If you are a New Mexico resident and your insurer denies your claim after the external review process, you can file a complaint with the New Mexico Attorney General’s Office. A copy of the complaint form can be found here.

Complaint information. Your complaint should include the following information:

  • The name, address, email address, and telephone number of the person filing the complaint (“Complainant”);
  • The name, address, and telephone number of the of insurance company;
  • What actions you have taken to resolve the issue;
  • The details of the complaint; and
  • What you consider to be a fair resolution.

Supporting documents. You should submit the following documents as supporting documents with your complaint:

  • A copy of your insurance card;
  • Copies of coverage denials or adverse benefit determinations from your insurer;
  • Copies of any determinations made by internal and external reviewers;
  • Any materials submitted with prior appeals and complaints;
  • Supporting documentation from your doctor;
  • A copy of your insurance policy; and
  • All responses from your insurer.[25]

How to submit. You can mail the complaint and supporting documents to the following address:

New Mexico Attorney General’s Office
Consumer and Family Advocacy Services Division
P.O. Drawer 1508
Santa Fe, NM 87504-1508[26]