Key Takeaways
- The New Mexico Life and Health Insurance Guaranty Association protects policyholders when insurers become insolvent
- Coverage limits are \$300,000 for life insurance death benefits and \$100,000 for cash values
- Health insurance coverage is limited to \$500,000 per individual
- Annuity coverage is limited to \$250,000 per contract owner
- Producers cannot use guaranty association coverage as a selling point
New Mexico Life and Health Insurance Guaranty Association
The New Mexico Life and Health Insurance Guaranty Association protects New Mexico residents when life and health insurance companies become insolvent.
Purpose and Function
The Association was established under New Mexico law to:
- Protect policyholders of insolvent insurers
- Continue coverage or pay claims up to limits
- Funded by assessments on member insurers
- Operates under state law supervision
Coverage Limits
The Association provides coverage up to specific limits:
Life Insurance
| Benefit Type | Maximum Coverage |
|---|---|
| Death Benefit | $300,000 per insured life |
| Cash Surrender Value | $100,000 per insured life |
Annuities
| Benefit Type | Maximum Coverage |
|---|---|
| Present Value | $250,000 per contract owner |
Health Insurance
| Coverage Type | Maximum Coverage |
|---|---|
| Major Medical | $500,000 per individual |
Aggregate Limit
The Association has an aggregate limit per individual:
| Limit Type | Maximum |
|---|---|
| Total per Individual | $300,000 for all coverages combined |
| Multiple Policies | Combined limit applies |
Excluded Coverages
The Association does NOT cover:
| Exclusion | Reason |
|---|---|
| Unallocated Annuity Contracts | Typically group contracts |
| Funding Agreements | Not traditional insurance |
| Structured Settlements | May have separate protections |
| Investment Contracts | Not guaranteed benefits |
| Policies from Non-Member Insurers | Must be member company |
Producer Restrictions
Producers cannot:
- Use guaranty association coverage as a selling point
- Advertise guaranty association protection
- Imply policies are "guaranteed" by the association
- Compare guaranty association to FDIC insurance
- Suggest one insurer is safer due to guaranty association
Penalties for Guaranty Association Violations
| Violation | Penalty |
|---|---|
| Using as Selling Point | Fine + possible suspension |
| Advertising Protection | Fine + corrective advertising |
| Misleading Comparisons | Disciplinary action |
Exam Tip: Remember that producers CANNOT use guaranty association coverage as a selling point. This is a frequently tested concept.
How the Guaranty Association Works
When an Insurer Becomes Insolvent
- Court Order: Court declares insurer insolvent
- Rehabilitation/Liquidation: Receiver appointed
- Assessment: Association assesses member insurers
- Claims Payment: Association pays covered claims
- Policy Transfer: Policies may be transferred to solvent insurers
Consumer Rights
| Right | Description |
|---|---|
| File Claims | Continue filing claims normally |
| Coverage Continuation | Coverage continues up to limits |
| Policy Transfer | May receive offer from new insurer |
| State Resources | Contact OSI for assistance |
What is the maximum death benefit coverage provided by the New Mexico Guaranty Association?
Can a New Mexico insurance producer use guaranty association coverage as a selling point?
What is the maximum annuity coverage provided by the New Mexico Guaranty Association?
How long must New Mexico producers retain client records?
You've completed this section
Continue exploring other exams