N.J. Admin. Code § 11:3-2A.2

Current through Register Vol. 56, No. 23, December 2, 2024
Section 11:3-2A.2 - Definitions

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 of Banking and Insurance.

"Emergency care" means all medically necessary treatment of a traumatic injury or a medical condition manifesting itself by acute symptoms of sufficient severity such that absence of immediate attention could reasonably be expected to result in: death; serious impairment to bodily functions; or serious dysfunction of a bodily organ or part. Such emergency care shall include, but not be limited to, immediate pre-hospitalization care, surgery, critical and acute care. Emergency care extends during the period of initial hospitalization until the patient is discharged from acute care by the attending physician. It shall also include all medically necessary treatment of permanent or significant brain injury, spinal cord injury or disfigurement after the patient is discharged from acute care.

"Emergency personal injury protection coverage" means the payment of benefits without regard to negligence, liability or fault of any kind, only to the named insured and dependant members of his or her family, as defined by the Federal Medicaid program, residing in his or her household, who sustain bodily injury as a result of an accident while occupying, entering into, alighting from or using an automobile, or as a pedestrian, caused by an automobile or by an object propelled by or from an automobile, and to other persons sustaining bodily injury while occupying, entering into, alighting from or using the automobile of the named insured, with the permission of the named insured.

"Insurer" means an entity authorized or admitted to transact insurance in this State pursuant to 17:17-1 et seq. or 17:32-1 et seq., as applicable.

"Insurance producer" means a person required to be licensed under the laws of this State to sell, solicit or negotiate insurance.

"LAD carrier" means a limited assignment distribution carrier that is a participating insurer and that agrees to accept assignments of another insurer pursuant to this subchapter and procedures set forth in the plan of operation.

"PAIP" means the New Jersey Personal Automobile Insurance Plan established pursuant to 17:29D-1 and N.J.A.C. 11:3-2.

"UCJF" means the Unsatisfied Claim and Judgment Fund, established pursuant to 39:6-61 et seq.

N.J. Admin. Code § 11:3-2A.2