N.J. Admin. Code § 11:4-53.1

Current through Register Vol. 56, No. 24, December 18, 2024

Section 11:4-53.1 - Purpose and scope

(a) The purpose of this subchapter is to:

1. Permit the sale of specified disease and critical illness coverage in New Jersey;

2. Provide for reasonable standardization of coverage and the simplification of terms and benefits of specified disease and critical illness policies;

3. Facilitate comparison of specified disease and critical illness policies in order to increase public understanding;

4. Prohibit policy provisions that may be misleading or confusing in connection with the purchase of specified disease and critical illness policies or with the settlement of claims;

5. Restrict provisions that may be contrary to the health care needs of the public;

6. Prohibit coverages that are so limited in scope as to be of no substantial economic value to the holders thereof; and

7. Provide for full disclosure in the sale of specified disease and critical illness policies.

(b) This subchapter shall apply to:

1. All specified disease policies and critical illness policies, as defined by this subchapter, delivered or issued for delivery in this State;

2. All certificates, as defined by this subchapter, issued under group specified disease or critical illness policies, which certificates have been delivered or issued for delivery in this State; and

3. All carriers, as defined in this subchapter, delivering or issuing for delivery specified disease or critical illness policies in this State, or delivering or issuing for delivery certificates in this State, which certificates were issued under a group specified disease or critical illness policy.

N.J. Admin. Code § 11:4-53.1