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New Mexico State Regulations & NAIC Insurance Law

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Licensing

To apply for a New Mexico resident producer’s license, you must:

  • Be at least 18 years old
  • Be a resident of New Mexico before you submit the application

Pre-licensing course and exam: Not required

New Mexico does not have specific pre-licensing requirements.

Fingerprints/background check

As part of the application process, you must submit fingerprints to the New Mexico Department of Insurance. Plan to get fingerprinted after you pass the state exam and at least one day before you apply for the license.

Controlled business

Controlled business is insurance written primarily for the benefit of the producer or the producer’s family members. Producers may not obtain a New Mexico insurance license for the sole purpose of writing controlled business.

You may sell a policy to yourself or to family members, but you can’t get licensed only to do that.

Non-resident license

To obtain a nonresident license, a licensed producer must meet the following requirements:

  • The individual must have a New Mexico resident producer license in good standing.

  • The individual must complete the appropriate application and submit the required fees to the insurance department/commission in each state where they want to be licensed.

  • The individual’s home state must offer equal reciprocity for the state where the individual is applying for a non-resident license. Currently, New Mexico has reciprocation agreements with all other states.

Temporary license

A temporary producer license is valid only if the temporary producer is sponsored and appointed by an insurance company. A temporary producer license is issued only once per line of authority and is valid for a maximum of 6 months from the date it is issued.

Inactive status

A New Mexico resident producer who is ordered to active military duty may place their license on inactive status until discharge. While the license is inactive, the producer may continue to receive residual (“trailing”) commissions, but may not solicit or transact any new business.

Renewal maintenance

New Mexico insurance licenses are initially issued for 2 years. A producer must renew the license every 2 years, by the last day of the licensee’s birth month.

  • There is a 30-day grace period for late renewals.
  • Renewing during the grace period results in a $50 late fee.
  • If the license is not renewed during the grace period, the license expires and all company appointments are canceled.

A producer may have a license reissued within 12 months of expiration without retesting. If a former producer has been without a license for more than 12 months, they must take the pre-licensing course, retest, and get fingerprinted before applying for a new license.

Continuing education

All states, including New Mexico, have continuing education (CE) requirements that must be met to renew any major lines (life, health, property, liability) insurance license. Individuals licensed in New Mexico must complete 24 hours of CE before renewing their license.

Notice of change of name or address

Any change of name or address (residential or business) must be reported by the licensee to the New Mexico Department of Insurance within 30 days of the change. Failure to do so may result in monetary fines and/or suspension of the license.

Company regulations

An insurance company must be authorized by the Department of Insurance to conduct business in New Mexico. To receive authorization, the insurance company must provide:

  • Rate tables
  • Articles of incorporation (including the nature and purpose of the company’s business intentions)
  • Corporate bylaws
  • Required fees

Place of business

Every resident insurance producer authorized to conduct business in New Mexico must maintain a place of business (with public access) within the state.

Capital and surplus requirement

An insurer authorized to conduct insurance business in New Mexico must meet minimum corporate standards. The certificate of authority allows the insurer to conduct business in the state only if it maintains the minimum capital or permanent surplus required.

Duties of the Superintendent of Insurance

The New Mexico Superintendent of Insurance is an appointed state executive position that leads the Office of Superintendent of Insurance, a consumer protection agency for insurance in New Mexico.

The Superintendent is appointed for a 4-year term by the Insurance Nominating Committee. The nominating committee has nine members:

  • Four insurance industry representatives
  • Four insurance consumer advocates

These eight members are appointed in equal number by the New Mexico legislative council and the Governor. The eight appointed members select the ninth member to serve as chair.

As head of the office, the Superintendent oversees private health and life, business, auto, home, and title insurance in the state. Duties include:

  • Investigate all claims and complaints of legal violations relating to insurance.

  • If the Superintendent finds that laws have been violated, forward findings and supporting documents to the state attorney general for prosecution.

  • Monitor transactions of all companies, including domestic, foreign, and alien insurance companies.

  • Audit the books and records of any resident producer as frequently as necessary.

  • Collect all fees associated with producers and insurers.

  • Determine and administer fines associated with violations for insurers and producers.

  • Issue reports pertaining to the suspension and revocation of producer licenses and the suspension and revocation of certificates of authority for insurers.

  • Approve documentation used by insurance companies, such as forms and rates.

  • Organize and manage the Office of Superintendent of Insurance.

  • Conduct examinations and investigations on insurance matters either expressly authorized authorization or based on probable cause of violations.

  • Make, enter into, and enforce contracts or agreements to exercise the office’s powers under the Insurance Code.

Sidenote
Know this...

The Superintendent does not have the authority to arrest, issue injunctions, or sentence jail time. The Superintendent can start the process, but it takes a law officer to arrest and a judge or court of law to issue injunctions or sentence jail time.

Suspend, revoke or non-renew

The Superintendent has the authority to suspend, revoke, or refuse to renew a license for:

  • Providing false information on the application for an insurance license.

  • Omitting any relevant information on an application that would have disqualified the individual from being eligible to receive a license.

  • Being found guilty of a violation or the noncompliance of insurance regulations and laws…

  • Committing fraud while attempting to obtain an insurance license.

  • Commingling policy owners’, insurers’, and beneficiaries’ money with the producer’s own money.

  • Providing false information in reference to the terms and conditions of an insurance contract.

  • Having been found guilty of a felony (or misdemeanor involving activities related to the individual’s moral character.)

  • Having been convicted of violations in reference to unfair trade practices or fraud.

  • Having engaged in activities of a fraudulent nature which allowed the person to involve themselves in dishonest, coercive, untrustworthy, and financially irresponsible practices.

  • Having had a prior insurance license revoked or suspended in a state other than New Mexico.

  • Using another person’s identity and forging their name on an insurance application.

  • Being found guilty of using unethical practices or cheating on an examination for an insurance license.

Cease and desist

If the Superintendent believes that a producer has violated (or is about to violate) an insurance regulation in New Mexico, the Superintendent may issue a cease and desist order. A cease and desist order does not, by itself, suspend or revoke the recipient’s registration, but it does require the recipient to stop or limit the activity addressed in the order.

Hearing

A cease and desist order must be followed immediately, but actions taken by the Superintendent are not “final and binding.” Any New Mexico resident producer subject to disciplinary action has the right to request a hearing to discuss the merits of the situation.

The Superintendent may also investigate any producer doing business in New Mexico to determine whether a hearing is required. If sufficient evidence is found, the Superintendent will issue a notice of hearing (date and time) to interested parties at least 20 days before the hearing.

If a hearing finds a known violation of New Mexico insurance law, the Superintendent may, in addition to issuing a cease and desist order, impose a civil penalty of up to$15,000 per violation.

Unfair claims settlement practices

  • The intentional obstruction and delay of claims payment or the delay of a claims investigation is a violation of regulation.

  • Neglecting to provide a prompt response and written explanation of insurance policy terms, conditions, and laws related to the contract are examples of unfair claims settlement practices.

  • Failure to provide claims without launching a thorough investigation is a violation of regulation.

  • Making settlement claims based on information contained on an application that has been altered without the insured’s consent is a violation of regulation.

  • Denying a claim without conducting a thorough investigation.

  • Attempting to settle a claim for less than fair market value.

Policy forms

New Mexico is a “file and use” state. A file and use filing is submitted to the Department, and the insurer may begin using it as soon as it is filed. The insurer does not have to wait for Department approval before using it.

File and use does not mean an insurer can submit anything it wants. The submission still must comply with the law, regulations, and bulletins.

If the wording on a health insurance policy (or other form) conflicts with New Mexico state law, the policy will be amended to minimum conformity with state statutes.

Record maintenance

Complete and accurate records must be kept at the producer’s place of business for a minimum of 3 years. Records must show every contract placed, the named insured, changes or amendments, and premiums received with each transaction. Records may be inspected at any time by the Department of Insurance or any representative appointed on its behalf.

Fraudulent producer representation

An insurance producer who represents to the public that they are licensed to conduct insurance business in New Mexico, but has not passed the appropriate licensing examination, is in violation of regulation. This includes public communication through advertisements, letterheads, circulars, business cards, and other methods of representation.

A producer found guilty of conducting business in New Mexico in any line of insurance for which they are not properly licensed may have any other insurance license suspended or revoked.

Misrepresentation

  • Misrepresentation involving the creation or distribution of policies, quotes, and illustrations designed to provide inaccurate information about the terms and conditions of a policy is prohibited.

  • Providing inaccurate or incomplete information or comparisons regarding the benefits of a policy is an example of misrepresentation.

  • Providing inaccurate or incomplete information with the sole purpose of inducing lapse, exchange, conversion, forfeiture, or surrender is a violation as well (twisting).

False advertising

Communication involving the publication of newspapers, magazines, radio, or television that is intended to deliver false information in reference to insurance is a violation of NAIC regulation.

Defamation

  • The intentional and malicious circulation of written or oral information intended for the direct or indirect dissemination of derogatory statements is prohibited.

  • Publishing and circulating inaccurate information regarding the financial condition of an insurer, person, or competitor in the insurance industry is a violation of NAIC regulation.

Boycott, coercion and intimidation

Participation in any boycott or activity involving coercion and intimidation for the sole purpose of retaining business, or that results in a monopoly of insurance business, is prohibited.

False financial statements

Any licensed producer who makes false statements containing inaccurate material facts or false statements on an application for insurance is in violation of NAIC regulation.

Illegal inducements

In New Mexico, it is prohibited to induce the purchase of insurance by offering anything with a monetary value in excess of $10. It is also prohibited to accept anything with a monetary value in excess of $10 from a client. Any producer participating in this activity is subject to suspension of their license and a monetary fine.

Unfair discrimination

Discriminating on the basis of class, race, marital status, or sexual preference is a violation of regulation. Any unfair discriminatory practices intended to directly or indirectly favor an applicant or insured are prohibited. Denying insurance coverage based on the blindness or partial blindness of an individual is considered discrimination and is a violation of NAIC regulation.

Errors & Omissions

Errors & Omissions (E&O) insurance is a type of professional liability insurance that protects insurance agents if they are sued for negligent performance of their duties. E&O covers only honest mistakes that result in financial damage to customers/prospects. There is no coverage for violations of insurance regulation.

Rebating

New Mexico licensed producers are prohibited from directly or indirectly giving any refund, discount, favor, or credit to reduce premiums to induce the purchase of insurance.

Furthermore, producers in New Mexico are also prohibited from receiving any payment for the sale, solicitation, or negotiation of insurance outside of commissions and/or salary.

Sidenote
Know this...

To “solicit” or “negotiate” insurance implies that the person is licensed.

Sharing commission

Splitting or sharing commissions with a licensed producer is allowed. Both parties must be licensed in the line of business in which the commission is being split.

Twisting

Providing false information or expressing derogatory ideas about the financial conditions of a competitor company with the intent to lapse or surrender an existing policy is a violation of the law. Any written or oral statements used to induce the lapse, termination, exchange, or surrender of an insurance contract based on inaccurate information are prohibited.

Unfair marketing practices

The Department of Insurance establishes minimum standards for full and fair disclosure of policy content. The Department also requires standardization and simplification of the terms used to describe insurance coverage. Advertising may not involve:

  • Any implication that policies are approved or that the financial condition of a company is endorsed by any government agency or by any independent group, individual, organization, or society.

  • Any statements regarding advertising that are false or untrue in reference to the time frame in which claims are paid.

Gramm-Leach Bliley Act (GLBA)

This law repealed the Glass-Steagall Act of 1933, allowing consolidation of commercial banks, investment institutions, and insurance companies. GLBA established a framework of responsibilities for federal and state regulators across these financial industries. It permits financial services companies to merge and engage in a variety of new business activities, including insurance, while attempting to address the regulatory issues raised by such combinations.

McCarran-Ferguson Act

Federal law signed in 1945 in which Congress declared that the insurance industry would be regulated at the state level. Grants insurers a limited exemption from federal antitrust legislation.

National Association of Insurance Commissioners (NAIC)

The U.S. standard-setting and regulatory support organization is created and governed by the chief insurance regulators from the 50 states, the District of Columbia, and five U.S. territories. Through the NAIC, state insurance regulators establish standards and best practices, conduct peer review, and coordinate their regulatory oversight. NAIC staff supports these efforts and represents the collective views of state regulators domestically and internationally. NAIC members, together with the central resources of the NAIC, form the national system of state-based insurance regulation in the U.S.

Fair Credit Reporting Act of 1971

If an applicant is denied insurance, employment, or credit due to information collected, this regulation grants access to the information and the reasons for the denial. After receiving notice that an adverse underwriting decision has been made (which must be communicated within 3 days), an individual has 90 business days to request a copy of the report.

Privacy Act of 1974

This regulation established a system for the collection, use, and dissemination of information gathered during the underwriting process. When an applicant for insurance signs the application (notice regarding insurance information practices), they give the insurer the right to check driving records, MIB, and consumer investigative reports. A signed application authorizes the insurer to collect information for 30 months. If the insurer has not done so by then, a new authorization must be obtained.

Telemarketing

The DO NOT CALL registry is a list of telephone numbers, and it is intended to prevent calls from telemarketers. Unsolicited sales calls must be made in accordance with the following provisions:

  • No call may be placed outside of the hours of 8 am to 9 pm local time where the call is received.

  • The sales nature of the call must be disclosed and the nature of the product/service being offered must be disclosed.

  • The caller must identify themselves and the broker/dealer they represent.

  • If a prize is being offered, the prize cannot be contingent on purchase.

CAN-Spam

When an unsolicited e-mail is sent, the sender must:

  • Use the word advertisement or the letters ADV on the subject line.

  • Notate the physical location from where the email originated.

  • Give the recipient the opportunity to opt out of ever receiving another email from the sender.

Insurance Guaranty Association

The New Mexico Insurance Guaranty Association is made up of authorized insurers and is controlled by a board. Joining the association is part of the authorization process that admits insurance companies to conduct business in New Mexico. This is not unique to New Mexico. Insurers must be authorized in every state where they transact business.

Once authorized, any insurer doing business in New Mexico must contribute to the New Mexico Insurance Guarantee Fund, which is intended to indemnify policy owners of insurance companies that have become insolvent (up to $100,000 cash and $300,000 total benefits).

Auto insurance state minimum

The “state minimum” auto insurance is the minimum amount of car insurance you must carry to legally drive a vehicle in New Mexico. It ensures you can pay for others’ injuries and damages if you cause a car accident. Driving without adequate coverage can result in financial repercussions such as fines, license suspensions, vehicle impoundment, and even jail time.

Auto insurance is typically structured as a split limit policy with coverage minimums represented by numbers and slashes. The first number is BI coverage per person, the second is BI coverage per incident (if multiple people are injured), and the third is PD per incident.

In New Mexico, the state minimum is 25/50/10. This covers up to $25,000 of bodily injury protection per person, up to $50,000 of bodily injuries per incident, and up to $10,000 of property damage per incident.

Licensing

  • Must be 18+ and NM resident before applying
  • No pre-licensing course/exam required
  • Fingerprints/background check required after passing state exam
  • Controlled business: license not for writing only self/family policies

Non-resident and Temporary Licenses

  • Non-resident: must have NM resident license, apply in other states, reciprocity required
  • Temporary license: sponsor/appointment required, valid once per line, max 6 months

Inactive Status

  • Active military duty: license may go inactive, can receive residual commissions, no new business

Renewal Maintenance

  • License valid 2 years, renew by birth month’s end
  • 30-day grace period ($50 late fee), then license expires
  • Reissue within 12 months without retest; after 12 months, must retake course/exam/fingerprints

Continuing Education

  • 24 hours CE required for renewal of major lines

Notice of Change of Name or Address

  • Must notify Department within 30 days
  • Failure: fines and/or suspension

Company Regulations

  • Insurers must be authorized by Department
  • Must provide rate tables, articles of incorporation, bylaws, fees

Place of Business

  • Resident producers must maintain a public-accessible business location in NM

Capital and Surplus Requirement

  • Insurers must meet minimum capital/surplus standards for certificate of authority

Duties of the Superintendent of Insurance

  • Appointed for 4 years by 9-member committee (industry & consumer reps)
  • Oversees all insurance lines, investigates violations, audits, collects fees, administers fines
  • Approves forms/rates, manages office, conducts exams/investigations
  • Cannot arrest, issue injunctions, or sentence jail time

Suspend, Revoke, or Non-renew

  • Grounds: false/omitted info, fraud, commingling funds, felony/moral turpitude, prior revocation, unethical practices, cheating, misrepresentation

Cease and Desist

  • Superintendent may order to stop/limit activities for violations
  • Does not suspend/revoke license by itself

Hearing

  • Right to hearing after disciplinary action
  • Notice at least 20 days prior
  • Civil penalty up to $15,000 per violation possible

Unfair Claims Settlement Practices

  • Delays, lack of investigation, altered info, unfair settlements, or denial without investigation are violations

Policy Forms

  • “File and use” state: forms used upon filing, must comply with law
  • Conflicting policy language amended to state minimums

Record Maintenance

  • Keep records at business for minimum 3 years
  • Must include contracts, insureds, amendments, premiums
  • Subject to Department inspection

Fraudulent Producer Representation

  • Illegal to claim licensure without passing exam
  • Conducting business in unlicensed lines may result in suspension/revocation

Misrepresentation

  • Prohibited: false/incomplete info in policies, quotes, illustrations, or comparisons
  • Twisting: inducing lapse/surrender with false info

False Advertising

  • Prohibited: false info in media regarding insurance

Defamation

  • Prohibited: malicious/false statements about insurers or competitors

Boycott, Coercion, and Intimidation

  • Prohibited: activities to retain business or create monopoly

False Financial Statements

  • Prohibited: false/inaccurate statements on insurance applications

Illegal Inducements

  • Cannot offer/accept inducements >$10 for insurance purchase
  • Violators face suspension and fines

Unfair Discrimination

  • Prohibited: discrimination by class, race, marital status, sexual preference, blindness

Errors & Omissions (E&O)

  • Protects agents from lawsuits for honest mistakes
  • No coverage for regulatory violations

Rebating

  • Prohibited: giving/receiving anything to reduce premiums or as payment outside commissions/salary

Sharing Commission

  • Allowed only with another licensed producer in same line

Twisting

  • Prohibited: false statements to induce lapse/surrender/exchange of policies

Unfair Marketing Practices

  • Must provide full/fair disclosure, standardization, and simplification
  • No implication of government/third-party endorsement
  • No false claims about claim payment timeframes

Gramm-Leach Bliley Act (GLBA)

  • Repealed Glass-Steagall, allows financial institution consolidation
  • Established regulatory framework for merged activities

McCarran-Ferguson Act

  • Insurance regulated at state level
  • Limited exemption from federal antitrust laws

National Association of Insurance Commissioners (NAIC)

  • Sets standards/best practices for state insurance regulation
  • Composed of chief insurance regulators from all states/territories

Fair Credit Reporting Act of 1971

  • Denied applicants must be notified within 3 days
  • 90 business days to request report copy

Privacy Act of 1974

  • Regulates collection/use of underwriting info
  • Signed application authorizes info collection for 30 months

Telemarketing

  • DO NOT CALL registry: restricts unsolicited calls
  • Calls only 8am–9pm, must disclose sales nature, caller identity, no purchase-required prizes

CAN-Spam

  • Unsolicited emails: must use “advertisement”/“ADV” in subject, show sender location, offer opt-out

Insurance Guaranty Association

  • All authorized insurers must join and contribute
  • Indemnifies policyholders of insolvent insurers (up to $100,000 cash, $300,000 total benefits)

Auto Insurance State Minimum

  • NM minimum: 25/50/10 split limit
    • $25,000 BI per person
    • $50,000 BI per incident
    • $10,000 PD per incident
  • Driving without minimum: fines, suspension, impoundment, jail possible

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New Mexico State Regulations & NAIC Insurance Law

Licensing

To apply for a New Mexico resident producer’s license, you must:

  • Be at least 18 years old
  • Be a resident of New Mexico before you submit the application

Pre-licensing course and exam: Not required

New Mexico does not have specific pre-licensing requirements.

Fingerprints/background check

As part of the application process, you must submit fingerprints to the New Mexico Department of Insurance. Plan to get fingerprinted after you pass the state exam and at least one day before you apply for the license.

Controlled business

Controlled business is insurance written primarily for the benefit of the producer or the producer’s family members. Producers may not obtain a New Mexico insurance license for the sole purpose of writing controlled business.

You may sell a policy to yourself or to family members, but you can’t get licensed only to do that.

Non-resident license

To obtain a nonresident license, a licensed producer must meet the following requirements:

  • The individual must have a New Mexico resident producer license in good standing.

  • The individual must complete the appropriate application and submit the required fees to the insurance department/commission in each state where they want to be licensed.

  • The individual’s home state must offer equal reciprocity for the state where the individual is applying for a non-resident license. Currently, New Mexico has reciprocation agreements with all other states.

Temporary license

A temporary producer license is valid only if the temporary producer is sponsored and appointed by an insurance company. A temporary producer license is issued only once per line of authority and is valid for a maximum of 6 months from the date it is issued.

Inactive status

A New Mexico resident producer who is ordered to active military duty may place their license on inactive status until discharge. While the license is inactive, the producer may continue to receive residual (“trailing”) commissions, but may not solicit or transact any new business.

Renewal maintenance

New Mexico insurance licenses are initially issued for 2 years. A producer must renew the license every 2 years, by the last day of the licensee’s birth month.

  • There is a 30-day grace period for late renewals.
  • Renewing during the grace period results in a $50 late fee.
  • If the license is not renewed during the grace period, the license expires and all company appointments are canceled.

A producer may have a license reissued within 12 months of expiration without retesting. If a former producer has been without a license for more than 12 months, they must take the pre-licensing course, retest, and get fingerprinted before applying for a new license.

Continuing education

All states, including New Mexico, have continuing education (CE) requirements that must be met to renew any major lines (life, health, property, liability) insurance license. Individuals licensed in New Mexico must complete 24 hours of CE before renewing their license.

Notice of change of name or address

Any change of name or address (residential or business) must be reported by the licensee to the New Mexico Department of Insurance within 30 days of the change. Failure to do so may result in monetary fines and/or suspension of the license.

Company regulations

An insurance company must be authorized by the Department of Insurance to conduct business in New Mexico. To receive authorization, the insurance company must provide:

  • Rate tables
  • Articles of incorporation (including the nature and purpose of the company’s business intentions)
  • Corporate bylaws
  • Required fees

Place of business

Every resident insurance producer authorized to conduct business in New Mexico must maintain a place of business (with public access) within the state.

Capital and surplus requirement

An insurer authorized to conduct insurance business in New Mexico must meet minimum corporate standards. The certificate of authority allows the insurer to conduct business in the state only if it maintains the minimum capital or permanent surplus required.

Duties of the Superintendent of Insurance

The New Mexico Superintendent of Insurance is an appointed state executive position that leads the Office of Superintendent of Insurance, a consumer protection agency for insurance in New Mexico.

The Superintendent is appointed for a 4-year term by the Insurance Nominating Committee. The nominating committee has nine members:

  • Four insurance industry representatives
  • Four insurance consumer advocates

These eight members are appointed in equal number by the New Mexico legislative council and the Governor. The eight appointed members select the ninth member to serve as chair.

As head of the office, the Superintendent oversees private health and life, business, auto, home, and title insurance in the state. Duties include:

  • Investigate all claims and complaints of legal violations relating to insurance.

  • If the Superintendent finds that laws have been violated, forward findings and supporting documents to the state attorney general for prosecution.

  • Monitor transactions of all companies, including domestic, foreign, and alien insurance companies.

  • Audit the books and records of any resident producer as frequently as necessary.

  • Collect all fees associated with producers and insurers.

  • Determine and administer fines associated with violations for insurers and producers.

  • Issue reports pertaining to the suspension and revocation of producer licenses and the suspension and revocation of certificates of authority for insurers.

  • Approve documentation used by insurance companies, such as forms and rates.

  • Organize and manage the Office of Superintendent of Insurance.

  • Conduct examinations and investigations on insurance matters either expressly authorized authorization or based on probable cause of violations.

  • Make, enter into, and enforce contracts or agreements to exercise the office’s powers under the Insurance Code.

Sidenote
Know this...

The Superintendent does not have the authority to arrest, issue injunctions, or sentence jail time. The Superintendent can start the process, but it takes a law officer to arrest and a judge or court of law to issue injunctions or sentence jail time.

Suspend, revoke or non-renew

The Superintendent has the authority to suspend, revoke, or refuse to renew a license for:

  • Providing false information on the application for an insurance license.

  • Omitting any relevant information on an application that would have disqualified the individual from being eligible to receive a license.

  • Being found guilty of a violation or the noncompliance of insurance regulations and laws…

  • Committing fraud while attempting to obtain an insurance license.

  • Commingling policy owners’, insurers’, and beneficiaries’ money with the producer’s own money.

  • Providing false information in reference to the terms and conditions of an insurance contract.

  • Having been found guilty of a felony (or misdemeanor involving activities related to the individual’s moral character.)

  • Having been convicted of violations in reference to unfair trade practices or fraud.

  • Having engaged in activities of a fraudulent nature which allowed the person to involve themselves in dishonest, coercive, untrustworthy, and financially irresponsible practices.

  • Having had a prior insurance license revoked or suspended in a state other than New Mexico.

  • Using another person’s identity and forging their name on an insurance application.

  • Being found guilty of using unethical practices or cheating on an examination for an insurance license.

Cease and desist

If the Superintendent believes that a producer has violated (or is about to violate) an insurance regulation in New Mexico, the Superintendent may issue a cease and desist order. A cease and desist order does not, by itself, suspend or revoke the recipient’s registration, but it does require the recipient to stop or limit the activity addressed in the order.

Hearing

A cease and desist order must be followed immediately, but actions taken by the Superintendent are not “final and binding.” Any New Mexico resident producer subject to disciplinary action has the right to request a hearing to discuss the merits of the situation.

The Superintendent may also investigate any producer doing business in New Mexico to determine whether a hearing is required. If sufficient evidence is found, the Superintendent will issue a notice of hearing (date and time) to interested parties at least 20 days before the hearing.

If a hearing finds a known violation of New Mexico insurance law, the Superintendent may, in addition to issuing a cease and desist order, impose a civil penalty of up to$15,000 per violation.

Unfair claims settlement practices

  • The intentional obstruction and delay of claims payment or the delay of a claims investigation is a violation of regulation.

  • Neglecting to provide a prompt response and written explanation of insurance policy terms, conditions, and laws related to the contract are examples of unfair claims settlement practices.

  • Failure to provide claims without launching a thorough investigation is a violation of regulation.

  • Making settlement claims based on information contained on an application that has been altered without the insured’s consent is a violation of regulation.

  • Denying a claim without conducting a thorough investigation.

  • Attempting to settle a claim for less than fair market value.

Policy forms

New Mexico is a “file and use” state. A file and use filing is submitted to the Department, and the insurer may begin using it as soon as it is filed. The insurer does not have to wait for Department approval before using it.

File and use does not mean an insurer can submit anything it wants. The submission still must comply with the law, regulations, and bulletins.

If the wording on a health insurance policy (or other form) conflicts with New Mexico state law, the policy will be amended to minimum conformity with state statutes.

Record maintenance

Complete and accurate records must be kept at the producer’s place of business for a minimum of 3 years. Records must show every contract placed, the named insured, changes or amendments, and premiums received with each transaction. Records may be inspected at any time by the Department of Insurance or any representative appointed on its behalf.

Fraudulent producer representation

An insurance producer who represents to the public that they are licensed to conduct insurance business in New Mexico, but has not passed the appropriate licensing examination, is in violation of regulation. This includes public communication through advertisements, letterheads, circulars, business cards, and other methods of representation.

A producer found guilty of conducting business in New Mexico in any line of insurance for which they are not properly licensed may have any other insurance license suspended or revoked.

Misrepresentation

  • Misrepresentation involving the creation or distribution of policies, quotes, and illustrations designed to provide inaccurate information about the terms and conditions of a policy is prohibited.

  • Providing inaccurate or incomplete information or comparisons regarding the benefits of a policy is an example of misrepresentation.

  • Providing inaccurate or incomplete information with the sole purpose of inducing lapse, exchange, conversion, forfeiture, or surrender is a violation as well (twisting).

False advertising

Communication involving the publication of newspapers, magazines, radio, or television that is intended to deliver false information in reference to insurance is a violation of NAIC regulation.

Defamation

  • The intentional and malicious circulation of written or oral information intended for the direct or indirect dissemination of derogatory statements is prohibited.

  • Publishing and circulating inaccurate information regarding the financial condition of an insurer, person, or competitor in the insurance industry is a violation of NAIC regulation.

Boycott, coercion and intimidation

Participation in any boycott or activity involving coercion and intimidation for the sole purpose of retaining business, or that results in a monopoly of insurance business, is prohibited.

False financial statements

Any licensed producer who makes false statements containing inaccurate material facts or false statements on an application for insurance is in violation of NAIC regulation.

Illegal inducements

In New Mexico, it is prohibited to induce the purchase of insurance by offering anything with a monetary value in excess of $10. It is also prohibited to accept anything with a monetary value in excess of $10 from a client. Any producer participating in this activity is subject to suspension of their license and a monetary fine.

Unfair discrimination

Discriminating on the basis of class, race, marital status, or sexual preference is a violation of regulation. Any unfair discriminatory practices intended to directly or indirectly favor an applicant or insured are prohibited. Denying insurance coverage based on the blindness or partial blindness of an individual is considered discrimination and is a violation of NAIC regulation.

Errors & Omissions

Errors & Omissions (E&O) insurance is a type of professional liability insurance that protects insurance agents if they are sued for negligent performance of their duties. E&O covers only honest mistakes that result in financial damage to customers/prospects. There is no coverage for violations of insurance regulation.

Rebating

New Mexico licensed producers are prohibited from directly or indirectly giving any refund, discount, favor, or credit to reduce premiums to induce the purchase of insurance.

Furthermore, producers in New Mexico are also prohibited from receiving any payment for the sale, solicitation, or negotiation of insurance outside of commissions and/or salary.

Sidenote
Know this...

To “solicit” or “negotiate” insurance implies that the person is licensed.

Sharing commission

Splitting or sharing commissions with a licensed producer is allowed. Both parties must be licensed in the line of business in which the commission is being split.

Twisting

Providing false information or expressing derogatory ideas about the financial conditions of a competitor company with the intent to lapse or surrender an existing policy is a violation of the law. Any written or oral statements used to induce the lapse, termination, exchange, or surrender of an insurance contract based on inaccurate information are prohibited.

Unfair marketing practices

The Department of Insurance establishes minimum standards for full and fair disclosure of policy content. The Department also requires standardization and simplification of the terms used to describe insurance coverage. Advertising may not involve:

  • Any implication that policies are approved or that the financial condition of a company is endorsed by any government agency or by any independent group, individual, organization, or society.

  • Any statements regarding advertising that are false or untrue in reference to the time frame in which claims are paid.

Gramm-Leach Bliley Act (GLBA)

This law repealed the Glass-Steagall Act of 1933, allowing consolidation of commercial banks, investment institutions, and insurance companies. GLBA established a framework of responsibilities for federal and state regulators across these financial industries. It permits financial services companies to merge and engage in a variety of new business activities, including insurance, while attempting to address the regulatory issues raised by such combinations.

McCarran-Ferguson Act

Federal law signed in 1945 in which Congress declared that the insurance industry would be regulated at the state level. Grants insurers a limited exemption from federal antitrust legislation.

National Association of Insurance Commissioners (NAIC)

The U.S. standard-setting and regulatory support organization is created and governed by the chief insurance regulators from the 50 states, the District of Columbia, and five U.S. territories. Through the NAIC, state insurance regulators establish standards and best practices, conduct peer review, and coordinate their regulatory oversight. NAIC staff supports these efforts and represents the collective views of state regulators domestically and internationally. NAIC members, together with the central resources of the NAIC, form the national system of state-based insurance regulation in the U.S.

Fair Credit Reporting Act of 1971

If an applicant is denied insurance, employment, or credit due to information collected, this regulation grants access to the information and the reasons for the denial. After receiving notice that an adverse underwriting decision has been made (which must be communicated within 3 days), an individual has 90 business days to request a copy of the report.

Privacy Act of 1974

This regulation established a system for the collection, use, and dissemination of information gathered during the underwriting process. When an applicant for insurance signs the application (notice regarding insurance information practices), they give the insurer the right to check driving records, MIB, and consumer investigative reports. A signed application authorizes the insurer to collect information for 30 months. If the insurer has not done so by then, a new authorization must be obtained.

Telemarketing

The DO NOT CALL registry is a list of telephone numbers, and it is intended to prevent calls from telemarketers. Unsolicited sales calls must be made in accordance with the following provisions:

  • No call may be placed outside of the hours of 8 am to 9 pm local time where the call is received.

  • The sales nature of the call must be disclosed and the nature of the product/service being offered must be disclosed.

  • The caller must identify themselves and the broker/dealer they represent.

  • If a prize is being offered, the prize cannot be contingent on purchase.

CAN-Spam

When an unsolicited e-mail is sent, the sender must:

  • Use the word advertisement or the letters ADV on the subject line.

  • Notate the physical location from where the email originated.

  • Give the recipient the opportunity to opt out of ever receiving another email from the sender.

Insurance Guaranty Association

The New Mexico Insurance Guaranty Association is made up of authorized insurers and is controlled by a board. Joining the association is part of the authorization process that admits insurance companies to conduct business in New Mexico. This is not unique to New Mexico. Insurers must be authorized in every state where they transact business.

Once authorized, any insurer doing business in New Mexico must contribute to the New Mexico Insurance Guarantee Fund, which is intended to indemnify policy owners of insurance companies that have become insolvent (up to $100,000 cash and $300,000 total benefits).

Auto insurance state minimum

The “state minimum” auto insurance is the minimum amount of car insurance you must carry to legally drive a vehicle in New Mexico. It ensures you can pay for others’ injuries and damages if you cause a car accident. Driving without adequate coverage can result in financial repercussions such as fines, license suspensions, vehicle impoundment, and even jail time.

Auto insurance is typically structured as a split limit policy with coverage minimums represented by numbers and slashes. The first number is BI coverage per person, the second is BI coverage per incident (if multiple people are injured), and the third is PD per incident.

In New Mexico, the state minimum is 25/50/10. This covers up to $25,000 of bodily injury protection per person, up to $50,000 of bodily injuries per incident, and up to $10,000 of property damage per incident.

Key points

Licensing

  • Must be 18+ and NM resident before applying
  • No pre-licensing course/exam required
  • Fingerprints/background check required after passing state exam
  • Controlled business: license not for writing only self/family policies

Non-resident and Temporary Licenses

  • Non-resident: must have NM resident license, apply in other states, reciprocity required
  • Temporary license: sponsor/appointment required, valid once per line, max 6 months

Inactive Status

  • Active military duty: license may go inactive, can receive residual commissions, no new business

Renewal Maintenance

  • License valid 2 years, renew by birth month’s end
  • 30-day grace period ($50 late fee), then license expires
  • Reissue within 12 months without retest; after 12 months, must retake course/exam/fingerprints

Continuing Education

  • 24 hours CE required for renewal of major lines

Notice of Change of Name or Address

  • Must notify Department within 30 days
  • Failure: fines and/or suspension

Company Regulations

  • Insurers must be authorized by Department
  • Must provide rate tables, articles of incorporation, bylaws, fees

Place of Business

  • Resident producers must maintain a public-accessible business location in NM

Capital and Surplus Requirement

  • Insurers must meet minimum capital/surplus standards for certificate of authority

Duties of the Superintendent of Insurance

  • Appointed for 4 years by 9-member committee (industry & consumer reps)
  • Oversees all insurance lines, investigates violations, audits, collects fees, administers fines
  • Approves forms/rates, manages office, conducts exams/investigations
  • Cannot arrest, issue injunctions, or sentence jail time

Suspend, Revoke, or Non-renew

  • Grounds: false/omitted info, fraud, commingling funds, felony/moral turpitude, prior revocation, unethical practices, cheating, misrepresentation

Cease and Desist

  • Superintendent may order to stop/limit activities for violations
  • Does not suspend/revoke license by itself

Hearing

  • Right to hearing after disciplinary action
  • Notice at least 20 days prior
  • Civil penalty up to $15,000 per violation possible

Unfair Claims Settlement Practices

  • Delays, lack of investigation, altered info, unfair settlements, or denial without investigation are violations

Policy Forms

  • “File and use” state: forms used upon filing, must comply with law
  • Conflicting policy language amended to state minimums

Record Maintenance

  • Keep records at business for minimum 3 years
  • Must include contracts, insureds, amendments, premiums
  • Subject to Department inspection

Fraudulent Producer Representation

  • Illegal to claim licensure without passing exam
  • Conducting business in unlicensed lines may result in suspension/revocation

Misrepresentation

  • Prohibited: false/incomplete info in policies, quotes, illustrations, or comparisons
  • Twisting: inducing lapse/surrender with false info

False Advertising

  • Prohibited: false info in media regarding insurance

Defamation

  • Prohibited: malicious/false statements about insurers or competitors

Boycott, Coercion, and Intimidation

  • Prohibited: activities to retain business or create monopoly

False Financial Statements

  • Prohibited: false/inaccurate statements on insurance applications

Illegal Inducements

  • Cannot offer/accept inducements >$10 for insurance purchase
  • Violators face suspension and fines

Unfair Discrimination

  • Prohibited: discrimination by class, race, marital status, sexual preference, blindness

Errors & Omissions (E&O)

  • Protects agents from lawsuits for honest mistakes
  • No coverage for regulatory violations

Rebating

  • Prohibited: giving/receiving anything to reduce premiums or as payment outside commissions/salary

Sharing Commission

  • Allowed only with another licensed producer in same line

Twisting

  • Prohibited: false statements to induce lapse/surrender/exchange of policies

Unfair Marketing Practices

  • Must provide full/fair disclosure, standardization, and simplification
  • No implication of government/third-party endorsement
  • No false claims about claim payment timeframes

Gramm-Leach Bliley Act (GLBA)

  • Repealed Glass-Steagall, allows financial institution consolidation
  • Established regulatory framework for merged activities

McCarran-Ferguson Act

  • Insurance regulated at state level
  • Limited exemption from federal antitrust laws

National Association of Insurance Commissioners (NAIC)

  • Sets standards/best practices for state insurance regulation
  • Composed of chief insurance regulators from all states/territories

Fair Credit Reporting Act of 1971

  • Denied applicants must be notified within 3 days
  • 90 business days to request report copy

Privacy Act of 1974

  • Regulates collection/use of underwriting info
  • Signed application authorizes info collection for 30 months

Telemarketing

  • DO NOT CALL registry: restricts unsolicited calls
  • Calls only 8am–9pm, must disclose sales nature, caller identity, no purchase-required prizes

CAN-Spam

  • Unsolicited emails: must use “advertisement”/“ADV” in subject, show sender location, offer opt-out

Insurance Guaranty Association

  • All authorized insurers must join and contribute
  • Indemnifies policyholders of insolvent insurers (up to $100,000 cash, $300,000 total benefits)

Auto Insurance State Minimum

  • NM minimum: 25/50/10 split limit
    • $25,000 BI per person
    • $50,000 BI per incident
    • $10,000 PD per incident
  • Driving without minimum: fines, suspension, impoundment, jail possible