N.J. Admin. Code § 11:2-41.3

Current through Register Vol. 56, No. 24, December 18, 2024

Section 11:2-41.3 - Content of one-page summary

(a) All one-page summary forms shall include the following content:

1. A heading, which shall be written in bold print and solid capital letters and shall say the following:

THIS SUMMARY HIGHLIGHTS THE NOTABLE COVERAGES AND EXCLUSIONS ASSOCIATED WITH YOUR

INSURANCE POLICY AND IS ONLY PROVIDED AS GUIDANCE IN HELPING YOU UNDERSTAND YOUR POLICY. THIS SUMMARY DOES NOT ALTER YOUR COVERAGE IN ANY WAY. YOUR INSURANCE POLICY IS A CONTRACT THAT GOVERNS YOUR LEGAL RIGHTS. PLEASE CONTACT IF YOU HAVE ANY QUESTIONS.

REFER TO YOUR DECLARATIONS PAGE FOR INFORMATION ON DEDUCTIBLES AND THE SPECIFIC LIMITS OF YOUR POLICY FOR EACH OF THE INCLUDED COVERAGES. REFER TO THE APPLICABLE POLICY PROVISIONS FOR OTHER INFORMATION SPECIFIC TO THESE COVERAGES, AND ON ANY ADDED COVERAGES OR EXCLUSIONS IN YOUR POLICY. ALSO, SEE THE "INSURING YOUR HOME GUIDE" FOR ADDITIONAL GUIDANCE AND INFORMATION ON THE N.J. DEPT. OF BANKING AND INSURANCE WEBSITE AT http://www.state.nj.us/dobi/division_consumers/pdf/insuringyourhome.pdf ;

2. A description of the common coverages typically included in homeowners policies of that type, as set forth in the applicable model summary. The content of this section of the applicable model summary shall be included by insurers verbatim;

3. The policy features set forth in the model summary for the policy type being issued. However, where an insurer's policy's features differ from the description of such features contained in that model summary, the company issuing such a policy may revise that text, so as to have it accurately reflect the content of the policy; and

4. Tables specifying the notable coverages and exclusions by type of loss that are included in the policy, which the one-page summary accompanies. The tables shall include headings entitled: "Your Policy Covers Losses Caused by" and "Your Policy Does Not Cover Losses Caused by," as shown in the model summaries in the Appendix to this subchapter.

(b) Insurers shall provide the summary applicable to the type of homeowners insurance policy being issued, delivered, or renewed as follows:

1. If the information in the applicable model one-page summary provided in the subchapter Appendix is accurate with regard to the policy it is to accompany and fully captures all notable coverages and exclusions of the policy by type of loss, the insurer may either:

i. Use the applicable model one-page summary provided in the subchapter Appendix; or

ii. Opt to use its own one-page summary that complies in all respects with (a) above and the content of which shall match that of the applicable model one-page summary in the subchapter Appendix; or

2. If the information in the applicable model one-page summary provided in the subchapter Appendix is not accurate with regard to the policy the summary is to accompany and/or does not fully capture all notable coverages and exclusions of the policy by type of loss, the insurer shall design and use its own one-page summary form. Any such form shall, at a minimum, comply in all respects with (a) above and include a table of the notable coverages and exclusions by type of loss as contained in the applicable model summary in the subchapter Appendix, with all necessary edits to ensure that the table is accurate with regard to the policy it is to accompany.

(c) The one-page summary shall be provided on one side of a single page, sized 8 1/2 by 11 inches, and shall be printed in not less than 10-point type.

(d) The following model one-page summaries are provided in the subchapter Appendix and are incorporated herein by reference:

1. Homeowners insurance one-page summary at Appendix Exhibit A;

2. Condominium insurance one-page summary at Appendix Exhibit B;

3. Renters insurance one-page summary at Appendix Exhibit C;

4. Mobile home owners insurance one-page summary at Appendix Exhibit D; and

5. Dwelling/fire insurance one-page summary at Appendix Exhibit E.

(e) An insurer that offers a policy that includes notable coverages and/or exclusions by type of loss that differ from those contained in the applicable model summary, and/or that includes additional notable coverages or exclusions by type of loss, shall file with the Department at least 30 days prior to its use a template of the insurer's one-page summary for each such policy. The templates shall include all of the information required in (a) above. The tables required by (a)4 above shall be capable of being modified to include the different notable coverages (whether available through the purchase of endorsements or included as part of the standard policy offered by the insurer) and/or exclusions by type of loss for each policy. Insurers shall also file the text explaining the different notable coverages and/or exclusions by type of loss that will or may be included in the tables of the one-page summary and indicate where such text will be located on the template. All such filings shall also include a certification by an authorized representative of the insurer confirming that the filing complies with all requirements imposed by this subchapter. All one-page summary templates and other filings required by this subsection shall be submitted through the National Association of Insurance Commissioners' System for Electronic Rate and Form Filing (SERFF) in accordance with N.J.A.C. 11:1-2. After review of the form, the Department, within 30 days of filing, will send the company a disposition in SERFF indicating one of the following: confirming that the form was placed on file; advising that the Department has questions and the form is still under review; or advising that the filing is disapproved. Notifications of questions or disapproval will provide the specifics of the Department's action on the filing.

(f) Insurers may use such a policy-specific one-page summary after filing, in accordance with (e) above, and may continue to do so for the policy to which the summary pertains unless otherwise notified by the Department in writing, so long as the policy remains unchanged and the summary fully corresponds to its content.

N.J. Admin. Code § 11:2-41.3

Adopted by 47 N.J.R. 529(a), effective 3/2/2015