per insured automobile statewide.
1. The flat and uniform fee per insured automobile required in (a) above shall be included in all new or renewal automobile policies issued on or after January 1, 1984.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 12 - AUTOMOBILE RATE FILERS: FLATTENING OF PREMIUM TAXES AND ASSESSMENTS MADE FOR UNSATISFIED CLAIM AND JUDGMENT FUND › Section 11:3-12.5 - Filing and reporting requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Each automobile insurer shall submit to the Commissioner for approval a rate filing designated to place the premium structure of the filer in compliance with the requirements of the New Jersey Automobile Insurance Reform Act of 1982 and this subchapter.
1. The rate filing submitted to the Commissioner shall include the uniform tax to be used by the filer.
2. Each filer shall submit to the Commissioner for approval any alteration, amendment or supplement to the rate filing specified in (a) above.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 13 - COLLISION AND COMPREHENSIVE COVERAGE DEDUCTIBLES AND OPTIONS › Section 11:3-13.1 - Purpose

Current through Register Vol. 56, No. 14, July 15, 2024
The New Jersey Automobile Insurance Reform Act of 1982 (17:29A-39 ) requires that each insurer offer a range of deductibles up to at least $ 2,000 for private passenger automobile collision and comprehensive coverage. This subchapter provides rules for the implementation of the requirement and provides other options that insurers shall offer.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 13 - COLLISION AND COMPREHENSIVE COVERAGE DEDUCTIBLES AND OPTIONS › Section 11:3-13.2 - Scope

Current through Register Vol. 56, No. 14, July 15, 2024
This subchapter applies to every insurer authorized to transact the business of automobile insurance in this State and every rating organization engaged in the business of rate-making for such insurers.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 3 - AUTOMOBILE INSURANCE › Subchapter 13 - COLLISION AND COMPREHENSIVE COVERAGE DEDUCTIBLES AND OPTIONS › Section 11:3-13.3 - Deductibles for private passenger automobile collision and comprehensive coverage

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The minimum schedules of deductibles for private passenger automobile collision and comprehensive coverages which each insurer shall offer, pursuant to P.L. 2003, c. 89, 17:29A-39 are as follows:
1. Deductibles for collision coverage:
$ 100.00
$ 750.00
$ 150.00
$ 1,000
$ 250.00
$ 1,500
$ 500.00
$ 2,000
i. An insurer may offer a $ 200.00 collision deductible in lieu of, or in addition to, the $ 250.00 deductible contained in (a)1 above.