N.J. Admin. Code § 11:2-13.3

Current through Register Vol. 57, No. 1, January 6, 2025

Section 11:2-13.3 - Effective date of discontinuance for nonpayment of premium or subscription charges

(a) If a policy or contract provides for automatic discontinuance after a premium or subscription charge has remained unpaid through the grace period allowed for such payment, the carrier shall be liable for valid claims for covered losses incurred and services or supplies provided prior to the end of the grace period. For all charges incurred with respect to hospitalization, the loss is considered incurred on the date of admission for all services and supplies provided through date of discharge.

(b) If the actions of the carrier after the end of the grace period indicate that it considers the policy or contract as continuing in force beyond the end of the grace period (such as, by continuing to recognize claims subsequently incurred or continuing to provide services or supplies), the carrier shall be liable for valid claims for losses beginning, and services or supplies provided, prior to the effective date of written notice of discontinuance to the policyholder, contractholder or other entity responsible for making premium payments or submitting subscription charges to the carrier. The effective date of the discontinuance shall be no earlier than midnight at the end of the third scheduled business day after the date that the notice is received.

N.J. Admin. Code § 11:2-13.3

Amended by R.1999 d.134, effective 4/19/1999.
See: 30 New Jersey Register 3356(a), 31 New Jersey Register 1101(a).
Rewrote the section.