N.J. Admin. Code § 11:1-10.7

Current through Register Vol. 56, No. 21, November 4, 2024

Section 11:1-10.7 - Review procedures; appeals

(a) Upon receipt of a final application, the Commissioner shall conduct a thorough background investigation and review which shall include the information contained in 11:1-10.4, 10.5 and 10.6, inquiries regarding claims settlement practices and any other information which, in the opinion of the Commissioner, may be necessary to make an appropriate decision on an application.

(b) Applicant companies shall ensure that all filings submitted to the Department are current. Any amendments, changes or replacements to constituent documents on file shall be timely updated.

(c) Applications accepted after November 15 of each year shall have their review deferred until the Annual Statement for the current year is available and received for review. The review of the filings of the prior year shall begin after the receipt by the Department of the latest annual statement and the latest financial information of the applicant is available in electronic format from the NAIC database.

(d) Before a decision on an application is made, the Department may request from an applicant, in writing, any additional information it may require. Failure by an applicant to respond to written inquiries by the Department within 45 days shall result in an application being deemed withdrawn.

(e) Application reviews shall be conducted by the Department on a monthly basis. The Committee on Admissions shall make a recommendation to the Commissioner concerning each application which has been reviewed. The Commissioner shall consider the recommendation and make his or her decision on the application within 10 working days from receipt of the recommendation. Written notice of the decision shall be mailed to the applicant by registered mail within 10 working days of the date of the Commissioner's decision.

(f) When the Commissioner rejects an application, the notice of rejection shall include a statement specifying the reasons for the rejection.

1. Such notice shall further inform the applicant of the right to request an informal Departmental review of the rejection within 20 days of receipt of the notice of rejection.

2. Such notice shall further inform the applicant of the right to provide to the Department a written statement, with supporting documentation, if any, disputing with specificity the reasons for rejection within 30 days of the receipt of the notice of rejection.

3. Upon the timely receipt of the request for Departmental review and the written statement of the company, if any, the Department shall promptly review the application, attached documents, department records and the written statement. In appropriate circumstances, the Commissioner may provide the applicant with an opportunity to present its position in person.

4. If, after reviewing the record, the Commissioner determines that the applicant has failed to qualify, the Commissioner shall promptly so inform the applicant.

N.J. Admin. Code § 11:1-10.7

Amended by R.1990, d.17, effective 1/2/1990.
See: 21 N.J.R. 3418(a), 22 N.J.R. 30(a).
No right to an appeal is granted statutorily, therefore the reference to the appeal according to the Administrative Procedure Act was removed, no such authorization by rule was intended at (f)4.
Amended by R.2003 d.209, effective 5/19/2003.
See: 35 N.J.R. 66(a), 35 N.J.R. 2182(a).
Rewrote (c); in (d), substituted "shall result in an application being deemed withdrawn" for "may be considered grounds for rejection of the application".