N.J. Admin. Code § 11:4-7.3

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

Section 11:4-7.3 - Filing requirements

(a) Applications shall be filed with the Commissioner within 20 work days after the insured has signed it or within 20 work days of the inception date of the policy, whichever is earlier. All applications shall be made by filing the appropriate application form included in the Appendix to this subchapter as Exhibits A, B, and C, incorporated herein by reference. The application forms are also available on the Department's website at www.dobi.nj.gov. Applications shall be sent to the Department through the use of the NAIC electronic filing system SERFF (System for Electronic Rate and Form Filing).

(b) Each application shall include the following information:

1. Name and address of company, and signature by authorized company representative;

2. Name, address, New Jersey license number and signature of producer;

3. Name and address of insured;

4. Effective date and expiration date of policy;

5. Policy number, if available;

6. Coverages applied for, including, but not limited to, limits, amounts of insurance and deductibles;

7. Exposure identification class, territory, description and use of automobile;

8. Premiums:

i. The premium developed by the rating system approved for the company for the coverages applied for, identified as "Normal Premium";

ii. The additional premium to be charged in consideration of the additional hazard, identified as "Additional Premium";

iii. The total of the two amounts identified as "Premium Payable".

9. Underwriting information in support of the additional premium under (b)8ii above. In the case of automobile insurance, liability and physical damage, a copy of the abstract of driving record from the Motor Vehicle Commission shall be submitted. Such abstract is not required if the coverage applied for is excess coverage over the coverages and limits available under any residual market mechanism providing automobile insurance pursuant to statute. In the case of fire insurance, an inspection report, based upon an inspection performed by a qualified person, shall be submitted.

10. The application shall be signed by the insured and contain the following statement:

"I consent to the premium shown as 'Premium Payable' on this application which is higher than would normally apply because of the greater hazard involved."

11. The application shall contain the following statement signed by the producer of record or by an officer of the company providing the coverage:

"Under penalty of N.J.S.A. 17:29A-16 and N.J.S.A. 17:29A-22, I declare that this application was fully completed as shown, before being signed by the applicant."

N.J. Admin. Code § 11:4-7.3

Amended by 51 N.J.R. 618(a), effective 5/6/2019