N.M. Admin. Code § 13.9.15.17

Current through Register Vol. 35, No. 24, December 23, 2024

Section 13.9.15.17 - INSURANCE COMPANY PRACTICES

A. Life insurance companies authorized to do business in this state shall respond to a request for verification of coverage from a viatical settlement provider or broker within thirty (30) calendar days of the date a request is received. The request shall be accompanied by:

(1) a current authorization consistent with applicable law, signed by the policyowner or certificateholder;

(2) in the case of an individual policy, a form substantially similar to Appendix B, which has been completed by the viatical settlement provider or broker in accordance with the instructions on the form.

(3) in the case of group insurance coverage a form substantially similar to Appendix C, which has been completed by the viatical settlement provider or broker in accordance with the instructions on the form, and which has previously been referred to the group policyholder and completed to the extent the information is available to the group policyholder.

B. A life insurance company and a viatical settlement provider or broker may use another verification of coverage form that has been mutually agreed upon in writing in advance of submission of the request.

C. A life insurance company may not charge a fee for responding to a request for verification of coverage from a viatical settlement provider or broker in excess of any usual and customary charges to contractholders, certificateholders or insureds for similar services.

D. The life insurance company may send an acknowledgment of receipt of the request for verification of coverage to the policyowner or certificateholder and, where the policy owner or certificate owner is other than the insured, to the insured. The acknowledgment may contain a general description of any accelerated death benefit that is available under a provision of or rider to the life insurance contract.

N.M. Admin. Code § 13.9.15.17

13.9.15.17 NMAC - N, 7-1-00