New Mexico Administrative Code

(Reserved.)

(Reserved.)

New Mexico State Corporation Commission [Public Regulation Commission], Department of Insurance, Post Office Box 1269, Santa Fe, NM 87504-1269.

A. Upon offering coverage under a policy or plan for any individual, family or group member, an insurer, fraternal benefit society, health maintenance organization or nonprofit healthcare plan shall provide the individual, family or group member with a written disclosure statemen…

A. All policy or plan forms, including applications, enrollment forms, policies, plans, certificates, evidences of coverage, riders, amendments, endorsements, and disclosure forms shall be submitted to the department of insurance for approval prior to use. B. No policy or plan ma…

All printed, radio or television communication intended to be used for marketing a policy or plan in the state and the disclosures required by NMSA 1978 Section 59A-23B-5 A NMSA 1978 shall be submitted for review and approval by the superintendent of insurance prior to use. The s…

The superintendent of insurance may revoke, suspend or refuse to continue the license or certificate of authority of any person who fails to comply with this rule and may impose such other applicable administrative penalties as may be authorized by the Insurance Code.

This rule applies to policies or plans issued after the effective date of this rule by health insurers, fraternal benefit societies, health maintenance organizations and nonprofit healthcare plans in accordance with the provisions of the Minimum Healthcare Protection Act, Section…

59A-2-9 and 59A-23B-11 NMSA 1978.

Permanent.

May 1, 1992, unless a later date is cited at the end of a section or paragraph. Repromulgated in NMAC format effective July 1, 1997.

This rule is intended to address limitations in access to healthcare by authorizing health insurers, fraternal benefit societies, health maintenance organizations and nonprofit healthcare plans to offer minimum healthcare services, policies or plans at affordable rates to those r…

Policies or plans issued pursuant to the Minimum Healthcare Protection Act which contain the following terms shall define such terms in the following manner: A. "Group" means a group of fewer than twenty members at initial enrollment formed for purposes other than obtaining insur…

A. Pursuant to Section 59A-23B-3B NMSA 1978, the individual, family or group obtaining coverage under the policy or plan shall have been without healthcare insurance, a health services plan or employer sponsored healthcare coverage for the six-month period immediately preceding t…

A. Mandatory provisions: Policies or plans issued pursuant to the Minimum Healthcare Protection Act shall meet the criteria set forth in Section 59A-23B-3B NMSA 1978 regarding eligibility, managed care provisions and minimum healthcare services to covered individuals. B. Optional…

New Mexico Public Regulation Commission Insurance Division.

A liability insurance policy as specified in Subsection B of 13.11.2.9 NMAC which contains a provision limiting legal defense costs shall be issued or renewed in this state only if the requirements of Subsections A and B of 13.11.2.10 NMAC are met, or if the requirement of Subsec…

A. Any policy issued or renewed in this state containing legal defense cost offset provisions must print such provisions in bold type on the face of the application for insurance and on the face of the policy. B. Any policy containing legal defense cost offset provisions specifie…

Where the liability limits of the policy are reduced by legal defense costs or where legal defense cost are applied against the deductible, the insurer shall notify the insured of the insured's right, upon written request, to an accounting of legal defense costs actually expended…

The premium and rate for any policy issued or renewed in this state containing legal defense cost offset provisions shall be commensurate with the coverage provided.

If the superintendent finds that application of this rule unduly hinders the availability of insurance or does not significantly benefit the consumers, he may grant such exemptions as he sees fit.

This rule applies to all liability insurance policies as defined herein and supersedes all policies now in effect which contain defense cost offsets within the policy limits or, deductibles.

Section 59A-2-9 and 59A-16-3 NMSA 1978.

Permanent.

October 13, 1988, unless a later date is cited at the end of a section.

The purpose of this rule is to prohibit the across-the-board use of legal defense cost offset provisions except for those exceptions found in 13.11.2.8 NMAC and 13.11.2.9 NMAC.

For the purpose of this rule, the following definitions apply. A. "Legal defense costs" mean allocated attorney and all other litigation expenses that can be separately identified as arising from the defense of a specific claim. B. "Liability insurance policy" means any insurance…

No liability insurance policy, unless specified in 13.11.2.9 NMAC, shall be issued in this state which contain provisions that: A. reduce the limits of liability in the policy by the amount of legal defense costs; or B. permit legal defense costs to be applied against the deducti…

A. This prohibition shall not apply to aircraft liability policies, fidelity and surety policies, nuclear liability policies, marine protection and indemnity policies, or prepaid legal service plans, reinsurance policies, or self-insured retentions. B. A legal defense offset prov…

New Mexico Public Regulation Commission Insurance Division.

All forms of endorsement for uninsured and unknown motorists coverage shall contain the provisions in 13.12.3.11 through 13.12.3.17 nmac.

The first page of the endorsement must contain: A. Space for insertion of name of company or companies issuing the endorsement and other matter permitted to be stated at the head of this endorsement. B. Space for description of insured motor vehicle or automobile, listing of rate…

In consideration of the payment of the premium for this endorsement and subject to all of the terms of this endorsement, the company agrees with the [*] as to the insuring agreements in 13.12.3.13 through 13.12.3.17 NMAC.

To pay all sums which the insured or his legal representative shall be legally entitled to recover as damages from the owner or operator of an uninsured motor vehicle because of: A. bodily injury, sickness or disease, including death resulting therefrom, hereinafter called "bodil…

A. Insured means: (1) the [*] as stated in the policy and, while residents of the same household, the spouse of any such [*] and relatives of either; (2) any other person while occupying an insured motor vehicle; and (3) any person with respect to damages he is entitled to recove…

This endorsement applies only to accidents which occur on and after the effective date of the endorsement, during the policy period and within the United States of America, its territories or possessions, or Canada.

This endorsement does not apply: A. to bodily injury to an insured with respect to which such insured, his legal representative or any person entitled to payment under this endorsement shall, without written consent of the company, make any settlement with any person or organizat…

A. Policy provisions: None of the insuring agreements, exclusions or conditions of the policy shall apply to the insurance afforded by this endorsement except the conditions "[**]", "changes", "assignment", "cancellation" and "declarations". B. Premium: If during the policy perio…

This rule shall govern the delivery or the issuance for delivery of any motor vehicle or automobile policy in this state, insuring against loss resulting from liability imposed by law for bodily injury or death suffered by any person or for injury to or destruction of property of…

Section 66-5-301 NMSA 1978.

Permanent.

July 1, 1997, unless a later date is cited at the end of a section.

The purpose of this rule is to specify the requirements for uninsured and unknown motorists endorsements in accordance with Section 66-5-301 NMSA 1978.

For the purposes of this rule: A. [*] (a single asterisk in brackets) means either the first named insured, named insured or principal named insured, as appropriate for the context of the rule. B. [**] (a double asterisk in brackets) means either "notice," "notice of accident," o…

Nothing contained in this rule shall prohibit any insurance company from filing an endorsement providing benefits for uninsured and unknown motorists which, in the opinion of the superintendent of insurance, is more favorable to the policyholder than the provisions permitted by t…

The rejection of the provisions covering damage caused by an uninsured or unknown motor vehicle as required in writing by the provisions of Section 66-5-301 NMSA 1978 must be endorsed, attached, stamped or otherwise made a part of the policy of bodily injury and property damage i…

New Mexico Public Regulation Commission, Insurance Division, Post Office Box 1269, Santa Fe, NM 87504-1269.

The application shall be accompanied by the following documents: A. a certified copy of the applicant's most recent audited financial statement; If the last audited statement is more than six months old, there shall be included an affidavit signed by the applicant's treasurer sta…

In determining if an applicant will be able to meet its obligations as a self-insured, both at the time of application and continuously thereafter if applicant is granted a certificate of self-insurance, the factors to be considered by the superintendent shall include, but not be…

Aicant shall prepare and maintain an up-to-date, detailed plan of operations for its self-insurance program. At a minimum, such plan shall include: A. an overview and narrative description of the proposed plan, with comments on all major aspects of operations, including administr…