New Mexico Administrative Code

A. Covered by this rule. The purpose of this rule is to set forth licensing requirements of public, independent and staff adjusters in this state. B. Exclusions: This rule does not apply to persons who are excluded pursuant to Subsection B of Section 59A-13-2 NMSA 1978.

As used in this rule: A. "Adjuster" has the meaning provided in Paragraph (1) of Subsection A of Section 59A-13-2 NMSA 1978. B. "Advertisement" is as set forth in Section 19 of this rule. C. "Business entity" has the meaning provided in Paragraph (3) of Subsection A of Section 59…

A. No individual or business entity shall act as or make any representation as being an adjuster unless licensed as such by the superintendent, nor shall such person accept a commission, service fee or other valuable consideration for investigating or settling claims in New Mexic…

The superintendent will issue, renew and continue adjuster's licenses for individual adjusters as follows: A. Electronic submission. The individual applicant shall submit the application electronically or as otherwise directed by the superintendent. B. Individual requirements. Th…

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

If requested, any of the following information sustaining a claim, other than a claim for return of premium on an individual policy of insurance, must be submitted to the receiver or ancillary receiver before the claim will be given consideration: A. The total amount of the claim…

This rule applies to all persons who submit claims in delinquency proceedings pursuant to the Insurers Conservation, Rehabilitation and Liquidation Law, Section 59A-41-1 NMSA 1978 et seq.

Section 59A-2-9 NMSA 1978.

Permanent.

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

The purpose of this rule is to specify the requirements for submitting claims to the receiver or ancillary receiver in delinquency proceedings pursuant to the Insurers Conservation, Rehabilitation and Liquidation Law, Section 59A-41-1 NMSA 1978 et seq.

[RESERVED]

If requested, any of the following documents sustaining a claim must be submitted to the receiver or ancillary receiver before the claim will be considered. A. Original policies, other contracts of insurance or other satisfactory proof of coverage, if the claim is made by the ins…

If requested, any of the following information sustaining a claim for a return of premium on an individual policy of insurance must be submitted to the receiver or ancillary receiver before the claim will be given consideration: A. the original policy of insurance or other satisf…

NM Office of Superintendent of Insurance, P.O. Box 1689, Santa Fe, NM 87504-1689.

This rule applies to all life and health insurers issuing individual life or health insurance policies or group life or health insurance policies sitused in New Mexico.

Sections 59A-1-10 through 59A-1-17; 59A-2-7 through 59A-2-9; 59A-5-10; 59A-6-l; 59A-18-12; 59A-18-13.2; 59A-18-16.l; 59A-18-16.2; 59A-21-l et seq.; 59A-22-l et seq. NMSA 1978.

Permanent.

April 1, 2018 unless a later date is cited at the end of a section.

The purpose of this rule is to address the use of forms previously filed and approved on a matrix basis for New Mexico-sitused group policyholders or for individual policies issued to New Mexico residents.

As used in this rule: A. "Group policy" means a contract for group life or group health insurance made between an insurer and an employer, association, trust or other group that covers individuals based on their relationships to the group policy holder with or without the covered…

No insurance policies or related certificates issued to New Mexico - sitused group policyholders or individual insurance policies issued to New Mexico residents with effective dates of July 1, 2019, or later may include matrix-based forms, subject to the exception as described in…

Matrix forms previously filed with and approved by the superintendent may continue to be used as follows: A. Matrix forms previously filed with and approved by the superintendent may continue to be marketed and sold in this state, provided that the individual policy or group poli…

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

This rule applies to any person engaged in selling real or personal property, or in the business of financing the purchase of real or personal property, or of lending money on the security of real or personal property.

Sections 59A-2-9 and 59A-16-14 NMSA 1978.

Permanent

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

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 …

[Reserved]

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 …

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 l…

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

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 co…

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 Nu…

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 (su…

This rule applies to all insurers subject to the New Mexico Unfair Insurance Practices Act, Section 59A-16-1 et seq NMSA 1978.

Section 59A-2-9 NMSA 1978.

Permanent.

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

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.

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.

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 N…

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 f…

New Mexico Office of Superintendent of Insurance ("OSI").

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 d…

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 d…

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.

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 e…

This rule applies to catastrophic claims settlement practices of insurers and other persons subject to Section 59A-16-20 NMSA 1978.