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  1. Timely renewal payments | Ask PIA

    A personal auto policyholder received a renewal bill; the premium due date was Nov. 5. The insured mailed the renewal premium payment on Nov. 4 and the carrier received the check on Nov. 7. Is the insured entitled to continue coverage?

    Yes. A renewal payment is deemed to have been received timely where the payment was mailed before 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 of the envelope or, alternatively, insurers may...

  2. ‘Unlimited’ employers’ liability | Ask PIA

    I am confused about the limits of liability afforded under Part Two (Employers’ Liability Insurance) in the workers’ compensation policy. Limits for this coverage are stated in the policy, but someone told me that the coverage is really unlimited. Could you please clarify?

    Prior to the Jan. 1, 1999, revision of the New Jersey workers’ compensation policy, which occurred in reaction to the Supreme Court’s Schmidt v. Smith decision in 1998, there was unlimited protection under Part Two—Employers’ Liability Insurance with respect to employees in operations subject to the New Jersey Workers’ Compensation Law....

  3. Discounts | Ask PIA

    Is there a maximum discount for workers’ compensation coverage premiums that can be offered to an employer for selecting a managed-care program?

    According to the New Jersey Compensation Rating and Inspection Bureau, there is no maximum set by law or regulation. NJCRIB will examine the underlying assumptions for filed discounts before approving them. Currently, approved discounts range from 5% (the minimum) up to 15% and average about 8%.

  4. Pre-existing condition | Ask PIA

    We have a small group health insurance client with 34 employees. We are putting this client into a new plan. One employee (who has been covered under the employer’s previous plan) has an ongoing health condition that requires treatment. How do we handle this pre-existing condition?

    Under small group health insurance policies, pre-existing condition limitations are no longer permitted to be added to health benefits. Effective Jan. 16, 2020, the statutes allowing pre-existing condition limitations have been repealed. "Pre-existing condition provisions prohibited in health benefit plan. A carrier that offers a health benefits plan in New...

  5. Obtaining elevation certificates | Ask PIA

    My mortgage company requires that I have flood insurance and I’m being told I now need an elevation certificate. How do I go about getting one and why do I now need this?

    In July 2012, the U.S. Congress passed the Biggert-Waters Flood Insurance Reform Act of 2012 (BW-12), which calls on the Federal Emergency Management Agency, and other agencies, to make a number of changes to the way the National Flood Insurance Program is run. Key provisions...

  6. Contested claims | Ask PIA

    Where does it say that if a workers’ compensation claim is contested, the state’s disability benefits will apply, subject to a lien against the workers’ compensation benefits?

    The provision is found in Section 43:21-30 of the state’s Temporary Disability Benefits Law, covering nonduplication of benefits. This section states (in part): “Where a claimant’s claim for compensation for temporary disability, under the provisions of Subsection a. of R.S.34:15-12 (Workers’ Compensation Law), is contested, and thereby delayed, and such...

  7. Former employee contacting agency’s customers | Ask PIA

    What can a company do when it discovers that a former employee is contacting its clients?

    When a company discovers that a former employee is contacting its clients, it can petition the court for a permanent injunction, together with a temporary restraining order, which will prevent the former employee and the new company from contacting any clients in question pending the final disposition of the matter....

  8. Concurrent employment benefits | Ask PIA

    An employee has two employers (A and B). The employee was injured while working for employer A. Will compensation for that injury include wages lost from his job with employer B?

    No. In N.J.S.A. 34:15-37, “wages” are defined as “the money rate at which the service rendered is recompensed under the contract of hiring in force at the time of the accident.” However, the employee should be able to collect temporary disability benefits for income lost from employer B. The Supreme...

  9. PIP threshold | Ask PIA

    If a husband has a personal auto policy with a zero threshold, and the wife also has a PAP but chooses the verbal threshold, what option would apply to children living in the home?

    If a child were injured while in a household auto, it’s likely that the threshold applicable to the policy covering that auto would apply. For an injury occurring in a borrowed or rented auto, it would likely be the no-threshold option. We have not yet seen any case law on...

  10. Uninsured motorists property damage coverage deductible | Ask PIA

    We have a client who has a $2,000 deductible on collision coverage and the mandatory $500 deductible on uninsured motorists property damage. She was rear-ended by an uninsured vehicle. The driver has no assets. Can she recover the $1,500 difference between the deductibles?

    Yes. Let’s say the total loss was $5,000. Her collision coverage (Part D) would pay $3,000 ($5,000 less the $2,000 deductible). Her uninsured motorists coverage (Part C) would pay $1,500 (the deductible amount of $2,000 less the $500 mandatory uninsured motorists deductible). New Jersey is one of 25 states that...