N.J. Admin. Code § 11:25-2.5

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

Section 11:25-2.5 - Notice to insureds and maintenance of data

(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.

N.J. Admin. Code § 11:25-2.5

Amended by R.2007 d.156, effective 5/7/2007.
See: 38 N.J.R. 4166(a), 39 N.J.R. 1737(b).
Rewrote (a).