N.J. Admin. Code § 11:3-5.1

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

Section 11:3-5.1 - Purpose and scope

(a) The purpose of this subchapter is to establish procedures for the resolution of disputes concerning the payment of medical expense and other benefits provided by the personal injury protection coverage in policies of automobile insurance. This subchapter implements 39:6A-5.1 and 5.2, which provide that PIP disputes shall be resolved by binding alternate dispute resolution as provided in the policy form approved by the Commissioner. This subchapter also implements provisions of 2A:23A-1 et seq., as applicable to PIP dispute resolution.

(b) This subchapter shall apply to disputes arising under policies of private passenger automobile insurance, on either a personal lines or commercial lines policy form, that provide medical expense benefits and other benefits under personal injury protection coverage, as follows:

1. PIP benefits under a standard automobile insurance policy pursuant to 39:6A-4;

2. PIP benefits under a basic automobile insurance policy pursuant to 39:6A-3.1;

3. PIP benefits provided by the UCJF pursuant to 39:6-86.1; and

4. Additional PIP benefits provided pursuant to 39:6A-10.

(c) This subchapter shall apply to policies issued or renewed on or after March 22, 1999 in accordance with the approved policy terms.

N.J. Admin. Code § 11:3-5.1