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  1. Waivers | Ask PIA

    Some states permit an uninsured subcontractor, operating as a sole proprietor or partner with no employees, to waive the right to workers’ compensation benefits. Is the waiver provision applicable in New Jersey?

    No, an agreement designed to waive responsibility for workers’ compensation obligations is not permitted by statute (N.J.S.A. 34:15:39). The court in Caicco v. Toto (62 N.J. 305) also makes it clear that “documents ostensibly indicating an independent contractor relationship will not affect the result where in substance the relationship is...

  2. One risk or two? | Ask PIA

    I have a New Jersey workers’ compensation risk that is two separate corporations under a common ownership. To be specific, it is a retail store that added a deli. The company indicated that I have to write two separate policies. Are they correct?

    No. According to the New Jersey Workers’ Compensation Manual (Part Three, Section 1-8), a “risk” is defined as the entire insured operations within the state of New Jersey or to which the New Jersey Compensation Law is applicable, conducted by any one legal entity, or by two or more separate...

  3. PAIP/CAIP eligibility | Ask PIA

    Is a leased private-passenger auto eligible for the New Jersey Commercial Automobile Insurance Plan by virtue of the fact that it is registered by a corporation (the leasing company)?

    The Commercial Automobile Insurance Plan’s Plan of Operation excludes  an “automobile” (as defined by statute) that is eligible for the Personal Automobile Insurance Plan. An "automobile" is eligible for PAIP if it is “owned or leased under contract for a continuous period of six months or more by an individual, a...

  4. Disability offset | Ask PIA

    We have an insured who is disabled due to an automobile accident. He had selected Additional Personal Injury Protection—Option 5. He is collecting disability pay from a combination of statutory disability coverage ($324 per week) and private disability coverage ($100 a week), for a total of $425 a week. However,...

    Unfortunately, the company is mostly right. The amount of state disability payments your insured is collecting is considered as an offset against the PIP benefits payable or collectible. The private disability benefit, however, is not an offset so the auto carrier should still be paying a small monthly amount (see...

  5. PAIP change—signatures | Ask PIA

    In the Personal Automobile Insurance Plan, do we need to get our client’s signature on a change request form?

    No, not on the change request form itself; however, certain changes involving choices for liability limits, uninsured/underinsured motorists limits, physical damage deductibles, the lawsuit limitation or PIP benefit options will require a signature on the mandatory Coverage Selection Form. In addition, when a photo inspection is required, the Acknowledgement of...

  6. Age discrimination | Ask PIA

    We had a company turn down our applicant for personal auto coverage, because he is over 70. How can they do this?

    They can't. N.J.S.A. 17:29B-4 defines unfair trade practices, including the following: “Making or permitting any unfair discrimination solely because of age in the issuance, withholding, extension or renewal of any policy or contract of automobile liability insurance ... or in the issuance or acceptance of any application therefor.”Your customer may...

  7. Tie-in sales | Ask PIA

    Can we require a client to consolidate all their business with our agency in order to enjoy some of the excellent products we offer? It would be more cost effective for us.

    No, you cannot. N.J.A.C. 11:17A-2.5(e) provides that “no insurance producer shall require an applicant or policyholder, or a member of the applicant's or policyholder's family, to purchase from him or her a collateral policy of insurance as a condition precedent to securing or renewing a policy of insurance.”The regulation does...

  8. Guaranty associations | Ask PIA

    What limit of protection is provided by New Jersey’s guaranty mechanism covering life insurance and annuities?

    New Jersey’s guaranty association covering life insurance and annuities, provides with respect to any one insured individual, regardless of the number of policies or contracts: life insurance—up to $500,000 in life insurance death benefits but not more than $100,000 in net-cash surrender and net-cash withdrawal values for life insurance;...

  9. Driver not “eligible” | Ask PIA

    We insure a household with three automobiles. The husband drives, but his wife does not. The wife's unmarried brother lives with them. He is employed as a New York City bus driver and is required by the bus company to hold a New York driver's license. He drives his brother-in-law's...

    The administrative manager at PAIP says that this individual would be declined, because the risk is not “qualified,” according to the manual rules. On the other hand, the individual is not by definition (in N.J.A.C. 11:2-34.4) an “eligible person” for the voluntary market. You are going to have to appeal...

  10. Renewal premium notices | Ask PIA

    What does the state say about the time frames for notifying insureds of renewal premium amounts on commercial policies?

    Notice of the amount of the renewal premium and any change in contract terms must be given to the insured in writing not more than 120 days nor less than 30 days prior to the due date of the premium. The notice must clearly state the effect of nonpayment of...

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