reglab/statecodes huggingface dataset:
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 2 - FREEDOM TO CHOOSE INSURANCE COMPANY AND INSURANCE PROFESSIONAL › Section 13.7.2.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The purpose of this rule is to protect borrowers and
				  purchasers from being required to purchase insurance from a particular
				  insurance company or insurance professional as a condition to receiving a loan
				  or mortgage by promulgating the form of notice required by Section 59A-16-14
				  NMSA 1978.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 2 - FREEDOM TO CHOOSE INSURANCE COMPANY AND INSURANCE PROFESSIONAL › Section 13.7.2.8 - NOTICE REQUIRED

Current through Register Vol. 35, No. 13, July 16, 2024
The following form shall be used to give the notice of rights
				  required by Section 59A-16-14 NMSA 1978:
FREEDOM TO CHOOSE
INSURANCE COMPANY AND INSURANCE PROFESSIONAL
The undersigned person hereby acknowledges that I have been
				  informed by (
individual's name
) on behalf of
				  (
name of lender
) that, although I may be required by
				  the seller or lender to purchase insurance to cover the property that is being
				  used as security for the loan, I may purchase that insurance from the insurance
				  company or agent of my choice, and cannot be required by the seller or lender,
				  as a condition of the sale or loan, to purchase or renew any policy of
				  insurance covering the property through any particular insurance company,
				  agent, solicitor, or broker. I hereby acknowledge receipt of a true copy of
				  this notice on the _____day of_____________, _____.
__________________________________
(Signature of Purchaser or Borrower)
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 2 - FREEDOM TO CHOOSE INSURANCE COMPANY AND INSURANCE PROFESSIONAL › Section 13.7.2.9 - AUTHORIZATION FOR LENDER TO OBTAIN INSURANCE

Current through Register Vol. 35, No. 13, July 16, 2024
The following form shall be used when the borrower or
				  purchaser, after signing the form required by 13 NMAC 7.2.8 [now
				  13.7.2.8 NMAC],
				  nevertheless chooses to authorize the lender to purchase the required
				  coverages:
AUTHORIZATION FOR LENDER TO OBTAIN INSURANCE
Although (
name of lender
) will
				  accept suitable insurance policies to protect our respective interests in the
				  property used as security for the loan through my choice of any agent of any
				  insurance company licensed in New Mexico, I have elected to authorize
				  (
name of lender
) to purchase insurance coverage for
				  our joint protection, and I hereby authorize (
name of
				  lender
) to obtain from any insurance company licensed in New
				  Mexico or any of its agents the following insurance polices, until such time as
				  I rescind this authorization or supply a substitute or replacement
				  policy:
DECLARATIONS FOR POLICIES OF INSURANCE
Name of Purchaser or
				  Borrower:_______________________________________________________________
Address:___________________________________________________________________________________
Name of
				  Mortgagee/Lienholder:_________________________________________________________________
Address:____________________________________________________________________________________
Name of Contingent Beneficiary, if
				  any:___________________________________________________________
Address:____________________________________________________________________________________
Name of Insurance
				  Company:____________________________________________________________________
COVERAGES
PREMIUMS
____________ $_____________
____________ $_____________
____________ $_____________
____________ $_____________
____________ $_____________
TOTAL $_____________
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 3 - MAINTENANCE OF COMPLAINT RECORDS › Section 13.7.3.1 - ISSUING AGENCY

Current through Register Vol. 35, No. 13, July 16, 2024
New Mexico State Corporation Commission [Public Regulation
				  Commission], Department of Insurance, Post Office Box 1269, Santa Fe, NM
				  87504-1269.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 3 - MAINTENANCE OF COMPLAINT RECORDS › Section 13.7.3.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
This rule applies to all insurers subject to the New Mexico
				  Unfair Insurance Practices Act, Section 59A-16-1 et seq NMSA
				  1978.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 3 - MAINTENANCE OF COMPLAINT RECORDS › Section 13.7.3.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
July 1, 1997, unless a later date is cited at the end of a
				  section or paragraph.
Compiler's note: The words or paragraph, above, are no
					 longer applicable. Later dates are now cited only at the end of sections, in
					 the history notes appearing in
					 brackets.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 3 - MAINTENANCE OF COMPLAINT RECORDS › Section 13.7.3.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The purpose of this rule is to prescribe the minimum
				  information to be maintained in the record of complaints required of all
				  insurers under Section 59A-16-22 NMSA 1978 and to provide a suggested format
				  for this record.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 3 - MAINTENANCE OF COMPLAINT RECORDS › Section 13.7.3.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
As used in this rule:
A.
"Complaint"
means a written
				communication primarily expressing a grievance.
B.
"Insurance department
				complaint"
means a written communication regarding a complaint
				transmitted by the department of insurance.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 3 - MAINTENANCE OF COMPLAINT RECORDS › Section 13.7.3.8 - CONTENT OF COMPLAINT RECORD

Current through Register Vol. 35, No. 13, July 16, 2024
13 nmac 7.3.11 [now
				  13.7.3.11
				  NMAC] sets forth the minimum information required to be contained in an
				  insurer's complaint record in order to comply with the statute. Refinements and
				  additions to the information specified may, of course, be maintained in the
				  complaint record. 13 NMAC 7.3.12 [now
				  13.7.3.12
				  NMAC] contains an explanation of the various headings, codes and other
				  notations contained in 13 nmac 7.3.11 [now
				  13.7.3.11
				  NMAC]. The codes are used in order to simplify both the classification of the
				  action underlying the complaint and the keeping of the
				  records.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 3 - MAINTENANCE OF COMPLAINT RECORDS › Section 13.7.3.9 - FORMAT OF COMPLAINT RECORD

Current through Register Vol. 35, No. 13, July 16, 2024
13 nmac 7.3.11 [now
				  13.7.3.11
				  NMAC] is the suggested format for the complaint record required to be
				  maintained by the statutes and this rule. Refinements, deviations from or
				  additions to this suggested format are permitted so long as the minimum
				  information contemplated by such format can be obtained for department of
				  insurance review within a reasonable time following a request therefor by an
				  authorized representative of the department of insurance.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 3 - MAINTENANCE OF COMPLAINT RECORDS › Section 13.7.3.10 - MAINTENANCE OF THE RECORD

Current through Register Vol. 35, No. 13, July 16, 2024
The complaint record shall be kept on a calendar year basis
				  and the number of complaints by line of insurance, function, reason,
				  disposition, and state of origin shall be compiled not less frequently than
				  annually. The maintenance of this complaint record shall be required for
				  complaints received on and after October 1, 1973.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 3 - MAINTENANCE OF COMPLAINT RECORDS › Section 13.7.3.11 - COMPLAINT RECORD - FORM

Current through Register Vol. 35, No. 13, July 16, 2024
NAME OF COMPANY: _______________________________
A
B
C
D
E
F
G
H
Function Code
Reason Code
Line Type
Company Disposition After Complaint Receipt
Date Received
Date Closed
Insurance Department Complaint
State of Origin
Company Identification Number
Agents Number Staff
Adjusters Number
Independent Adjuster
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 3 - MAINTENANCE OF COMPLAINT RECORDS › Section 13.7.3.12 - COMPLAINT RECORD - EXPLANATION

Current through Register Vol. 35, No. 13, July 16, 2024
A.
A - Company identification number:
As noted, this refers to the
				company's identification number of the complaint or other means or identifying
				the complaint, and shall also include the license number or other means of
				identifying any licensee of the department of insurance (such as agent,
				adjuster or independent adjuster) whose conduct or records are involved in the
				complaint.
B.
B - Function
				code:
Complaints are to be classified by function(s) of the company
				involved. Separate classifications are to be maintained for underwriting,
				marketing and sales, claims, policyholder service and miscellaneous.
C.
B - Reason code:
Complaints
				are also to be classified by the nature of the complaint. The following is the
				classification required for each function specified above:
(1)
Underwriting:
(a) company underwriting;
(b) individual's application underwriting
				(this refers to any complaint where misrepresentations or declarations in an
				application for insurance resulted in company action involved in the
				complaint);
(c)
				cancellation;
(d)
				rescission;
(e)
				non-renewal;
(f) premiums and
				rating;
(g) delays;
(h) refusal to insure;
(i) miscellaneous (not covered by
				above).
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 4 - CATASTROPHIC CLAIMS › Section 13.7.4.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
This rule applies to catastrophic claims settlement practices
				  of insurers and other persons subject to Section
				  59A-16-20 NMSA
				  1978.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 4 - CATASTROPHIC CLAIMS › Section 13.7.4.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Sections
				  59A-2-9,
				  59A-16-20 and
				  59A-16-20.1 NMSA
				  1978.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 4 - CATASTROPHIC CLAIMS › Section 13.7.4.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
March 1, 2023, unless a later date is cited at the end of a
				  section.
Compiler's note: The words or paragraph, above, are no
					 longer applicable. Later dates are now cited only at the end of sections, in
					 the history notes appearing in brackets.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 4 - CATASTROPHIC CLAIMS › Section 13.7.4.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
This rule establishes definitions and procedures for
				  implementing Subsection F of Section
				  59A-16-20 NMSA 1978 requiring all
				  catastrophic claims to be settled within a 90-day period after the assignment
				  of a catastrophic claim number when a catastrophic loss has been declared and
				  subjecting insurers who fail to settle catastrophic claims within this time
				  period to the enforcement and penalty provisions of the Insurance Code,
				  specifically those pertaining to the Unfair Claims Practices
				  Act.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 4 - CATASTROPHIC CLAIMS › Section 13.7.4.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
"Catastrophe"
means a disaster, natural disaster or accident or
				series of disasters, natural disasters or accidents arising out of a single
				event that results in the submittal of claims against insurers by at least
				three percent of the population of the geographic area directly impacted by the
				event, results in:
(1) the submittal of
				claims against insurers by at least three percent of the population of the
				geographic area directly impacted by the event, results in total insured losses
				in New Mexico of more than $2,500,000 and takes place within a period of seven
				consecutive days; or
(2) the
				declaration of an emergency by the Governor of New Mexico under the governor's
				statutory powers including, but not necessarily limited to, those enumerated
				under the All Hazard Emergency Management Act or the Public Health Emergency
				Response Act, followed by the Superintendent's independent determination that a
				catastrophe has occurred.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 4 - CATASTROPHIC CLAIMS › Section 13.7.4.8 - CATASTROPHIC CLAIMS BUREAU

Current through Register Vol. 35, No. 13, July 16, 2024
The superintendent will designate a catastrophic claims
				  bureau to make recommendations to the superintendent concerning the declaration
				  of a catastrophe and assignment of a catastrophic claim number. The
				  superintendent may choose to make such designation using any of the
				  arrangements described in Subsection D of Section 7 of this rule. The
				  superintendent may require an insurer to report information concerning each
				  catastrophic claim to the catastrophic claims bureau.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 4 - CATASTROPHIC CLAIMS › Section 13.7.4.9 - PRE-DECLARATION INSURER REPORTING REQUIREMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
Upon the existence of a potentially qualifying event, the
				  superintendent will issue a bulletin describing data required to be submitted
				  by insurers. An insurer shall report the information described in the bulletin
				  to the catastrophic claims bureau within seven days of the issuance of the
				  bulletin. If an insurer reasonably believes additional information will aid the
				  superintendent in deciding whether to declare a catastrophe, the insurer shall
				  also submit that information. Nothing in this rule diminishes the
				  superintendent's authority to require additional reporting.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 4 - CATASTROPHIC CLAIMS › Section 13.7.4.10 - DECLARATION OF CATASTROPHE

Current through Register Vol. 35, No. 13, July 16, 2024
Upon the occurrence of an event that reasonably appears to be
				  a catastrophe, and after receipt of the pre-declaration insurer reports
				  required pursuant to Section 9 of this rule, the superintendent will consult
				  with the catastrophic claims bureau as soon as practicable and will decide
				  whether or not to declare a catastrophic loss. If the superintendent declares a
				  catastrophic loss, then the superintendent will immediately assign a
				  catastrophic claim number to that loss.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 4 - CATASTROPHIC CLAIMS › Section 13.7.4.11 - CATASTROPHIC CLAIMS SETTLEMENT PRACTICES

Current through Register Vol. 35, No. 13, July 16, 2024
A. An insurer shall settle each catastrophic
				claim within a 90-day period after the superintendent has declared a
				catastrophic loss and has assigned a catastrophic claim number.
B. If the governor has declared an emergency,
				then the event giving rise to the governor's emergency declaration may, at the
				superintendent's discretion, be treated as a catastrophe consistent with the
				provisions of Section 10 of this rule, without the need for the pre-declaration
				insurer reports. Under such circumstances, an insurer shall settle each
				catastrophic claim within a 90-day period after the superintendent has
				exercised this discretion and declared a catastrophe. However, nothing in this
				rule shall be construed to reduce any of the superintendent's powers or alter
				any of the superintendent's duties as provided by Section 59A- 2-7 NMSA 1978,
				the All Hazard Emergency Management Act, the Public Health Emergency Response
				Act or any rule implementing those laws.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 4 - CATASTROPHIC CLAIMS › Section 13.7.4.12 - EXCEPTION FOR POST-DECLARATION CLAIMS

Current through Register Vol. 35, No. 13, July 16, 2024
If a claim is a post-declaration claim, an insurer shall
				  settle such post-declaration claim within a 90-day period after such claim is
				  reported to the insurer.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 4 - CATASTROPHIC CLAIMS › Section 13.7.4.13 - TOLLING

Current through Register Vol. 35, No. 13, July 16, 2024
An insurer may toll the 90-day period described in Section
				  10, 11, or 12 of this Rule by one of the following mechanisms:
A. If, prior to the expiration of the 90-day
				period described in Section 10, 11, or 12 of this Rule, whichever is
				applicable, an insurer presents sufficient evidence to the superintendent to
				demonstrate a reasonable belief or probable cause that one or more claims
				subject to this Rule was fraudulent, the applicable 90 day period shall be
				tolled during the pendency of the investigation into such fraud. However, if
				the superintendent determines that the evidence is insufficient, the 90 day
				time period shall not be tolled, and, if this determination is made after the
				expiration of the 90-day period, the insurer will be deemed to be in violation
				of this Rule.
B. If, prior to the
				expiration of the 90-day period described in Section 10, 11, or 12 of this
				Rule, whichever is applicable, an insurer demonstrates to the superintendent
				that a claimant has not submitted all required documentation for the claim, the
				applicable 90-day period shall be tolled until the claimant produces sufficient
				documentation.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 5 - CONFIDENTIAL ABUSE INFORMATION › Section 13.7.5.1 - ISSUING AGENCY

Current through Register Vol. 35, No. 13, July 16, 2024
New Mexico State Corporation Commission [Public Regulation
				  Commission], Department of Insurance, Post Office Box 1269, Santa Fe, NM
				  87504-1269.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 5 - CONFIDENTIAL ABUSE INFORMATION › Section 13.7.5.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
A. This rule
				applies to those insurers and insurance support organizations which receive or
				maintain confidential abuse information in connection with insurance actions
				which pertain to persons who are residents of this state or involve policies
				delivered, issued for delivery, or renewed in this state.
B. This rule does not apply to the following
				lines of insurance:
(1) fidelity or surety
				bonds, or any other bonding obligations;
(2) warranties or service
				contracts;
(3) title
				insurance;
(4) marine and
				transportation insurance;
(5)
				boiler and machinery insurance.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 5 - CONFIDENTIAL ABUSE INFORMATION › Section 13.7.5.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Sections 59A-16B-6 and 59A-16B-7, NMSA
				  1978.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 5 - CONFIDENTIAL ABUSE INFORMATION › Section 13.7.5.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
January 1, 1999, unless a later date is cited at the end of a
				  section or paragraph.
Compiler's note: The words or paragraph, above, are no
					 longer applicable. Later dates are now cited only at the end of sections, in
					 the history notes appearing in
					 brackets.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 5 - CONFIDENTIAL ABUSE INFORMATION › Section 13.7.5.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The purpose of this rule is to implement the Domestic Abuse
				  Insurance Protection Act, Sections 59A-16B-1 et seq., NMSA 1978 by establishing
				  requirements for the protection of, and procedures for the transfer and
				  disclosure of, confidential abuse information received by insurers or insurance
				  support organizations in connection with insurance actions.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 5 - CONFIDENTIAL ABUSE INFORMATION › Section 13.7.5.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
In addition to the definitions provided in Section 59A-16B-3,
				  NMSA 1978, as used in this rule:
A.
"Applicant"
means a person who seeks to contract for insurance
				coverage other than a person seeking group insurance that is not individually
				underwritten.
B.
"Insurance
				support organization"
means any person who regularly engages, in whole
				or in part, in the practice of assembling or collecting information about
				protected persons for the primary purpose of providing the information to an
				insurer for insurance actions.
C.
"Insurance action"
means any action involving insurance which
				entails:
(1) the determination of a protected
				person's eligibility for an insurance coverage, benefit or payment;
(2) the renewal, reinstatement, change of
				location information endorsement, or change in insurance benefits of a
				policy.
(3) a claim for
				benefits.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 5 - CONFIDENTIAL ABUSE INFORMATION › Section 13.7.5.8 - NOTICE OF CONFIDENTIAL ABUSE INFORMATION PRACTICES

Current through Register Vol. 35, No. 13, July 16, 2024
An insurer shall provide a separate notice of confidential
				  abuse information practices in connection with the insurance actions set forth
				  in 13 nmac 7.5.11 [now
				  13.7.5.11
				  NMAC]. The notice shall be written in plain language and shall:
A. state that confidential abuse information
				may be received in the course of collecting information from persons other than
				the protected person;
B. state the
				types of confidential abuse information that may be received and the types of
				sources and investigative techniques that may be used to collect
				information;
C. state that the
				insurer is prohibited by law from using confidential abuse status as a basis
				for denying, refusing to issue, renew or reissue or canceling or otherwise
				terminating a policy, restricting or excluding coverage or benefits of a policy
				or charging a higher premium for a policy;
D. state the types of disclosures identified
				in Section 59A-16B-4 NMSA 1978 and the circumstances under which such
				disclosures may be made without prior authorization;
E. state that confidential abuse information
				used by an insurance support organization to prepare its report to the insurer
				may be retained by the insurance support organization but may not be disclosed
				to other persons without the written consent of the protected person except as
				otherwise permitted by Section 59A-16B-4 NMSA 1978]
F. describe the rights established in 13 nmac
				7.5.14 , 7.5.15 and 7.5.17 [now 13.7.5.14 NMAC, 13.7.5.15 NMAC and 13.5.7.17
				NMAC] and the manner in which such rights may be exercised;
G. describe the insurer's location
				information confidentiality program and instructions for applying to
				participate in the program;
H.
				provide a convenient means of notifying the insurer that the person wishes to
				be a protected person.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 5 - CONFIDENTIAL ABUSE INFORMATION › Section 13.7.5.9 - ABBREVIATED NOTICE PERMITTED

Current through Register Vol. 35, No. 13, July 16, 2024
In lieu of the notice prescribed in 13 nmac 7.5.8 [now
				  13.7.5.8
				  NMAC], the insurer may provide an abbreviated notice which shall:
A. state that confidential abuse information
				may be received from persons other than the protected person;
B. state that the insurer is prohibited by
				law from using confidential abuse status as a basis for denying, refusing to
				issue, renew or reissue or canceling or otherwise terminating a policy,
				restricting or excluding coverage or benefits of a policy or charging a higher
				premium for a policy;
C. state that
				a right of access and correction exists with respect to all confidential abuse
				information received;
D. state that
				the full notice prescribed in 13 nmac 7.5.8 [now 13.7.5.8 NMAC] will be
				furnished upon request;
E. provide
				a convenient means of notifying the insurer that the person wishes to be a
				protected person.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 5 - CONFIDENTIAL ABUSE INFORMATION › Section 13.7.5.10 - ALTERNATIVE NOTICE PERMITTED

Current through Register Vol. 35, No. 13, July 16, 2024
In lieu of the notices prescribed in 13 nmac 7.5.8 and 7.5.9
				  [now
				  13.7.5.8
				  NMAC and
				  13.7.5.9
				  NMAC], an insurer may provide the notice required by Section 4 of the NAIC
				  Insurance Information and Privacy Protection Model Act (1980 proceedings of the
				  NAIC, as amended) if the notice is modified to make specific reference to
				  confidential abuse information and to provide a convenient means of notifying
				  the insurer that the person wishes to be a protected person.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 5 - CONFIDENTIAL ABUSE INFORMATION › Section 13.7.5.11 - WHEN NOTICE TO BE GIVEN

Current through Register Vol. 35, No. 13, July 16, 2024
The notice of confidential abuse information practices shall
				  be provided to:
A. all persons who
				submit applications for insurance or claims for benefits on or after the
				effective date of this rule as follows:
(1)
				in the case of an application for insurance, a notice shall be provided at the
				time the applicant is asked to execute a record release authorization
				form;
(2) in the case of a claim
				for benefits, if a claimant is asked to execute a record release authorization
				form before the claim can be processed, a notice shall be provided at the same
				time.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 5 - CONFIDENTIAL ABUSE INFORMATION › Section 13.7.5.12 - CONTENT OF RECORD RELEASE AUTHORIZATION FORMS

Current through Register Vol. 35, No. 13, July 16, 2024
Whenever a record release authorization form is used by an
				  insurer or insurance support organization to obtain a protected person's
				  authorization for the types of persons specified in the form to release records
				  which may contain confidential abuse information about the protected person to
				  the insurer or insurance support organization, the record release authorization
				  form must:
A. be written in plain
				language;
B. be dated;
C. specify the types of persons authorized to
				release records which may contain confidential abuse information about the
				protected person;
D. name the
				insurer and identify by generic reference representatives of the insurer to
				whom the protected person is authorizing information to be released;
E. specify the purposes for which the
				released information is being collected;
F. specify the length of time such
				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) thirty (30) months from the
				date the authorization is signed if the application or request involves life,
				health or disability insurance;
(b)
				one (1) year from the date the authorization is signed if the application or
				request involves property or casualty insurance;
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 5 - CONFIDENTIAL ABUSE INFORMATION › Section 13.7.5.13 - CONFIDENTIAL ABUSE INFORMATION POLICIES AND PROCEDURES

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Employees:
An insurer shall,
				by the effective date of this rule, develop, make available for inspection by
				the superintendent, and implement written policies and procedures to protect
				against any collection, use, disclosure or transfer of confidential abuse
				information by the insurer which would violate the Domestic Abuse Insurance
				Protection Act or this rule. These policies and procedures shall include:
(1) limiting access to confidential abuse
				information to only those persons who reasonably need access to the information
				in order to perform their jobs;
(2)
				appropriate training for all employees with access to confidential abuse
				information who work in New Mexico or serve New Mexico applicants, insureds, or
				claimants;
(3) disciplinary
				measures for violations of the confidential abuse information policies and
				procedures;
(4) methods for
				handling, disclosing, storing and disposing of confidential abuse information;
				[and]
(5) periodic monitoring of
				employees who have access to confidential abuse information to ensure they are
				complying with the insurer's confidential abuse information policies and
				procedures.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 5 - CONFIDENTIAL ABUSE INFORMATION › Section 13.7.5.14 - ACCESS TO CONFIDENTIAL ABUSE INFORMATION

Current through Register Vol. 35, No. 13, July 16, 2024
A. If any protected person, after proper
				identification, submits a written request to an insurer or insurance support
				organization for access to confidential abuse information about the protected
				person which is reasonably described by the protected person and reasonably
				locatable and retrievable by the insurer or insurance support organization, the
				insurer or insurance support organization shall within thirty (30) business
				days from the date such request is received:
(1) inform the protected person of the nature
				and substance of such confidential abuse information in writing, by telephone
				or by other oral communication, whichever the insurer or insurance support
				organization prefers;
(2) permit
				the protected person to see and copy, in person, such confidential abuse
				information pertaining to him or her or to obtain a copy of such confidential
				abuse information by mail, whichever the protected person prefers, unless such
				confidential abuse information is in coded form, in which case an accurate
				translation in plain language shall be provided in writing;
(3) disclose to the protected person the
				identity, if recorded, of those persons to whom the insurer or insurance
				support organization has disclosed such confidential abuse information within
				two (2) years prior to such request, and if the identity is not recorded, the
				names of those insurers and insurance support organizations or other persons to
				whom such information is normally disclosed; and
(4) provide the protected person with a
				summary of the procedures by which he or she may request correction, amendment
				or deletion of confidential abuse information.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 5 - CONFIDENTIAL ABUSE INFORMATION › Section 13.7.5.15 - CORRECTION, AMENDMENT OR DELETION OF CONFIDENTIAL ABUSE INFORMATION

Current through Register Vol. 35, No. 13, July 16, 2024
A. Within thirty
				(30) business days from the date of receipt of a written request from a
				protected person to correct, amend or delete any confidential abuse information
				about the protected person within its possession, an insurer or insurance
				support organization shall either:
(1)
				correct, amend or delete the portion of the confidential abuse information in
				dispute; or
(2) notify the
				protected person of:
(a) its refusal to make
				such correction, amendment or deletion;
(b) the reasons for the refusal;
				and
(c) the protected person's
				right to file a statement as provided in 13 NMAC 7.5.15.3 [now Subsection C of
				13.7.5.15 NMAC].
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 5 - CONFIDENTIAL ABUSE INFORMATION › Section 13.7.5.16 - RECORD OF CONFIDENTIAL ABUSE INFORMATION DISCLOSED BY INSURER

Current through Register Vol. 35, No. 13, July 16, 2024
An insurer shall maintain a record of all disclosures of
				  confidential abuse information, except those disclosures permitted by paragraph
				  4A(3) of the Domestic Abuse Insurance Protection Act, made to any person who is
				  not an employee or agent of the insurer. The record shall include:
A. the name and address or location of the
				person to whom the information is disclosed; if the information is disclosed to
				an institution, a contact person shall be named;
B. the date and purpose of the
				disclosure;
C. a description of the
				information disclosed;
D. the
				authorization or release form allowing the disclosure of the information, if
				required.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 7 - INSURANCE TRADE PRACTICES AND FRAUDS › Part 5 - CONFIDENTIAL ABUSE INFORMATION › Section 13.7.5.17 - MAINTAINING CONFIDENTIALITY OF LOCATION INFORMATION

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Insurer program required:
Each insurer shall develop by the effective date of this rule a location
				information confidentiality program to be followed by all persons who have
				access to the location information of protected persons. The program shall
				include:
(1) a reasonable procedure by which
				a protected person can request participation in the insurer's location
				information confidentiality program;
(2) a system of internal control procedures
				for maintaining the confidentiality of the location information of a protected
				person, including provisions for regular internal review; and
(3) procedures to be followed when any action
				is taken with respect to an application, policy, claim, or other material
				involving a protected person, including procedures for the designation of a
				mailing address to be used by the insurer.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 8 - INSURANCE POLICIES AND RATES › Part 2 - RATE FILINGS BY INSURERS AND RATE SERVICE ORGANIZATIONS › Section 13.8.2.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
This rule applies to all rate and rate-related rules filings
				  made on or after the effective date of this rule pursuant to Chapter 59A,
				  Article 17 NMSA 1978, including but not limited to rate filings applicable to
				  risks covered through assigned risk pools and similar residual market
				  plans.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 8 - INSURANCE POLICIES AND RATES › Part 2 - RATE FILINGS BY INSURERS AND RATE SERVICE ORGANIZATIONS › Section 13.8.2.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
Sections 59A-2-9, 59A-17-2, 59A-17-3, 59A-17-4, 59A-17-5,
				  59A-17-6.1, 59A-17-6.2, 59A-17-16, 59A-17-17, 59A-17-28, 59A-17-29 and
				  59A-32-13 NMSA 1978.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 8 - INSURANCE POLICIES AND RATES › Part 2 - RATE FILINGS BY INSURERS AND RATE SERVICE ORGANIZATIONS › Section 13.8.2.4 - DURATION

Current through Register Vol. 35, No. 13, July 16, 2024
Sections 1 through 27 and 29 of 13.8.2 NMAC are permanent.
				  13.8.2.28
				  NMAC shall expire on October 1, 2010.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 8 - INSURANCE POLICIES AND RATES › Part 2 - RATE FILINGS BY INSURERS AND RATE SERVICE ORGANIZATIONS › Section 13.8.2.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
July 1, 1997, unless a later date is cited at the end of a
				  section.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 8 - INSURANCE POLICIES AND RATES › Part 2 - RATE FILINGS BY INSURERS AND RATE SERVICE ORGANIZATIONS › Section 13.8.2.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The purpose of this rule is to provide standards, procedures,
				  and methods which fairly and appropriately meet the statutory
				  mandates.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 8 - INSURANCE POLICIES AND RATES › Part 2 - RATE FILINGS BY INSURERS AND RATE SERVICE ORGANIZATIONS › Section 13.8.2.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Advisory
				filing
means any filing by a licensed advisory organization within the
				scope of its license, solely for informational purposes and such limited uses
				as provided in 13.8.2.20 NMAC. The term includes a rate filing limited to pure
				premium rates, supplementary rates, and supporting data developed and trended
				as appropriate.
B.
Advisory
				organization
has the meaning given in Section 59A-17-4 NMSA
				1978.
C.
Credible
or
credibility
in connection with statistical data is used in
				conformance with generally-accepted actuarial standards.
D.
Commercial insurance
has the
				meaning given in Section 59A-17-4 NMSA 1978.
E.
Expenses
include acquisition
				expenses, field supervision and collection expenses, general expenses, taxes,
				licenses and fees.
F.
Filing
means any submission to the superintendent to establish or revise
				rates.
G.
Line of
				business
means a line of business as shown in the annual statement to
				the superintendent.
H.
Pure
				premium rate
means that portion of a rate which represents the loss cost
				per unit of exposure, and may include loss adjustment expense.
I.
Regular business day
means
				every day except Saturday, Sunday and official state government
				holidays.
J.
Regular
				business hours
are 8:00 a.m. to 5:00 p.m., mountain standard or mountain
				daylight time, whichever is applicable, on regular business days; provided that
				regular business hours may be shortened on certain days without notice by
				official action of the governor or the public regulation commission.
K.
Supplementary rate
				information
has the meaning given in Section 59A-17-4 NMSA
				1978.
L.
Supporting
				data
means data and information which justifies, supports, interprets,
				describes, explains or underlies any rate or supplementary rate information,
				including but not limited to data the superintendent requires or may require
				pursuant to this rule.
M.
Reference filing
as used in 13.8.2 NMAC and in Paragraph C of Section
				59A-17-9 NMSA 1978 means a filing by an insurer to adopt a legally effective
				filing by an advisory organization to which the insurer is a member, a
				subscriber or an affiliate.
[See Section 59A-17-4 NMSA 1978 for additional
				  definitions]
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 8 - INSURANCE POLICIES AND RATES › Part 2 - RATE FILINGS BY INSURERS AND RATE SERVICE ORGANIZATIONS › Section 13.8.2.8 - FILING PROCEDURES

Current through Register Vol. 35, No. 13, July 16, 2024
A. Every
				filing shall be made by submitting it to the superintendent in accordance with
				13.8.2.8 NMAC.
B. Filings shall be
				made separately from policy form filings.
C. Filings may be made by mail, courier, the
				national association of insurance commissioners' system for electronic rate and
				forms filing (SERFF) or in person and shall be addressed to the
				superintendent.
D. Paper filings
				shall be submitted in an original and one copy, along with a self-addressed
				stamped envelope.
E. All filings
				shall be submitted with the appropriate current completed transmittal documents
				in substantially the format of the national association of insurance
				commissioners' uniform transmittal documents, which are available online at
www.naic.org
.
(1) The
property and casualty
				transmittal
document shall include:
(a) group name and "NAIC" number;
(b) company name, domicile, "NAIC" number and
				"FEIN" number;
(c) company tracking
				number;
(d) contact information of
				filer or corporate officer, including: name and address; title; telephone
				numbers; fax numbers and e-mail address;
(e) signature and printed name of authorized
				filer;
(f) type and sub-type of
				insurance;
(g) state specific
				product code, if applicable;
(h)
				company program title;
(i) filing
				type;
(j) effective date requested,
				including: new or renewal;
(k) a
				statement indicating whether the filing is a reference filing, including the
				reference organization name and reference organization number and title, if
				applicable;
(l) company's date of
				filing;
(m) status of filing in
				domicile;
(n) company tracking
				number;
(o) filing description;
				and
(p) the appropriate filing
				fees, including check number and fee amount, if applicable.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 8 - INSURANCE POLICIES AND RATES › Part 2 - RATE FILINGS BY INSURERS AND RATE SERVICE ORGANIZATIONS › Section 13.8.2.9 - AMENDING FILINGS

Current through Register Vol. 35, No. 13, July 16, 2024
Any pending filing may be amended, provided that the entire
				  filing, including the amendment, shall be deemed made as of the date the
				  amendment was filed, unless waived by the superintendent.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 8 - INSURANCE POLICIES AND RATES › Part 2 - RATE FILINGS BY INSURERS AND RATE SERVICE ORGANIZATIONS › Section 13.8.2.10 - FILINGS OF CONFIDENTIAL MATERIAL

Current through Register Vol. 35, No. 13, July 16, 2024
Materials that are required by statute to be kept
				  confidential or that are considered by the filer to be trade secrets shall be
				  filed separately from materials that are required to be open to public
				  inspection.
A. Filings of underwriting
				guidelines pursuant to Section 59A-17-5.1 NMSA 1978 shall be submitted with the
				following words in bold uppercase type on the heading of the cover letter:
CONFIDENTIAL UNDERWRITING GUIDELINES.
B. Filings of materials other than
				underwriting guidelines or insurance scoring models that the filer considers to
				be a trade secret shall be submitted with the following words in bold uppercase
				type on the heading of the cover letter:
REQUESTED CONFIDENTIAL
				MATERIALS.
The superintendent shall advise the filer within 30 days
				whether such material shall be open to public inspection. The superintendent
				shall keep such materials closed from public inspection prior to his
				determination on their confidentiality.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 8 - INSURANCE POLICIES AND RATES › Part 2 - RATE FILINGS BY INSURERS AND RATE SERVICE ORGANIZATIONS › Section 13.8.2.11 - NOTIFICATION

Current through Register Vol. 35, No. 13, July 16, 2024
The superintendent shall notify by mail or electronic media
				  the filer and each other party of his approval or disapproval of each filing.
				  Where a filing is disapproved, the superintendent shall state the reasons for
				  disapproval.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 8 - INSURANCE POLICIES AND RATES › Part 2 - RATE FILINGS BY INSURERS AND RATE SERVICE ORGANIZATIONS › Section 13.8.2.12 - RIGHT TO HEARING

Current through Register Vol. 35, No. 13, July 16, 2024
Any person aggrieved by any action, threatened action or
				  failure to act of the superintendent in connection with a filing has the right
				  to request a hearing pursuant to Section 59A-17-34 A NMSA 1978. The
				  superintendent may grant or deny the request.
New Mexico Administrative Code › Title 13 - INSURANCE › Chapter 8 - INSURANCE POLICIES AND RATES › Part 2 - RATE FILINGS BY INSURERS AND RATE SERVICE ORGANIZATIONS › Section 13.8.2.13 - REVIEW OF FINAL ORDER

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Reconsideration.
The filer or any other party aggrieved by the
				superintendent's final order deciding the issues following a hearing, or
				refusing to grant a hearing, pursuant to13.8.2.12 NMAC, may, in addition to
				other remedies provided by law, move for reconsideration, stating in detail the
				basis therefor. Any motion for reconsideration shall be filed within fifteen
				days of the superintendent's final order, and is barred thereafter. A motion
				for reconsideration is an optional remedy, and need not be exhausted as a
				condition of further administrative appeal.
B.
Appeal.
The filer or any
				party aggrieved by the superintendent's final order deciding the issues
				following hearing, or refusing to grant a hearing, pursuant to 13.8.2.12 NMAC,
				may request a review by the public regulation commission pursuant to this
				section.
(1) Following exhaustion of any right
				to hearing before the superintendent, the filer or any other aggrieved party
				may request the public regulation commission to review any final order of the
				superintendent made pursuant to13.8.2.12 NMAC.
(2) Every such request for review shall be
				made within thirty days after the superintendent's final order, and is barred
				thereafter; provided, that if a motion for reconsideration is timely filed with
				the superintendent, a request for review shall be made within thirty days after
				the date the motion is filed.
(3)
				The public regulation commission's review shall be on the record before the
				superintendent, unless the public regulation commission in its discretion deems
				it necessary or appropriate to supplement the evidence through public hearing
				or otherwise; provided, that the scope of review shall be limited to the issues
				raised before the superintendent; and further provided, that the public
				regulation commission may summarily affirm or reverse the superintendent
				without hearing.
(4) Every request
				for review shall state with particularity the grounds upon which review is
				sought, and shall itemize each alleged error with citations to the applicable
				portions of the official record. If the transcript of record is not available
				despite appellant's prompt request therefor, citations shall be filed within
				ten days after the transcript first becomes available in substantially complete
				form. In any event, the request for review, with or without record citations
				must be timely filed within the time period specified in Paragraph (2) of
				Subsection B of 13.8.2.13 NMAC.
(5)
				The costs of transcribing the record shall be borne by the appellant.