Detailed Answer
Once you submit additional medical evidence to support your personal injury claim in New Mexico, you can take targeted steps to keep the process on track. New Mexico law requires insurance companies to acknowledge and pay covered claims promptly under NMSA 1978, Section 59A-16-20 (Prompt Payment of Claims) and to avoid unfair settlement practices under NMSA 1978, Section 59A-16-30 (Unfair Claims Settlement Practices). Follow these steps:
1. Confirm Receipt Immediately
Send your medical evidence by certified mail or secure electronic portal. Ask the adjuster to confirm in writing that they received each document. Save all tracking records and email confirmations.
2. Create a Follow-Up Schedule
Note the date you submitted evidence and add a reminder in 7–10 business days. If you hear nothing by then, reach out for an update. Under NMSA 59A-16-20, insurers must pay or deny covered benefits within 15 working days of receiving proof of loss.
3. Make a Professional Inquiry
Call the adjuster or claims representative. State your claim number, date of evidence submission, and the specific records sent. Ask for an estimated decision date. Record the date, time, and name of the person you speak with.
4. Send a Formal Follow-Up Letter
If phone calls go unanswered or the adjuster delays, draft a concise letter. Include your claim number, list of enclosed materials, and your prior follow-up attempts. Request a status update within 10 business days. Mail it via certified or registered service.
5. Escalate When Necessary
If you still receive no response, ask to speak with a claims manager or supervisor. Explain your history of timely submissions. Cite the insurer’s obligations under NMSA 59A-16-20 and NMSA 59A-16-30 to encourage a swift reply.
6. Document Every Interaction
Keep a centralized log of calls, letters and emails. Note dates, times, topics discussed and promises made. Good records strengthen your position if you must file a complaint.
7. Consider a Regulatory Complaint
If the insurer unreasonably delays or denies a valid claim, you may file a complaint with the New Mexico Office of Superintendent of Insurance (OSI Insurance Complaints). Provide your documentation and follow their instructions.
Disclaimer: This article provides general information only. It does not constitute legal advice. Consult a licensed attorney in New Mexico to discuss your specific situation.
Helpful Hints
- Always ask for written confirmation of received evidence.
- Use certified mail or trackable delivery services.
- Maintain a clear timeline of all follow-up steps.
- Be polite but persistent when communicating.
- Reference applicable statutes to remind the insurer of their duties.
- Escalate to supervisors early if initial efforts stall.
- Keep copies of every document you send.
- Check the OSI website before filing a formal complaint.