Results 1131 - 1140 of 3226
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No-fault: out-of-state PIP | Ask PIA
We wrote a business auto policy for a law firm. One partner, who normally drives a corporate-owned vehicle, was injured while a passenger in a friend’s car. The friend’s vehicle is insured and garaged in Florida, where the accident occurred. The partner sold her individually owned vehicle several months ago...
Florida no-fault benefits will extend to passengers, so the attorney should seek recovery under her friend’s Florida policy. However, be aware that the minimum no-fault benefits in Florida (and in most no-fault states) are considerably less than those of New Jersey. To be eligible for New Jersey PIP benefits...
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Surplus-lines disclosure | Ask PIA
Is any disclosure notice required when writing a surplus-lines policy?
Yes. When coverage is placed with an eligible surplus-lines insurer, the policy, certificate, cover note or confirmation of insurance must disclose that: This policy is written by a surplus-lines insurer and is not subject to the filing or approval requirements of the New Jersey Department of Banking and Insurance....
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PAIP application—witness of signature | Ask PIA
My client needs to apply to the New Jersey Automobile Insurance Plan for coverage immediately. The problem is that she is currently in Florida with her critically ill mother. Can we send her the forms by overnight service, telling her to have her signature notarized and overnight them back?
According to N.J.A.C. Section 11:17A-4.2: In cases where an applicant’s signature is required, an insurance producer who takes an application for insurance shall be required to witness the signature of the prospective insured on the application prior to the submission of the application to the insurer...
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Arson investigation immunity | Ask PIA
One of our insureds is being investigated in connection with a suspected arson fire. Our office is in New York, but the property that burned is in New Jersey. We have been asked to provide insurance information to the local law-enforcement team that is investigating the fire. Could you tell...
New York Insurance Law Section 406 provides broad immunity for any information you give relating to suspected insurance fraud when furnished to law-enforcement officials. Another section (Section 3432) provides immunity with respect to information given to a law-enforcement agency in connection with a fire investigation. New Jersey has a similar...
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Rating sole-proprietor contractors | Ask PIA
It recently came to our attention that an area competitor has been writing minimum-premium “clerical” workers’ compensation policies for sole-proprietor contractors who have no employees, rather than writing the minimum premium policy for the governing class of business they are in. Consequently, the sole proprietor can supply a certificate of...
The New Jersey Compensation Rating and Inspection Bureau responds: We expect Workers’ Compensation Insurance Plan applications to reflect the actual or potential exposure of the employer. When a contractor comes to you for insurance, they require both commercial general liability and workers’ compensation. When they apply for the...
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Time frames for binding new auto policy | Ask PIA
How much time do companies have to bind coverage for eligible auto applicants requesting private-passenger auto insurance. I know the Department of Banking and Insurance has said “five days,” so why do we hear about five, seven, eight or even more days?
New Jersey regulations provide that “insurers shall have five business days from the date of receipt of a completed written application to either provide or decline insurance or, if requested, to notify the applicant whether coverage will be provided or denied. An insurer shall obtain and retain documentation of the...
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Loss run time frame | Ask PIA
I need loss experience data on one of my commercial auto clients. How much time does a company have to provide this information?
New Jersey law (N.J.S.A. 17:18-17) requires every company, upon request by the policyholder, to furnish a complete accounting record of any compensation paid to, or on behalf of, the policyholder including dollar amounts for each specific time (e.g., attorneys’ fees, court costs, any deductibles and the amount of compensation actually...
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Claim denial deadline | Ask PIA
Our client has a business interruption claim arising from an incident that happened months ago. The company dragged its feet, then finally told the insured’s attorney that it will deny the claim but won’t put it in writing. What are the rules applying to company claims-settlement time frames?
In general, all first-party claims under property/liability policies (except auto physical damage and personal injury protection claims) must be paid within 30 calendar days from receipt by the insurer of properly executed proofs of loss [N.J.A.C. 11:2-17.7(c)(1)]. (However, the fair claims settlement regulations [N.J.A.C. 11:2-17.1, et seq.] do not apply...
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Two corporations, one risk | Ask PIA
We insure two corporations. The same person owns and is an executive officer of both. How should we handle this situation for workers’ compensation purposes; that is, should the executive officer remuneration be included in the rating base of both policies?
These two corporations should be written under a single workers’ compensation policy, without any duplication in rating the remuneration of the executive officer. Check the definition of “risk” in PART THREE, Section 1, item 8 of the Workers’ Compensation Manual: Risk-Definition. Risk in this manual shall mean and include the entire...
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Injury reporting deadline | Ask PIA
Our client’s workers’ compensation carrier is denying a claim for a hernia because it wasn’t reported within 48 hours. Where does it say they can do this?
In the Workers’ Compensation Law, the main notice requirements are found in Section 34:15-17. This section establishes that “unless knowledge be obtained [by the employer], or notice given, within 90 days after the occurrence of the injury, no compensation shall be allowed.” However, a different notice standard for hernias is...