Bill > S2558

Introduced Session

This bill includes self-insured entities and plans under certain provisions of the "New Jersey Insurance Fraud Prevention Act." Specifically, the bill provides that persons or practitioners violate that act if they: (1) Present or cause to be presented any written or oral statement as part of, or in support of or opposition to, a claim for payment or other benefit pursuant to a self-insured plan, knowing that the statement contains any false or misleading information concerning any fact or thing material to the claim; (2) Prepare or make any written or oral statement that is intended to be presented to a self-insured entity, or in support of or opposition to any claim for payment or other benefit to a self-insured plan, knowing that the statement contains false or misleading information concerning anything material to the claim; or (3) Conceal or knowingly fail to disclose the occurrence of an event which affects any person's initial or continued right or entitlement to any benefit or payment under a self-insured plan. Under the bill, a "self-insured entity" is a public or private entity that retains the risk and responsibility for paying for losses from contingent events for beneficiaries of its self-insured plan, in accordance with the terms of its self-insured plan, from its own funds or from its own funds together with funds contributed by or on behalf of the beneficiaries of the self-insured plan. A "self-insured plan" is any plan of benefits for losses incurred from contingent events, which may include health, bodily injury, property damage, liability, disability, life, workers' compensation or other benefits not prohibited by law, offered by a self-insured entity to its employees, members, officers, owners or other persons entitled to benefits under the terms of the self-insured plan. The bill provides that self-insured entities damaged as the result of a violation of any provision of the "New Jersey Insurance Fraud Prevention Act" may bring suit in a court of competent jurisdiction to recover compensatory damages. The bill provides that the Commissioner of Banking and Insurance may make relevant papers, documents, reports, or evidence available to a self-insured entity injured by a violation of the "New Jersey Insurance Fraud Prevention Act" consistent with the purposes of that act and under such conditions as the commissioner deems appropriate.

Committee Categories

Bob Singer (R)*, 

Introduced in the Senate, Referred to Senate Commerce Committee (on 02/08/2024)

Official Document