New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 15 - GROUP SELF-INSURANCE › Subchapter 7 - STATE COLLEGE RISK MANAGEMENT GROUPS › Section 11:15-7.2 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The following words and terms, as 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 or an Associate in good standing of the Casualty Actuarial Society with five years recent experience in loss reserving.
"Administrator" means a person, partnership, corporation or other legal entity engaged by the board of trustees, as defined in this section, to act as executive director to carry out the policies established by the board of trustees and to otherwise administer and provide day-to-day management of the risk management group. The administrator may also be the lead agency, an employee of the group, a group member, or an independent contractor.
"Automobile and equipment liability" means liability resulting from the use of or operation of motor vehicles, equipment or apparatus owned by or controlled by the member.
"Board of trustees" or "trustees" means the board of trustees established pursuant to the bylaws of the State college risk management group to govern or manage the risk management programs, joint liability funds, and related services of the group.
"Certified audit" means an audit upon which an auditor expresses a professional opinion that the accompanying statements present fairly the financial position of a joint liability fund in conformity with generally accepted accounting principles consistently applied, and includes tests of the accounting records and other auditing procedures as considered necessary in the circumstances.
"Chairman" means the chairman of the board of trustees as may be elected or designated by the trustees.
"Commissioner" means the Commissioner of the New Jersey Department of Banking and Insurance.
"Contributions" means the moneys paid by a member of a State college risk management group in amounts as may be set by the board of trustees or other officers as provided in the group's bylaws for the purposes of participating in a joint liability fund or funds, or securing risk management programs or related services.
"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 or her employment by the employer, which is not covered by a workers' compensation law.
"Excess carrier" means an insurer that provides excess insurance or reinsurance to a group.
"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, covering losses in excess of an amount established between the risk management group and the insurer up to the limits of coverage set forth in the insurance contract on a specific per occurrence, per accident, or annual aggregate basis.
"Fiscal year" or "fund year" means the fiscal year July 1 through June 30.
"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 conditions, a group, 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 risk management group 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 group.
"Insolvent group" means a risk management group 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 funds" or "JIFs," as used in the chapter Appendix, shall be deemed to refer to State college risk management groups for purposes of their application to this subchapter.
"Joint liability fund" or "fund" means a fund of public moneys from contributions made by members of a State college risk management group for the purpose of securing insurance protection, risk management programs, or related services as authorized by 18A:64-86 et seq.
"Member" means a State college which is a member of a State college risk management group.
"Net current surplus" or "surplus" means that amount of monies in a trust account established pursuant to 11:15-7.6(c)10  that is in excess of all costs, earned investment income, refunds made pursuant to 11:15-7.2 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 17:22A-26 et seq.
"Property damage" means any loss or damage, however caused, on or to property, motor vehicles, equipment or apparatus owned by a member.
"Risk management program" means a plan and activities carried out under the plan, by a State college risk management group to reduce risk of loss with respect to liabilities incurred by member State colleges, including safety engineering and other loss prevention and control techniques. Risk management program also includes the administration of one or more funds, including the processing and defense of claims brought against or on behalf of members of the group.
"Secretary" means the secretary of the risk management group's board of trustees as may be designated by the trustees.
"Servicing organization" means an individual, partnership, association or corporation, other than the administrator, that has contracted with the group to provide, on the group's behalf, any function as designated by the trustees 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 group'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 group for excess insurance or reinsurance from an insurer, member assessment and fee development, report preparation pursuant to 18A:64-86 et seq. and this subchapter, and such other duties as designated by the group.
"State college" means any of the State colleges or universities established pursuant to 18A:64-1 et seq.
"State college risk management group," "risk management group" or "group" means an association formed by two or more State colleges for the development, administration, and provision of risk management programs; joint liability funds for the payment of liabilities incurred by the State colleges and not funded by the State of New Jersey pursuant to the provisions of the "New Jersey Tort Claims Act," 59:1-1 et seq.; and related services.
"Trustees" means the board of trustees established pursuant to the bylaws of the risk management group to govern or manage the risk management programs, joint liability fund or funds and related services of the group.
"Unpaid claims" or "unpaid losses" means case reserves and reserves for incurred but not reported claims attributed to the group 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.