NM LEG Unfair Insurance Claim Practice

Updated on: Apr 14, 2025

Latest Event


  • Apr. 2025 NM LEG Governor Approval
  • On Apr. 8, 2025, NM LEG reported governor approved SB 221, assigned as Ch. 120.

On Mar. 21, NM LEG bill to prevent improper claim categorization.

  • NM LEG passed SB 221 to define and prohibit additional unfair ins claims practices.
  • Amended NM INS 59A-16-20 to clarify that an insurer cannot treat an inquiry as a claim when coverage does not apply, no payment is made, and no fraud is involved.
  • Legislative History
  • On Jan. 31, 2025, bill was introduced in Senate; on Mar. 11, 2025, bill passed Senate.
  • On Mar. 12, 2025, bill was introduced in House; on Mar. 21, 2025, bill passed House.
  • Effectiveness
  • Upon enactment, bill is effective 90 days after adjournment, on Jun. 20, 2025.
  • Apr. 2025 NM LEG Governor Approval
  • On Apr. 8, 2025, NM LEG reported governor approved SB 221, assigned as Ch. 120.
Regulators
NM LEG
Entity Types
Ins
Reference
Bill, Ch. 120, 4/8/2025; Bill SB221, 3/21/2025; Citation: NM INS 59A-16-20;
Functions
Claims/Accelerated Benefits; Compliance; Legal; Operations
Countries
United States of America
Category
State
N/A
Products
Dental; Insurance; Insurance-Casualty; Insurance-Health; Insurance-Life; Insurance-Property
Rule Type
Final
Regions
Am
Rule Date
Mar 21, 2025
Effective Date
Jun 20, 2025
Rule ID
248190
Linked to
N/A
Reg. Last Update
Apr 8, 2025
Report Section
US Insurance