N.J. Admin. Code § 11:1-5.3

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

Section 11:1-5.3 - FAIR Plan short notice cancellation procedures

(a) When a notice of cancellation is served by mail, three days from the date of mailing shall be added to the otherwise applicable notice period.

(b) The association shall submit to the Commissioner, no later than three days after the last day of each month, a copy of all short notice cancellations issued during that month.

(c) The association shall notify the insured of any cancellation in a writing setting forth the reason or reasons for cancellation and the effective date. The writing shall advise the insured of a right to appeal the cancellation to the association within 15 days of the date of mailing, and if the appeal is denied, to the Department of Banking and Insurance. This hearing shall not be considered a contested case under the Administrative Procedure Act (APA). The appeal shall be processed in the following manner:

1. Upon issuance of a short notice cancellation, the file will be placed into special suspense, for a period of 15 days from the date of mailing of notice. If no written notice of appeal is received from the insured or his representative within that period, cancellation will be processed and return premium (if any) forwarded to the producer of record.

2. If timely written request for appeal is received, the following steps will be taken:

i. The N.J.I.U.A. appeals committee will review and determine the appeal within five working days from receipt of request for appeal. If the result of the appeal is favorable, a letter advising the insured or his representative, the producer and the mortgagee (if any) of favorable action will be sent together with reinstatement notice stating that no lapse in coverage has occurred.

ii. If the appeals committee denies the appeal for reinstatement, a letter advising the insured or his representative, the producer or mortgagee (if any) of this action and a right to appeal to the Commissioner will be sent; a copy will be forwarded to the Department of Banking and Insurance.

(1) The file will remain in suspense for 30 days awaiting notice of appeal to the Commissioner.

(2) Upon receipt of the appeal request, the Department of Banking and Insurance will notify N.J.I.U.A. and advise that the file should be held in suspense for an additional period.

(3) If, after 35 days have elapsed from the association's decision to deny appeal and no notification has been received from the Department of Banking and Insurance of a pending appeal, cancellation will be processed and premium returned (if any) to the producer of record.

(4) The Department of Banking and Insurance will advise N.J.I.U.A. of its decision. If the appeal is granted, the policy will be reinstated without lapse. If the appeal is denied, cancellation will be processed and premium returned (if any) to the producer of record.

N.J. Admin. Code § 11:1-5.3

New Rule, R.1975 d.210, effective 7/23/1975.
See: 7 N.J.R. 273(a), 7 N.J.R. 369(b).
"New Jersey Special Joint Underwriting Association charge".
Amended by R.1976 d.134, effective 5/5/1976.
See: 8 N.J.R. 197(a), 8 N.J.R. 300(a).
Repealed by R.1977 d.17, effective 1/26/1977.
See: 8 N.J.R. 559(a), 9 N.J.R. 93(a).
New Rule, R.1979 d.219, effective 6/6/1979.
See: 11 N.J.R. 249(e), 11 N.J.R. 348(b).
Amended by R.1984 d.426, effective 10/1/1984.
See: 16 N.J.R. 1689(a), 16 N.J.R. 2677(a).
Recodified from 11:1-5.6.
Amended by R.2001 d.75, effective 3/5/2001.
See: 32 N.J.R. 4184(a), 33 N.J.R. 794(a).
Rewrote (c).