New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 4 - ACTUARIAL SERVICES
Subchapter 30 - ACCELERATED DEATH BENEFITS
Section 11:4-30.3 - Definitions

Universal Citation: NJ Admin Code 11:4-30.3
Current through Register Vol. 56, No. 18, September 16, 2024

The following terms, when used in this subchapter, shall have the following meanings:

"Accelerated death benefits" means the advance payment of some or all of the death proceeds payable under a life insurance policy or group certificate:

1. To the owner or certificate holder, during the lifetime of the insured, at the time of a qualifying event;

2. That reduces the death benefit otherwise payable under the policy or certificate; and

3. That is payable upon the occurrence of a single qualifying event resulting in the payment of a benefit amount fixed at the time of acceleration.

"Commissioner" means the Commissioner of the Department of Banking and Insurance, State of New Jersey.

"Department" means the Department of Banking and Insurance, State of New Jersey.

"Qualifying event" means the following:

1. A medical condition that is reasonably expected to result in a drastically limited life span for the insured. The definition of a drastically limited life span shall have a minimum of "six months or less" and a maximum of "24 months or less" and shall be specified in the policy or certificate; and

2. At the option of the insurer, the policy or certificate may also include one or more of the following:

i. A medical condition that requires extraordinary medical intervention, such as a major organ transplant or continuous artificial life support, without which the insured would die;

ii. A condition that is reasonably expected to require continuous confinement in an institution, as defined in the policy or certificate, and the insured is expected to remain there for the rest of his or her life;

iii. A specified medical condition that, in the absence of extensive or extraordinary medical treatment, would result in a drastically limited life span;

iv. A chronic illness as defined in 26 U.S.C. § 7702B(c)(2)(A), that is, a permanent inability to perform, without substantial assistance from another individual, a specified number of activities of daily living (bathing, continence, dressing, eating, toileting and transferring) and/or permanent severe cognitive impairment and similar forms of dementia; and

v. Any other qualifying events which the Commissioner may approve.

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