New Jersey § 39:6a-3

§ 39:6a-3.

a. In order to assist certain low income individuals in this State and encourage their

greater compliance in satisfying the mandatory private passenger automobile insurance

requirements, the Legislature intends to establish a special automobile insurance

policy. The special automobile insurance policy shall be offered only to individuals who

qualify for and are actively covered by designated government subsidized programs

in the State. For the purpose of this section, “eligible low income individual” means an individual

who meets the income criteria established by the commissioner by regulation. In setting the low income criteria, the commissioner shall limit availability to

those persons eligible and enrolled in the federal Medicaid program. b. As an additional option to the mandatory coverage provided in sections 3 and 4

of P.L.1972, c. 70 ( C.39:6A-3 and 39:6A-4 ) or the alternative covered provided in section 4 of P.L.1998, c. 21 ( C.39:6A-3.1 ), an owner or registered owner of an automobile registered or principally garaged

in this State, who is an eligible low income individual, may elect a special automobile

insurance policy providing the following coverage: (1) Emergency personal injury protection coverage, for the payment of benefits without

regard to negligence, liability or fault of any kind, only to the named insured and

dependent members of his family, as defined by the federal Medicaid program, residing

in his household, who sustain bodily injury as a result of an accident while occupying,

entering into, alighting from or using an automobile, or as a pedestrian, caused by

an automobile or by an object propelled by or from an automobile, and to other persons

sustaining bodily injury while occupying, entering into, alighting from or using the

automobile of the named insured, with the permission of the named insured. “ Emergency personal injury protection coverage ” issued pursuant to this section means and includes only payment of treatment for

emergency care in an amount not to exceed $250,000 per person per accident. “ Emergency care ” means all medically necessary treatment of a traumatic injury or a medical condition

manifesting itself by acute symptoms of sufficient severity such that absence of immediate

attention could reasonably be expected to result in: death; serious impairment to

bodily functions; or serious dysfunction of a bodily organ or part. Such emergency care shall include all medically necessary care immediately following

an automobile accident, including, but not limited to, immediate pre-hospitalization

care, transportation to a hospital or trauma center, emergency room care, surgery,

critical and acute care. Emergency care extends during the period of initial hospitalization until the patient

is discharged from acute care by the attending physician. Emergency care shall be presumed when medical care is initiated at a hospital within

120 hours of the accident. “Emergency personal injury protection coverage” shall also include all medically necessary

treatment of permanent or significant brain injury, spinal cord injury or disfigurement

after the patient is discharged from acute care. In the event benefits paid by an insurer pursuant to this subsection are in excess

of $75,000 on account of bodily injury to any one person in any one accident covered

by a policy issued or renewed prior to January 1, 2004, that excess shall be paid

by the insurer and shall be reimbursable to the insurer from the Unsatisfied Claim

and Judgment Fund pursuant to section 2 of P.L.1977, c. 310 ( C.39:6-73.1 ); (2) Death benefit in the amount of $10,000; (3) The tort option provided in subsection a. of section 8 of P.L.1972, c. 70 ( C.39:6A-8 ) shall apply to every named insured and any other person to whom the special automobile

insurance policy applies. c. A special automobile insurance policy shall not provide liability, collision, comprehensive,

uninsured or underinsured motorist coverage. d. The policy form for special automobile insurance policies shall be subject to the

approval of the Commissioner of Banking and Insurance and shall clearly and conspicuously

set forth the limitations on benefits provided under the policy. e. The commissioner shall approve the rating system to be used for a special automobile

insurance policy, which shall be administered by the plan created pursuant to section

1 of P.L.1970, c. 215 ( C.17:29D-1 ), to provide a uniform Statewide rate to be utilized by all insurers providing coverage

through a special automobile insurance policy. The rate established by the commissioner shall be sufficient to reimburse the insurer

for the cost of writing the policy and an amount set by the commissioner to be forwarded

to the Unsatisfied Claim and Judgment Fund to offset claims paid by the Unsatisfied

Claim and Judgment Fund. The commissioner may adjust the rate annually. f. Special automobile insurance policies shall be assigned to insurers pursuant to

the apportionment methodology of the plan created pursuant to section 1 of P.L.1970,

c. 215 ( C.17:29D-1 ). The number of policies assigned pursuant to this subsection shall not be included

in the determination of a competitive market pursuant to subsection d. of section

27 of P.L.1990, c. 8 ( C.17:33B-15 ).