New Mexico Statutes
Article 16 - Trade Practices and Frauds
Section 59A-16-23 - False applications, claims, proofs of loss.

A. An agent, broker, solicitor, examining physician, applicant or other person shall not knowingly or willfully:
(1) make a false or fraudulent statement or representation as to a material fact in or with reference to an application for insurance or other coverage;
(2) for the purpose of obtaining money or benefit, present or cause to be presented a false or fraudulent claim or proof in support of such a claim for payment of loss under a policy;
(3) prepare, make or subscribe a false or fraudulent account, certificate, affidavit or proof of loss or other document with intent that the same may be presented or used in support of such a claim; or
(4) make a false or fraudulent statement or representation on or relative to an application for a policy for the purpose of obtaining a fee, commission or benefit from an insurer, agent, broker or individual.
B. A false statement or representation made under oath shall constitute and be punishable as perjury. A violation of the provisions of this section when the purported loss or potential loss to the victim insurer is:
(1) two hundred fifty dollars ($250) or less is a petty misdemeanor;
(2) over two hundred fifty dollars ($250) but not more than five hundred dollars ($500) is a misdemeanor;
(3) over five hundred dollars ($500) but not more than two thousand five hundred dollars ($2,500) is a fourth degree felony;
(4) over two thousand five hundred dollars ($2,500) but not more than twenty thousand dollars ($20,000) is a third degree felony; or
(5) over twenty thousand dollars ($20,000) is a second degree felony.
History: Laws 1984, ch. 127, § 290; 2006, ch. 29, § 27.
The 2006 amendment, effective July 1, 2006, added Paragraph (1) of Subsection B to provide that if the loss is $250 or less, the crime is a petty misdemeanor; added Paragraph (2) of Subsection A to provide that if the loss is more than $250, but not more than $500, the crime is a misdemeanor; added Paragraph (3) of Subsection A to provide that if the loss is more than $500, but not more than $2,500, the crime is a fourth degree felony; added Paragraph (4) of Subsection A to provide that if the damage is more than $2,500 but not more than $20,000, the crime is a third degree felony; and added Paragraph (5) of Subsection B to provide that if the damage is more than $20,000, the crime is a second degree felony.
Insurance agent did not violate Subsection A by listing "draperies sales" as the type of business insured, after inspecting the premises and seeing that drapery sales, as well as manufacturing, took place there. Corbin v. State Farm Ins. Co., 1990-NMSC-014, 109 N.M. 589, 788 P.2d 345.
Am. Jur. 2d, A.L.R. and C.J.S. references. — Negligent misrepresentation as "accident" or "occurrence" warranting insurance coverage, 58 A.L.R.5th 483.

Structure New Mexico Statutes

New Mexico Statutes

Chapter 59A - Insurance Code

Article 16 - Trade Practices and Frauds

Section 59A-16-1 - Scope of article.

Section 59A-16-2 - Purpose of article.

Section 59A-16-3 - Practices and acts prohibited, in general.

Section 59A-16-4 - Misrepresentation, false advertising of policies.

Section 59A-16-5 - False information, advertising.

Section 59A-16-6 - "Twisting" prohibited.

Section 59A-16-7 - Replacement of life insurance.

Section 59A-16-7.1 - Unclaimed life insurance benefits.

Section 59A-16-8 - Falsification, omission of records; misleading financial statements.

Section 59A-16-9 - Publication of nonstatutory financial statements.

Section 59A-16-10 - Defamation.

Section 59A-16-11 - Unfair discrimination prohibited; life and health insurance.

Section 59A-16-11.1 - Medical Insurance Pool Act; unfair referral.

Section 59A-16-12 - Discrimination in insurance.

Section 59A-16-12.1 - Discrimination on the basis of deterioration in health.

Section 59A-16-13 - Prohibiting sex discrimination in insurance.

Section 59A-16-13.1 - Craniomandibular and temporomandibular joint disorders.

Section 59A-16-13.2 - Discrimination on the basis of blindness.

Section 59A-16-14 - Coercion of business prohibited; notice required; charges prohibited.

Section 59A-16-15 - Discrimination; rebates and certain inducements prohibited; life, health and annuity contracts.

Section 59A-16-16 - Exceptions to discrimination, rebate and inducement prohibition; life, health and annuity contracts.

Section 59A-16-17 - Discrimination, rebates and certain inducements prohibited; other coverages.

Section 59A-16-18 - Receipt of rebates and inducements; penalty.

Section 59A-16-19 - Monopolistic practices prohibited.

Section 59A-16-20 - Unfair claims practices defined and prohibited.

Section 59A-16-20.1 - Homeowner's casualty insurance; premium rate and policy; protection after natural disaster.

Section 59A-16-21 - Payment of claim by check, draft or electronic transfer; failure to pay; interest.

Section 59A-16-21.1 - Health plan requirements.

Section 59A-16-21.2 - Health benefits plans; prohibition; unlicensed health benefits plans; unapproved health benefits plans.

Section 59A-16-21.3 - Health care providers; surprise billing prohibited.

Section 59A-16-22 - Record of complaints required.

Section 59A-16-23 - False applications, claims, proofs of loss.

Section 59A-16-24 - Illegal dealing in premiums; excess charges for coverage.

Section 59A-16-25 - Knowledge of insurer of prohibited acts.

Section 59A-16-26 - Insurer name; deceptive use prohibited.

Section 59A-16-27 - Desist orders for prohibited practices.

Section 59A-16-28 - Procedure as to undefined practices.

Section 59A-16-29 - Penalties.

Section 59A-16-30 - Private right of action.