17:46D-8 Preexisting conditions, exclusion, eligibility, pet insurance.
344 words·~2 min read·
/nj/title-17/chapter-46d/17-46d-8A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
6. a. A pet insurer may issue policies that exclude coverage on the basis of one or more preexisting conditions with appropriate disclosure to the consumer. The pet insurer has the burden of proving that the preexisting condition exclusion applies to the condition for which a claim is being made.
b. A pet insurer may issue policies that impose waiting periods upon effectuation of the policy that do not exceed 30 days for illnesses or orthopedic conditions not resulting from an accident. Waiting periods for accidents are prohibited. An insurer shall issue coverage to be effective by 12:01 a.m. on the second calendar day after purchase, subject to the following exceptions:
(1)if an insurer elects to conduct individualized underwriting on a specific pet, then coverage shall be effective by 12:01 a.m. on the second calendar day after the insurer has determined the pet is eligible for coverage;
(2)an insurer may delay coverage from becoming effective to establish a method for the consumer or group administrator to pay the premium;
(3)for pet insurance coverage acquired by an individual through an employer or organization, the coverage effective date may be delayed to align with the eligibility and effective date requirements of the employer or organization’s benefit plan; or
(4)if a policy does not include a waiting period for an illness or orthopedic condition, an insurer may set a policy effectuation date that is up to 15 calendar days after purchase, if the policy effectuation date is clearly disclosed and no premium is charged before the policy becomes effective.
c. A pet insurer shall not require a veterinary examination of the covered pet for the insured to have their policy renewed.
d. If a pet insurer includes any prescriptive, wellness, or non-insurance benefits in the policy form, then it shall be made part of the policy contract and shall follow all applicable laws and regulations.
e. An insured’s eligibility to purchase a pet insurance policy shall not be based on participation, or lack of participation, in a separate wellness program.
L.2025, c.224, s.6.