N.J. Admin. Code § 11:15-3.21

Current through Register Vol. 56, No. 21, November 4, 2024

Section 11:15-3.21 - Disbursements and/or payment of claims

(a) All disbursements, payments of claims settlements or other expenditure of funds of the joint insurance fund whether for administrative expenses or for claims purposes must be approved by a majority of the joint insurance fund commissioners or the executive committee thereof, unless approved pursuant to (b) below.

(b) To allow the expeditious resolution of certain claims, the fund commissioners may designate the fund's administrator or servicing organization as a "certifying and approving officer" pursuant to 40A:5-17. The certifying and approving officer may be authorized by the fund commissioners to approve for payment any or specified types of claims not to exceed an amount approved by the Commissioner in the plan of risk management. The authority of the certifying and approving officer may be conditioned or restricted by the fund commissioners to require prior consultation, limitation as to the types or total amount of claims or payments which may be approved, or other procedures or restrictions as the fund commissioners may deem appropriate. The authority of the certifying and approving officer may be revoked or modified at any time by the fund commissioners.

1. Upon approval, the certifying and approving officer shall certify the amount and particulars of the approved claims to the official having custody of the fund's assets, directing that a check for payment be prepared.

2. The certifying and approving officer shall prepare a report of all claims approved by him or her since the last report, detailing the nature and amount of the claim, the payee, the reasons supporting payment and any other pertinent information. This report shall be submitted to the fund commissioners at their next scheduled meeting. The fund commissioners shall review and approve the actions of the certifying and approving officer. In the event a claim approved and paid by the certifying and approving officer is not approved by the fund commissioners, they shall direct appropriate action to be taken.

(c) All requests for payments must be accompanied by a detailed bill of items or demand, specifying particularly how the bill or demand is made up, with the certification of the party claiming payment that it is correct, and must carry the certification of some officer or duly designated agent or employee of the fund having knowledge of the facts that the goods have been received by, or the services rendered to the fund. In the case of claims or losses to be charged against any loss fund, the fund's claims administrator, if there is one, shall certify the claim's correctness and validity.

(d) All claims shall be paid by check. The check shall be signed by two persons so designated by the fund commissioners. Payment of claims may be made in such other manner as provided in the fund's bylaws as approved by the Commissioner and the Commissioner of the Department of Community Affairs.

(e) All claims and other disbursements approved for payments by the fund commissioners or the certifying and approving officer shall be recorded in a claims register maintained by the custodian of the fund's assets.

N.J. Admin. Code § 11:15-3.21

Amended by R.1996 d.535, effective 11/18/1996.
See: 28 New Jersey Register 4036(a), 28 New Jersey Register 4885(a).