New Jersey Statutes 17:23A-6. Content of disclosure authorization forms
Terms Used In New Jersey Statutes 17:23A-6
- person: includes corporations, companies, associations, societies, firms, partnerships and joint stock companies as well as individuals, unless restricted by the context to an individual as distinguished from a corporate entity or specifically restricted to one or some of the above enumerated synonyms and, when used to designate the owner of property which may be the subject of an offense, includes this State, the United States, any other State of the United States as defined infra and any foreign country or government lawfully owning or possessing property within this State. See New Jersey Statutes 1:1-2
- State: extends to and includes any State, territory or possession of the United States, the District of Columbia and the Canal Zone. See New Jersey Statutes 1:1-2
a. Is written in plain language;
b. Is dated;
c. Specifies the types of persons authorized to disclose information about the individual;
d. Specifies the nature of the information authorized to be disclosed;
e. Names the insurance institution or agent and identifies by generic reference representatives of the insurance institution to whom the individual is authorizing information to be disclosed;
f. Specifies the purposes for which the information is collected;
g. Specifies the length of time the authorization shall remain valid, which shall be no longer than:
(1) In the case of authorizations signed for the purpose of collecting information in connection with an application for an insurance policy, a policy reinstatement or a request for change in policy benefits,
(a) 30 months from the date the authorization is signed if the application or request involves life, health or disability insurance, or
(b) One year from the date the authorization is signed if the application or request involves property or casualty insurance;
(2) In the case of authorizations signed for the purpose of collecting information in connection with a claim for benefits under an insurance policy,
(a) The term of coverage of the policy if the claim is for a health insurance benefit, or
(b) The duration of the claim if the claim is not for a health insurance benefit; and
h. Advises the individual or a person authorized to act on behalf of the individual that the individual or the individual’s authorized representative is entitled to receive a copy of the authorization form.
L. 1985, c. 179, s. 6.