If you are a New Mexico resident, you have coverage through a managed health care insurer, and you believe your insurer did something illegal or unethical, you can file a complaint with the Office.

Complaint information. Your complaint should include the following information:

  • The name, address, telephone number, and email address of the insured;
  • The type of complaint;
  • The name of your employer and type of plan;
  • The name of the insurance company;
  • The reason for the complaint;
  • The level your claim has reached in the internal and external review processes;
  • The details of your complaint; and
  • What you think would be a fair resolution.[21]

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

  • A copy of your benefits booklet;
  • A copy of your insurance policy;
  • A copy of all correspondence related to your claim;
  • A copy of your adverse benefit determination letter; and
  • Copies of any supporting documents from your healthcare provider.[22]

How to submit. You can submit your complaint and supporting documents in the following ways:

  • Online here;
  • By email to [email protected]
  • By fax to (505) 827-4734; or
  • By mailing a copy to the following address:

Office of Superintendent of Insurance
1120 Paseo de Peralta
Santa Fe, NM 87501[23]