OSI Events Calendar View our calendar of events What does the Office of Superintendent of Insurance do? We ensure compliance of Insurance Statutes and Regulations under the New Mexico Insurance Code by all Insurance Companies, Agents, Adjusters, Third Party Administrators, and other insurance industry staff operating within the State. We provide consumers and the insurance company staff members with information regarding the policies and procedures involving insurance within New Mexico. In assisting consumers, the Consumer Assistance Bureau accepts complaints who are having difficulty in dealing with insurance companies regarding policy applications, binding of policies, claim handling and other matters involving insurance. Before filing a complaint Contact your insurance company and request an explanation. Make sure you have provided all information requested by the company. If you are concerned about the handling of a health insurance claim, ask what appeal and grievance procedures are available to you. (Add MHC content) If you are not satisfied with the company’s response to your concerns, you may consider filing a complaint. Be prepared to summarize your complaint, so people who are not familiar with your issue will be able to understand. What the Superintendent of Insurance cannot do: Order the company to pay your claim or refund premium Decide who was at fault in an accident Act as a court of law or provide legal advice Recommend an agent, company, or products Identify an insurance company with whom a particular person may hold a policy Establish the facts surrounding a claim (for example: who is being truthful when there are conflicting reports of a situation) Determine the cause of loss, the value of a claim, the amount owed to you, or act as your adjuster Address issues the Department can’t legally enforce Home, Auto & Life Insurance Complaint Form Home, Auto & Life Insurance Related Complaint Form Managed Healthcare Complaint Form The Managed Health Care Bureau will investigate this complaint to determine if there are any violations of the New Mexico Insurance Code, Managed Health Care Rule or insurance policy language. Managed Health Care Complaint Form Pharmacy Benefits Complaint “Pharmacy Benefits Manager” means a person or a wholly or partially owned or controlled subsidiary of a person that provides claims administration, benefit design and management, pharmacy network management, negotiation and administration of product discounts, rebates and other benefits accruing to the pharmacy benefits manager or other prescription drug or device services to third parties, but “pharmacy benefits manager” does not include licensed health care facilities, pharmacies, licensed health care professionals, health insurers, unions, health maintenance organizations, Medicare advantage plans or prescription drug plans when providing formulary services to their patients, employees, members or beneficiaries. Pharmacy Benefits Manager Complaint Form Provider Complaint Form Office of Superintendent of Insurance investigates health care provider complaints filed against health care insurers such as health maintenance organizations, individual health plans, group and blanket plans, provider service networks, non-profit healthcare plans, and third-party payers or their agents that provide, offer or administer health benefit plans subject to the insurance laws and regulations of this state. The Superintendent can assist with grievances regarding provider termination, discrimination, credentialing, timely payment of claims and other provider concerns in regards to the operations of the health insurer or plan. Please do not use this form if you are a treating provider or facility filing on behalf of a patient for a medical benefit denial. Use the Managed Healthcare Complaint Form instead for that purpose. Download Insurance Health Care Provider Complaint Form Report Insurance Fraud Form If you believe a person in New Mexico is trying to cheat or commit fraud against an insurer or agent, you should report insurance fraud to our office. Common reasons to file an insurance fraud report include: Falsely reporting a stolen vehicle or property Filing claims with multiple companies, sometimes known as double-dipping Medical insurance fraud including billing for services not rendered Report Insurance Fraud Title Insurance Complaint Form Title Insurance Bureau processes all complaints involving Title Insurance in New Mexico. OSI Consumer Complaint Form Submit all other generic questions, concerns, and complaints here: OSI General Question/Concerns/Complaints
August 24, 2026 Bulletins COVERAGE REQUIREMENTS AND STANDARDIZED LANGUAGE REGARDING COMPLEX REHABILITATION TECHNOLOGY (CRT) BULLETIN 2026-012: During the 2023 Legislative Session, Governor Michelle Lujan Grisham signed House Bill 131 specifying medical necessity and nondiscrimination standards that provide coverage for prosthetic and orthotic devices. During the 2026 Legislative Session, the governor expanded access by signing House Bill 38 to amend Sections 59A‑16‑21.4, 59A‑22‑62, 59A‑23‑32, 59A‑46‑72, and 59A‑47‑66 NMSA 1978. Legislative testimony in […] Read More
June 26, 2026 Bulletins COMPENSATION OF HEARING OFFICERS AND CO-HEARING OFFICERS DESIGNATED ON HEARINGS UNDER 13.10.16 AND 13.10.17 NMAC BULLETIN 2026-007: This Bulletin repeals and replaces Bulletins Nos. 2003-006 and 2015-008, and any other Bulletin on this same topic issued prior to the date of this Bulletin. This Bulletin is issued in accordance with NMSA 1978, Sections 59A-2-8 and 59A-57-1 through – 11; and 13.10.16 and 13.10.17 NMAC. The purpose of this Bulletin is to amend […] Read More
