New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 25 - OFFICE OF THE INSURANCE CLAIMS OMBUDSMAN
Subchapter 2 - INTERNAL APPEALS PROCEDURE
Section 11:25-2.5 - Notice to insureds and maintenance of data
Universal Citation: NJ Admin Code 11:25-2.5
Current through Register Vol. 56, No. 18, September 16, 2024
(a) All insurers shall provide policyholders and claimants with a written explanation of the insurer's internal appeals system which is consistent with this subchapter, including any pertinent telephone numbers, fax numbers, e-mail addresses (if used) and business addresses to which the internal appeals shall be submitted.
(b) The insurer shall maintain continuously updated records regarding all internal appeals processed in accordance with this subchapter and shall make the data available, upon request, to the Department or to the Office of the Insurance Claims Ombudsman. The data shall include, but not be limited to:
1. A copy of the internal appeal filed by the
insured;
2. A copy of the decision
being appealed;
3. A list of the
documents, records and other pertinent information relied upon by an internal
appeals panel in deciding the appeal; and
4. A copy of the notice sent to the claimant
advising the claimant of the decision and the right to subsequent appeals in
accordance with
11:25-2.3.
Disclaimer: These regulations may not be the most recent version. New Jersey may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
