N.J. Admin. Code § 11:27-14.3

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

Section 11:27-14.3 - Designation of range of annual rate change limitation

(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 for that category, subcategory, specialty or subspecialty:

i. There is a significant restriction on the availability and affordability of medical malpractice liability insurance for a category, subcategory, specialty or subspecialty of health care provider, and there is no significant negative impact to the capitalization and reserve requirements necessary to ensure the solvency of insurers; or

ii. There are significant limitations on access to care by the citizens of this State to a category, subcategory, specialty or subspecialty of health care provider, and there is no significant negative impact to the capitalization and reserve requirements necessary to ensure the solvency of insurers.

2. If the Commissioner finds that the limitations in (a)1 above do not significantly exist, and that one of the following conditions exist, then the range of annual rate change shall be plus or minus 15 percent for that category, subcategory, specialty or subspecialty of health care provider:

i. Data indicate high frequency and severity of medical malpractice liability insurance claims; or

ii. Data indicate upward trends in the costs of investigating, defending and settling claims.

3. If the Commissioner finds one of the following with respect to a category, subcategory, specialty or subspecialty of healthcare provider, then the range of annual rate change shall not apply to that category, subcategory, specialty or subspecialty:

i. The data indicate that the circumstances in (a)1 or 2 above do not significantly exist;

ii. The nature of the category, subcategory, specialty or subspecialty of health care provider being insured; the complexity of such provider's insurance requirements and such provider's access to professional risk management services, are such that they are not rated as a class but each risk is individually rated; or

iii. The risk is of an unusual nature or high loss hazard or difficult to place.

N.J. Admin. Code § 11:27-14.3