New Mexico Administrative Code

Sections 59A-2-9, 59A-16-20 and 59A-16-20.1 NMSA 1978.

Permanent.

March 1, 2023, unless a later date is cited at the end of a section.

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 …

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 directl…

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 arrangem…

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 issuan…

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

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 …

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 prov…

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…

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 …

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 locatabl…

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…

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 inclu…

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 pr…

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…

Sections 59A-16B-6 and 59A-16B-7, NMSA 1978.

Permanent.

January 1, 1999, unless a later date is cited at the end of a section or paragraph.

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 o…

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 organ…

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 …

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 …

New Mexico Public Regulation Commission Insurance Division.

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 …

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.

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.

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 to 13.8.2.12 NMAC, may, in addition to other remedies provided by law, move for reconsideration, statin…

A. Any insurer may make rates and rate filings on its own behalf in accordance with this section and other applicable portions of this rule. B. Any insurer may file at any time any rate or supplementary rate information applicable to any line or part of a line of property and cas…

Company filings shall meet all statutory rate standards and take into consideration all applicable rate factors. Subject to the foregoing sentence, an insurer may base a company rate filing on: A. the insurer's own experience in the particular line of business, including but not …

The superintendent may authorize an insurer to make a company rate filing on any basis meeting statutory rate standards, including but not limited to ratemaking by reference to an approved New Mexico filing of another company, or any other appropriate method, where the insurer de…

A. Rate filings that require supporting information shall include the following exhibits for each line of business, showing by individual insurer for the three most recently-completed consecutive calendar or calendar-accident years: (1) actual direct written premiums; (2) actual …

Rate filings are subject to the following ratemaking requirements, in addition to all other requirements prescribed by law. A. Rate filings may be based on any reasonable base period of at least three recent consecutive calendar, calendar-accident or policy years, or any combinat…

A. Filings made to modify rates shall be made pursuant to 13.8.5 NMAC, Rate Modification Plans. B. If requested by an insured, experience modifiers shall be developed and applied separately and individually to each insured legal entity in New Mexico; provided, that if past experi…

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 mark…

A. Any licensed advisory organization may make advisory filings within the scope of its license as provided in 13.8.2 NMAC. B. Advisory filings shall be made for informational purposes and such uses as permitted in 13.8.2 NMAC. Advisory rate filings are limited to pure premium ra…

A. For purposes of rate filings, assigned risk plans and similar residual market plans applicable to risks not insurable through the voluntary market shall be considered and treated as if the plan were a single insurer. B. Rates for assigned risk plans and other residual market p…

Rate filings need not be followed in connection with policies bid or to be issued to state or local governmental entities in New Mexico; provided, that no rate to any such governmental entity shall exceed the filed rate or rates which would be applicable to the entity but for the…

No advisory organization shall require any member or subscriber insurer to adhere to the organization's New Mexico filings, whether made on behalf of the insurer or otherwise. No advisory organization shall in any manner limit or refuse to grant any insurer any right or privilege…

The superintendent may require insurers to provide statistical information in a standard format. The superintendent may designate an advisory organization to receive such information and tabulate it. The superintendent may act pursuant to this section by notifying affected insure…

An insurer that wishes to adopt an approved advisory workers compensation filing that has been filed on its behalf by the workers compensation advisory organization designated by the superintendent, with no deviation other than effective date, shall do so in accordance with Parag…

An insurer may satisfy its obligation to make a rate filing by authorizing the superintendent of insurance to have its loss cost multipliers and, if utilized, expense constants be applicable to future revisions of the advisory organization's advisory prospective loss costs. Howev…

Regardless of whether an insurer is required to file its rates with the superintendent, an insurer shall maintain a copy of its rates and supplementary rate information currently in effect in sufficient detail to produce the premium charged on a policy. This information shall be …

A. The following markets lack a reasonable degree of competition and are therefore subject to the filing and prior approval requirements of Paragraph B of Section 59A-17-9 NMSA 1978: (1) farmowners multiple peril, due to the concentration of market share within a relatively small…

The following factors are likely indicators of a reverse competitive market: A. insurance products sold or solicited in point-of-sale conjunction with purchases of consumer goods; B. insurance products sold or solicited by individuals other than professional insurance agents; C. …

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.

Sections 1 through 27 and 29 of 13.8.2 NMAC are permanent. 13.8.2.28 NMAC shall expire on October 1, 2010.

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

The purpose of this rule is to provide standards, procedures, and methods which fairly and appropriately meet the statutory mandates.