N.M. Admin. Code § 13.7.5.14

Current through Register Vol. 35, No. 20, October 22, 2024

Section 13.7.5.14 - ACCESS TO CONFIDENTIAL ABUSE INFORMATION

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 locatable and retrievable by the insurer or insurance support organization, the insurer or insurance support organization shall within thirty (30) business days from the date such request is received:

(1) inform the protected person of the nature and substance of such confidential abuse information in writing, by telephone or by other oral communication, whichever the insurer or insurance support organization prefers;

(2) permit the protected person to see and copy, in person, such confidential abuse information pertaining to him or her or to obtain a copy of such confidential abuse information by mail, whichever the protected person prefers, unless such confidential abuse information is in coded form, in which case an accurate translation in plain language shall be provided in writing;

(3) disclose to the protected person the identity, if recorded, of those persons to whom the insurer or insurance support organization has disclosed such confidential abuse information within two (2) years prior to such request, and if the identity is not recorded, the names of those insurers and insurance support organizations or other persons to whom such information is normally disclosed; and

(4) provide the protected person with a summary of the procedures by which he or she may request correction, amendment or deletion of confidential abuse information.

B. Any confidential abuse information provided pursuant to 13 NMAC 7.5.14.1 [now Subsection A of 13.7.5.14 NMAC] shall identify the person or governmental entity that provided it unless the person who provided it is an agent; the protected person who is the subject of the information; or a natural person acting in a personal capacity rather than in a business or professional capacity.

C. An insurer or insurance support organization may charge a reasonable fee to cover the costs incurred in providing a copy of confidential abuse information to persons.

D. The obligations imposed by this section upon an insurer may be satisfied by another insurer authorized to act on its behalf. With respect to the copying and disclosure of confidential abuse information pursuant to a request under 13 NMAC 7.5.14.1 [now Subsection A of 13.7.5.14 NMAC], an insurer or insurance support organization may make arrangements with an insurance support organization to copy and disclose confidential abuse information on its behalf.

E. The rights granted to protected persons in this section shall extend to all persons to the extent confidential abuse information about them is received and maintained by an insurer or insurance support organization in connection with an insurance action. The rights granted to all persons by this subsection shall not extend to information about them that relates to and is received in connection with or in reasonable anticipation of a claim or civil or criminal proceeding involving them.

N.M. Admin. Code § 13.7.5.14

1/1/99; Recompiled 11/30/01