New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 4 - ACTUARIAL SERVICES
Subchapter 17 - HEALTH INSURANCE SOLICITATION
Section 11:4-17.4 - Unfair and deceptive acts

Universal Citation: NJ Admin Code 11:4-17.4

Current through Register Vol. 56, No. 18, September 16, 2024

(a) No person shall engage in any unfair, deceptive, misleading, or unreasonably confusing practice in the promotion, solicitation or sale of individual health insurance.

(b) The following acts and practices shall be deemed prima facie evidence of a violation of this regulation and of demonstrated unworthiness on the part of any licensee or insurer:

1. Any act tending to induce an applicant or other person to purchase duplicative coverage;

2. Encouraging an applicant to omit pertinent underwriting information from an application for health insurance;

3. Any act tending to induce a prospective insured to sign a blank or incomplete application or form;

4. Failure to disclose upon initial contact with a prospective applicant the licensee's affiliation with an insurance company.

5. Any representations, expressed or implied, unless the licensee has been specifically authorized in writing by the organization, that the licensee is affiliated with or authorized by any civic, social, government or other organization;

6. Making any false or misleading statements as to the length of time an insurance offering may or may not be available;

7. The sale of any policy withdrawn from or disapproved for filing as not in compliance with the New Jersey insurance laws or regulations;

8. Selling Medicare supplement insurance to any person not eligible for Medicare;

9. Falsely answering any question or signing any certification in an application or in any other form required to be completed by the licensee; or

10. Failure to remit, within seven business days, the amount of premium collected from an applicant that is due the company.

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