New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 25 - OFFICE OF THE INSURANCE CLAIMS OMBUDSMAN
Subchapter 1 - GENERAL POWERS AND DUTIES
Section 11:25-1.5 - Trade and marketing practices; investigations, hearings and complaints
Current through Register Vol. 56, No. 18, September 16, 2024
(a) The Ombudsman may, upon his or her initiative, or upon the filing of a complaint by any interested party, conduct an investigation and/or hearing into an insurer's trade practices, including claims settlement practices, and marketing practices which may deviate from 17:29B-1 et seq., 17B:30-1 et seq., and/or N.J.A.C. 11:2-17.
(b) When making investigations or conducting hearings, the Ombudsman may consider any and all information deemed necessary and proper to resolve the issues raised by the investigation or hearing.
(c) The Ombudsman may inspect and copy books, papers, objects, documents, records and other evidence considered material or relevant to the matter under investigation, and may issue a subpoena to compel any person to attend and testify as well as to produce documents, books, papers, objects, records and other evidence at such place and time as is selected by the Ombudsman.
(d) At the conclusion of the investigation, inquiry or hearing, the Ombudsman may, in his or her discretion or at the request of the Commissioner, issue a report as to any findings and conclusions reached regarding the trade practice, marketing practice, policy or provision being investigated. The Ombudsman may determine if any policy provision, endorsement or form is unfairly discriminatory, confusing, misleading or contrary to public policy together with a specific recommendation as to the modification or discontinuance of the policy, form or provision. The report may also include a recommendation to the Commissioner regarding any further investigation of an insurer's practices together with a recommendation regarding the imposition of penalties or other sanctions.
