Chapter 59A, Article 16C NMSA 1978 may be cited as the “Insurance Fraud Act”. History: Laws 1998, ch. 115, § 1; 2018, ch. 42, § 1. ANNOTATIONS The 2018 amendment, effective March 1, 2018, deleted “This act” and added “Chapter 59A, Article 16C NMSA 1978”.
A. Within six months of the effective date of the Insurance Fraud Act and by July 1 of each succeeding year every insurer who in the previous calendar year reported ten million dollars ($10,000,000) or more in direct written premiums in New Mexico shall establish, prepare, implement and submit to the superintendent an anti-fraud plan […]
A. The superintendent’s investigators shall be peace officers pursuant to the provisions of Chapter 29, Article 1 NMSA 1978. B. An investigator who meets the requirements for certification for law enforcement training pursuant to Section 29-7-6 NMSA 1978 shall be authorized to carry a firearm. History: Laws 1998, ch. 115, § 11; 2005, ch. 245, […]
When so requested by the superintendent, the attorney general shall commission as a special assistant attorney general any attorney employed by the superintendent or contracted with by the superintendent and approved by the attorney general to assist the superintendent in carrying out his duties, including providing legal advice and prosecuting offenders. The actual costs associated […]
The superintendent may create an insurance fraud policy advisory group consisting of representatives of authorized insurers, consumers of insurance products not otherwise connected with the insurance industry and other appropriate persons. The superintendent shall appoint the members of the advisory group and shall provide by rule for the creation, governance, duties and termination of the […]
A. There is created an “insurance fraud fund” in the state treasury. All fees collected pursuant to the provisions of the Insurance Fraud Act shall be deposited in the fund and are subject to appropriation for use in paying the expenses incurred by the superintendent in carrying out the provisions of the Insurance Fraud Act. […]
A. No authority granted the superintendent under the Insurance Fraud Act shall be construed to abrogate or interfere with the authority of the safety and fraud division of the workers’ compensation administration under the Workers’ Compensation Act [Chapter 52, Article 1 NMSA 1978] or of the medicaid fraud control unit under the Medicaid Fraud Act […]
The superintendent may promulgate rules deemed necessary or appropriate by the superintendent for the administration of the Insurance Fraud Act. History: Laws 1998, ch. 115, § 16.
A. The “automobile theft prevention authority” is created in the office of superintendent of insurance. The automobile theft prevention authority shall be governed by a board of directors. The board shall consist of nine members as follows: (1) the superintendent; (2) the director of the administrative office of the district attorneys or the director’s designee; […]
A. The legislature finds that insurance fraud is pervasive and expensive, and has the potential for increasing premium rates, placing businesses at risk, reducing the ability of consumers to raise their standard of living and decreasing the economic vitality of the state. Therefore, the legislature believes that the state must aggressively confront the problem of […]
As used in the Insurance Fraud Act: A. “fund” means the insurance fraud fund; B. “insurance fraud” means any act or practice in connection with an insurance transaction that constitutes a crime under the Criminal Code or the Insurance Code; C. “insurance transaction” means any act or practice relating to insurance and includes complying with […]
The superintendent shall: A. initiate inquiries and conduct investigations when the superintendent has reason to believe that insurance fraud may have been or is being committed; B. respond to notifications or complaints of suspected insurance fraud generated by state and local police or other law enforcement authorities and governmental units, including the federal government and […]
The superintendent may: A. select and contract with investigative personnel and prosecutors to discharge the superintendent’s duties pursuant to the provisions of the Insurance Fraud Act; B. conduct statewide investigations and prosecutions related to automobile theft; C. coordinate with law enforcement agencies to investigate and with the attorney general and district attorneys to prosecute cases […]
A. Every insurer or licensed insurance professional that has a reasonable belief that an act of insurance fraud will be, is being or has been committed shall furnish and disclose knowledge and information about it to the superintendent and shall cooperate fully with any investigation conducted by the superintendent. Failure to comply with this subsection […]
A. The provisions of Section 59A-4-21 NMSA 1978 regarding immunity from civil liability for enforcement actions performed in good faith by the superintendent, his authorized representatives and examiners shall apply to the Insurance Fraud Act. B. Except when a person intentionally communicates false information he actually believes to be false, a person shall not be […]
Within six months of the effective date of the Insurance Fraud Act all claim forms and applications for insurance shall contain a statement permanently affixed to the application or claim form which states substantially as follows: “ANY PERSON WHO KNOWINGLY PRESENTS A FALSE OR FRAUDULENT CLAIM FOR PAYMENT OF A LOSS OR BENEFIT OR KNOWINGLY […]
If any person licensed by any agency of any state or the federal government or holding credentials from any professional organization is convicted of insurance fraud in this state, the superintendent shall notify the appropriate licensing or credentialing authority of the judgment for appropriate disciplinary action. History: Laws 1998, ch. 115, § 9.
