Interest rate applicable to unpaid claims 45 days after required proof of loss has been furnished.

SUPERINTENDENT OF INSURANCE John G. Franchini 505-827-4299 [LOGO] DEPUTY SUPERINTENDENT Robert Doucette 505-827-5832 NEW MEXICO OFFICE OF SUPERINTENDENT OF INSURANCE 2018 JUN 21 PM 2:33 FILED Bulletin 2018-006 June 21, 2018 TO: INSURANCE COMPANIES AUTHORIZED TO TRANSACT BUSINESS OF INSURANCE IN NEW MEXICO RE: INTEREST RATE APPLICABLE TO UNPAID CLAIMS 45 DAYS AFTER REQUIRED PROOF OF LOSS HAS BEEN FURNISHED THE FOLLOWING BULLETIN is issued pursuant to NMSA 1978, § 59A-2-8, and 13.1.2.8 NMAC et seq. New Mexico Statutes Annotated NMSA 1978, § 59A-16-21(B) provides that: Notwithstanding any provision of the Insurance Code, any insurer issuing any policy, certificate or contract of insurance, surety, guaranty or indemnity of any kind or nature which fails for a period of forty-five days, after required proof of loss has been furnished, to pay to the person entitled the amount justly due shall be liable for the amount due and unpaid with interest on that amount at the rate of one and one-half times the prime lending rate as determined by the superintendent, for New Mexico banks per year during the period the claim is unpaid. Additionally, 13.10.22.12(O) NMAC provides that: Each contract shall provide that a MHCP failing to pay a health care professional or failing to pay a covered person for out of pocket covered expenses within forty-five days after a clean claim has been received by the MHCP shall be liable for the amount due and unpaid with interest on that amount at the rate of one and one half times the rate established by a bulletin entered by the superintendent in January of each calendar year MHCP failing to pay a health care professional or failing to pay a covered person for out of pocket covered expenses within forty-five days after a clean claim has been received by the MHCP shall be liable for the amount due and unpaid with interest on that amount at the rate of one and one half times the rate established by a bulletin entered by the superintendent in January of each calendar year. For the purposes of this section, “clean claim” means a manually or electronically submitted claim that contains all the required data elements necessary for accurate adjudication without the need for additional information from outside of the MHCP’s system and contains no deficiency or impropriety, including lack of substantiating documentation currently required by the MHCP, or particular circumstances requiring special treatment that prevents timely payment from being made by the MHCP. Main Phone: 505-827-4601 Main Fax: 505-827-4734 Toll Free: 1-855-4-ASK-OSI Mailing Address: P.O. Box 1689 Santa Fe, NM 87504-1689 Physical Address: 1120 Paseo de Peralta Santa Fe, NM 87501 Website: WWW.OSI.STATE.NM.US Due to the recent increase in the prime lending rate, commencing July 1, 2018, the interest rate applicable to the referenced statute and rule is 7.125%. This rate shall remain in effect until superseded by a subsequent bulletin specifying a different rate. The Superintendent intends to publish a rate bulletin at least once per-year. The Superintendent may publish rate bulletins more frequently if the prime interest rate materially fluctuates, or less frequently if the prime interest rate remains stable. An insurer who owes interest pursuant to the referenced statue or rule shall use the rate specified in the rate bulletin in effect 45 days after the insurer was furnished a proof of loss or claim. Please direct your questions regarding this bulletin to Anna Krylova at (505) 827-4529, or via e-mail at anna.krylova@state.nm.us. DONE AND ORDERED this 21st day of June, 2018. st rate remains stable. An insurer who owes interest pursuant to the referenced statue or rule shall use the rate specified in the rate bulletin in effect 45 days after the insurer was furnished a proof of loss or claim. Please direct your questions regarding this bulletin to Anna Krylova at (505) 827-4529, or via e-mail at anna.krylova@state.nm.us. DONE AND ORDERED this 21st day of June, 2018. JOHN G. FRANCHINI Superintendent of Insurance Main Phone: 505-827-4601 Main Fax: 505-827-4734 Toll Free: 1-855-4-ASK-OSI Mailing Address: P.O. Box 1689 Santa Fe, NM 87504-1689 Physical Address: 1120 Paseo de Peralta Santa Fe, NM 87501 Website: WWW.OSI.STATE.NM.US