New Jersey Administrative Code

The following words and terms, as used in this subchapter, shall have the following meaning, unless the context clearly indicates otherwise. "Commissioner" means the Commissioner of the New Jersey Department of Banking and Insurance. "Control," "controlling" or "controlled by" ar…

Not less than one-third of the directors of an insurer, and not less than one-third of the members of each committee of the board of directors of any insurer, shall be persons who are not officers or employees of that insurer or of any entity controlling, controlled by, or under …

(a) The board of directors of an insurer shall establish one or more independent board member committees. Such committees shall be comprised of at least two members and shall be comprised solely of directors who are not officers or employees of the insurer or of any entity contro…

Failure to comply with the provisions of this subchapter shall result in the imposition of penalties as authorized by law, including, but not limited to, the penalties authorized by N.J.S.A. 17:33-2. Notes N.J. Admin. Code § 11:27-12.5

(a) The purpose of this subchapter is to provide for the biannual reporting of information related to rate modifiers used by medical malpractice liability insurers writing physicians and surgeons coverage in this State. (b) This subchapter shall apply to all insurers authorized t…

The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise. "Department" means the New Jersey Department of Banking and Insurance. "Insurer" means an insurer authorized to transact medical malprac…

(a) All insurers shall file with the Department biannually the information set forth in Exhibit 1 in the Appendix to this subchapter, incorporated herein by reference, no later than August 1 and February 1 of each year, for the immediately preceding six month periods of January 1…

Failure to comply with the provisions of this subchapter shall result in the imposition of penalties as authorized by law, including, but not limited to, penalties authorized pursuant to N.J.S.A. 17:33-2. Notes N.J. Admin. Code § 11:27-13.4

(a) This subchapter sets forth: 1. The procedures by which the Commissioner shall establish the designated range of annual rate change that may become effective 30 days after filing pursuant to N.J.S.A. 17:29AA-5.1; 2. The filing requirements for changes in rates for medical malp…

The following words and terms, as used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise. "Commissioner" means the Commissioner of the New Jersey Department of Banking and Insurance. "Department" means the New Jersey Department …

(a) The Commissioner shall designate the range of annual rate change pursuant to N.J.S.A. 17:29AA-5.1 as set forth in this section. 1. If the Commissioner finds that either of the following conditions exist, then the range of annual rate change shall be plus or minus five percent…

(a) The Commissioner's findings as provided in N.J.A.C. 11:27-14.3 shall be made no less frequently than once every three years as follows: 1. The Department shall issue a public notice setting forth the Commissioner's proposed findings in accordance with N.J.A.C. 11:27-14.3 purs…

Any medical malpractice liability insurance rate changes, unless such are required to be filed for prior approval pursuant to this subchapter, shall be filed with the Department no later than 30 days prior to the implementation thereof, and thereafter may be implemented unless di…

(a) Any insurer or rating organization seeking to change or modify its rating system for medical malpractice liability insurance shall provide the following information in support of its application: 1. A narrative overview that sets forth the contents of the filing, and explains…

(a) In computing any period of time fixed by this subchapter, the day of the act or event from which the designated period begins to run is not to be included. The last day of the period so computed is to be included, unless it is on a Saturday, Sunday or legal holiday, in which …

Any change to an insurer's or rating organization's rating system that has no impact on premiums charged (for example, a company introduces a new limit and factor with no impact on premium) shall be filed with the Department for review no later than 30 days prior to the implement…

Failure to comply with this subchapter may result in the imposition of penalties as authorized by law, including, but not limited to, those penalties authorized pursuant to N.J.S.A. 17:33-2. Notes N.J. Admin. Code § 11:27-14.9

(a) The purpose of this subchapter is to provide an option to insureds covered by medical malpractice insurance policies that contain a "consent by the insured to settle" provision to waive that provision by way of endorsement, and to require insurers to provide a premium reducti…

(a) A medical malpractice liability insurance policy may provide that a person insured under the policy has the exclusive right to require the insurer to obtain the consent of the insured to settle any claim filed against the insured. (b) If a medical malpractice liability policy…

This subchapter sets forth the requirements applicable to deductibles which shall be offered by all authorized medical malpractice liability insurers on medical malpractice liability insurance policies transacted in this State. Notes N.J. Admin. Code § 11:27-3.1

(a) All insurers authorized to transact medical malpractice liability insurance in this State shall include in their offered medical malpractice liability insurance policies a range of at least five deductible amounts applicable to indemnity only, with the selection of the deduct…

All authorized medical malpractice insurers shall provide an appropriate premium reduction for any deductible chosen by an insured pursuant to the above section. Notes N.J. Admin. Code § 11:27-3.3

An insurer authorized to transact medical malpractice liability insurance in this State shall, where required by N.J.S.A. 17:29AA-5 and N.J.A.C. 11:1-2, file a manual rule on the deductible options offered pursuant to N.J.A.C. 11:27-3.2 and on the corresponding premium credits pr…

(a) All authorized medical malpractice insurers may require insureds to provide collateral for the deductible option chosen by the insured pursuant to N.J.A.C. 11:27-3.2. 1. Any collateral required shall be in an amount that bears a reasonable relationship to the amount of the de…

(a) Every insurer authorized to transact medical malpractice liability insurance in this State shall offer its insureds an installment premium payment option on such policies, and shall file manual rules which shall include: 1. A minimum initial deposit required, which shall be n…

(a) The purpose of this subchapter is to prohibit increases in premiums for New Jersey medical malpractice insurance policy renewals based upon claims filed against insureds where the insured is dismissed from a civil action based upon that claim at an early stage of the civil pr…

The following words and terms, when used in this subchapter, shall have the following meanings unless the context clearly indicates otherwise. "Action" means a civil action commenced in a court of any State or a Federal court. "Responsive pleading" means any pleading other than a…

(a) An insurer authorized to transact medical malpractice liability insurance in this State shall not increase the premium of any medical malpractice liability insurance policy upon the renewal of that policy on the basis of a claim of medical negligence or malpractice against th…

Medical malpractice liability insurers shall comply with N.J.A.C. 11:1-20 with regard to notices of renewal and nonrenewal of medical malpractice liability insurance policies. Notes N.J. Admin. Code § 11:27-6.1

(a) The purpose of this subchapter is to set forth procedures for the assessment of certain practitioners and employers for the Fund, and the procedures and methodology for determining eligibility for, making application for, and determining the amount of disbursements from the F…

The following words and terms, as used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise. "Board" or "Boards" means the New Jersey State Board of Medical Examiners, New Jersey State Board of Chiropractic Examiners, New Jersey St…

(a) In accordance with N.J.S.A. 17:30D-29, notices imposing an annual charge in the sum of $ 75.00 shall be issued on behalf of the Boards to every physician, podiatrist, chiropractor, dentist and optometrist: 1. Who holds an active license granted on a date one year or more befo…

(a) The Department shall request that insurers and other entities providing medical malpractice liability insurance in this State provide the following information with respect to data as of December 31, 2004, 2005 and 2006: 1. The company's base rates (based on $ 1 million/$ 3 m…

(a) The Commissioner shall determine the class or classes of practitioners eligible for the subsidy, by specialty or subspecialty, for each type of practitioner whose average medical malpractice liability insurance premium, as a class, on or after December 31, 2002, is in excess …

(a) Practitioners and healthcare providers deemed eligible to apply for a subsidy from the Fund as provided at N.J.A.C. 11:27-7.5 shall file an application in a form to be prescribed by the Department and posted on the Department's website at www.nj.gov/dobi. The information prov…

(a) When distributed based upon a determination of eligibility as set forth in N.J.A.C. 11:27-7.5(a) and (b), the amount of the subsidy to be distributed for a relevant period shall be in the proportion that the qualifying increases in premiums and funding obligations for all eli…

(a) Pursuant to N.J.S.A. 17:30D-30d(1), a practitioner who receives a premium subsidy pursuant to N.J.S.A. 17:30D-30 shall thereafter be required to continue to practice at least to the same extent (for example, full-time or part-time, and no restriction in specialty or subspecia…

(a) No person who is an officer, director or board member of a professional association for health care providers shall serve concurrently as an officer, director or board member of a State-domiciled medical malpractice liability insurer that is licensed in New Jersey and offerin…

(a) This subchapter implements P.L. 2004, c. 17 by establishing rules for the formation and operation of medical malpractice liability insurance purchasing alliances. (b) This subchapter shall apply to alliances of eligible physicians as defined at N.J.S.A. 45:9-1 et seq. Notes N…

The following words and terms, as used in this subchapter, shall have the following meanings unless the context clearly indicates otherwise: "Board" means a medical malpractice liability insurance purchasing alliance board of directors as provided for at P.L. 2004, c. 17, §14. "C…

(a) Within 30 days of formation, a medical malpractice liability insurance purchasing alliance shall file the following with the Commissioner: 1. A certification by a senior officer or other authorized representative of the purchasing alliance, which shall include:i. The name of …

The purchasing alliance shall adopt by-laws, which shall comply with the requirements of P.L. 2004, c. 17, §14c, and otherwise comply with the provisions of P.L. 2004, c. 17 and this subchapter. Notes N.J. Admin. Code § 11:27-9.4

(a) A physician or physician group practice may discontinue purchasing coverage as a member of a purchasing alliance at any time. (b) A purchasing alliance may include a requirement in its bylaws or joint contract that members provide no more than 30 days notice of discontinuance…

(a) A purchasing alliance shall not:1. Assume risk for the cost or provision of medical malpractice liability insurance; 2. Exclude a member who agrees to pay fees for membership and the premium for medical malpractice liability insurance coverage, and who abides by the bylaws of…

Failure to comply with any of the requirements of this subchapter shall be a violation of P.L. 2004, c. 17. The purchasing alliance in violation shall be subject to all penalties provided by applicable law including, but not limited to, an order directing that the purchasing alli…

(a) The purpose of this subchapter is to set forth the admission procedures and financial reporting requirements which are necessary to implement N.J.S.A. 17:47B-1 et seq. (b) This subchapter shall apply to all captive insurance companies licensed under N.J.S.A. 17:47B-1 et seq. …

A licensed captive shall require the independent certified public accountant to immediately notify in writing an officer and all members of the board of directors of the captive of any determination by the independent certified public accountant that the captive has materially mi…