2023 New Mexico Statutes › Chapter 59A - Insurance Code › Article 17A - Personal Insurance Credit Information Act › Section 59A-17A-5 - Exception procedures.

A. As used in this section, "extraordinary life circumstance" means:
(1) an acute or chronic medical condition, illness, injury or disease;
(2) divorce;
(3) death of a spouse, child or parent;
(4) involuntary loss of employment for more than three consecutive months;
(5) identity theft;
(6) total or other loss that makes a home uninhabitable; or
(7) other circumstances prescribed by the superintendent in a rule.
B. Insurers that use credit information to calculate an insurance score or to underwrite, rate or renew personal insurance coverage shall, upon written request from a consumer, provide a reasonable exception to the insurer's rates, rating classifications, company placement, tier placement or underwriting policies, procedures or guidelines when that consumer's credit information has been adversely impacted by an extraordinary life circumstance that has occurred within three years of the date of application for or renewal of personal insurance coverage.
C. Insurers shall file their extraordinary life circumstances exception policies and procedures and amendments to the policies and procedures with the superintendent. Filings shall include the following:
(1) a list of extraordinary life circumstances;
(2) procedures describing how a consumer may apply for the extraordinary life circumstances exception;
(3) a description of the required substantiating information;
(4) general guidelines for when an extraordinary life circumstances exception will be granted;
(5) a description of how a consumer's treatment in underwriting or rating would be modified by the granting of an extraordinary life circumstances exception;
(6) time frames for considering the extraordinary life circumstances exception request; and
(7) any other information prescribed by the superintendent in a rule.
D. An insurer's extraordinary life circumstances exception policies and procedures shall be effective for use upon filing with the superintendent.
E. The superintendent may disapprove an insurer's extraordinary life circumstances exception policies or procedures at any time upon providing the insurer with a sixty-day written notice setting forth the reasons for the disapproval. Disapproval shall be based upon a determination that the extraordinary life circumstances exception policies and procedures as contained in the filing are inadequate pursuant to this section, and the notice of disapproval shall specify the respects in which they are inadequate. An insurer affected by a disapproval may request a hearing before the superintendent pursuant to Section 59A-4-15 NMSA 1978, and the request for a hearing stays the effectiveness of the disapproval. No disapproval shall affect an action or determination made by an insurer concerning an application or policy of insurance made prior to the date of a notice of final determination of the disapproval.
F. An insurer may require the consumer to provide reasonable, independently verifiable written documentation of the event and the direct effect of the event on the consumer's credit before granting an exception.
G. An insurer that grants an extraordinary life circumstances exception shall maintain that exception for an amount of time that is reasonable for the particular circumstance. Once that reasonable amount of time is exhausted, the insurer is not required to grant another exception for the same specific extraordinary life circumstance.
H. An insurer is not out of compliance with a law or rule relating to underwriting, rating or rate filing as a result of granting an exception under this section.
History:
Laws 2005, ch. 275, § 5.
ANNOTATIONS
Effective dates.
— Laws 2005, ch. 275, § 13 made Laws 2005, ch. 275, § 5 effective January 1, 2006.
ANNOTATIONS
Applicability.
— Laws 2005, ch. 275, § 12 provided that Laws 2005, ch. 275, §§ 1 through 11 apply to personal insurance policies written to be effective or renewed on or after January 1, 2006.