0001| HOUSE BILL 291
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0002| 43RD LEGISLATURE - STATE OF NEW MEXICO - SECOND SESSION, 1998
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0003| INTRODUCED BY
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0004| LARRY A. LARRANAGA
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0005|
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0006|
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0007|
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0008|
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0009|
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0010| AN ACT
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0011| RELATING TO MOTOR VEHICLE INSURANCE; ENACTING THE PERSONAL
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0012| CHOICE AUTO INSURANCE ACT; AMENDING AND ENACTING SECTIONS OF
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0013| THE NMSA 1978.
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0014|
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0015| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
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0016| Section 1. [NEW MATERIAL] SHORT TITLE.--Sections 1
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0017| through 25 of this act may be cited as the "Personal Choice
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0018| Auto Insurance Act".
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0019| Section 2. [NEW MATERIAL] LEGISLATIVE FINDINGS--
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0020| PURPOSES OF ACT.--
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0021| A. The legislature finds that under former law,
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0022| New Mexico motorists were required to purchase liability
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0023| insurance primarily for the benefit of others. To protect
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0024| themselves and their family members from other motorists who
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0025| chose not to comply with the law, motorists had to purchase
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0001| additional insurance coverage. Motorists who did not purchase
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0002| liability insurance required by law were nonetheless permitted
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0003| to make liability claims against motorists who had purchased
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0004| liability insurance. That system for compensating injured
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0005| motorists was inefficient and over compensated persons with
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0006| non-serious injuries. The costs of compensating injured
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0007| persons were compounded by extraordinary litigation and claim-
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0008| processing costs that were ultimately borne by insurance
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0009| consumers and taxpayers of New Mexico.
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0010| B. The purposes of the Personal Choice Auto
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0011| Insurance Act are to:
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0012| (1) give owners of motor vehicles the option
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0013| to reduce insurance costs by choosing how they will satisfy
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0014| the requirements of the Mandatory Financial Responsibility
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0015| Act. Under the Personal Choice Auto Insurance Act, motorists
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0016| may choose to:
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0017| (a) forgo their right to sue for non-
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0018| economic and compensated economic damages arising out of a
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0019| motor vehicle accident except in certain circumstances, by
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0020| purchasing a personal compensation policy; or
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0021| (b) retain the right to recover for
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0022| damages under tort principles by rejecting purchase of a
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0023| personal compensation policy as provided in the Personal
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0024| Choice Auto Insurance Act;
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0025| (2) require insurers to make certain optional
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0001| coverages available at additional cost to motorists who choose
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0002| to purchase a personal compensation policy;
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0003| (3) encourage motorists to comply with
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0004| Mandatory Financial Responsibility Act requirements by
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0005| limiting uninsured motorists' rights to recover for loss;
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0006| (4) speed the administration of justice, ease
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0007| the burden of litigation on New Mexico courts, decrease the
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0008| expenses associated with litigation and create a system of
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0009| arbitration of claims for personal compensation benefits; and
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0010| (5) correct imbalances and abuses in the
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0011| operation of the motor vehicle accident insurance system,
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0012| encourage prompt medical treatment and rehabilitation, provide
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0013| offsets to avoid duplicate recovery and require medical
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0014| examinations.
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0015| Section 3. [NEW MATERIAL] DEFINITIONS.--As used in the
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0016| Personal Choice Auto Insurance Act:
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0017| A. "accidental bodily injury" means bodily injury,
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0018| sickness, disease or death arising out of a motor vehicle
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0019| accident, where the motor vehicle accident is unintended by
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0020| the injured person;
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0021| B. "cause of action for injury" means a claim for
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0022| accidental bodily injury caused by the negligence or
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0023| intentional misconduct of another person, including a claim by
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0024| a person other than the injured person based on such injury,
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0025| including loss of consortium, companionship or another
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0001| derivative claim;
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0002| C. "dependent" means all individuals related to
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0003| another person by blood, affinity or adoption who reside in
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0004| the same household with the person and receive financial or
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0005| services support from the person;
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0006| D. "driving under the influence of intoxicating
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0007| liquor or drugs" means an individual has been convicted, as
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0008| defined in Subsection B of Section 66-5-28 NMSA 1978, of
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0009| violating Subsection A, B, C or D of Section 66-8-102 NMSA
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0010| 1978;
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0011| E. "economic loss" means pecuniary loss and
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0012| monetary expense incurred by or on behalf of an injured person
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0013| as the result of an accidental bodily injury;
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0014| F. "injured person" means an individual who
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0015| sustains accidental bodily injury, or the personal
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0016| representative of a deceased individual's estate;
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0017| G. "insurer" means an insurer or qualified self-
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0018| insurer providing coverage on motor vehicles pursuant to the
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0019| provisions of the Personal Choice Auto Insurance Act;
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0020| H. "intentional misconduct" means conduct whereby
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0021| bodily injury is intentionally caused by a person who acts or
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0022| fails to act for the purpose of causing bodily injury, or who
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0023| knows or reasonably should have known that bodily injury is
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0024| substantially certain to result. A person does not
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0025| intentionally cause bodily injury:
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0001| (1) merely because his act or failure to act
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0002| is intentional; or
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0003| (2) if the act or omission causing bodily
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0004| injury is for the purpose of averting bodily harm to the
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0005| person so acting or to another;
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0006| I. "loss of income from work" means:
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0007| (1) if the injured person was employed or
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0008| self-employed at any time during the year preceding an
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0009| accident, eighty percent of the average weekly amount the
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0010| injured person would have earned, or could have reasonably
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0011| expected to earn but for the accidental bodily injury, through
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0012| employment in his usual occupation or profession, reduced by
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0013| either:
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0014| (a) eighty percent of the average
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0015| weekly amount received from substitute employment or self-
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0016| employment; or
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0017| (b) the average weekly amount of income
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0018| the injured person would have earned in available appropriate
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0019| substitute employment that the person was capable of
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0020| performing but unreasonably failed to undertake; or
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0021| (2) if the injured person was unemployed, the
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0022| amount of unemployment compensation benefits the injured
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0023| person would have been eligible to receive but for the
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0024| accidental bodily injury, except that "loss of income from
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0025| work" does not include any loss of income after an injured
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0001| person's death;
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0002| J. "medical expenses" means reasonable expenses
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0003| incurred by or on behalf of an injured person for necessary
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0004| medical, chiropractic, surgical, dental, ambulance, hospital,
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0005| medical rehabilitation, physical therapy and professional
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0006| nursing services and drugs, medically necessary equipment
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0007| designed primarily for a medical purpose, eyeglasses, hearing
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0008| aids and prosthetic devices, except for those expenses
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0009| incurred when accidental bodily injury is first discovered and
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0010| treated more than one year after the date of the accident or
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0011| any expense incurred more than three years after the date of
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0012| the accident. "Medical expenses" does not include:
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0013| (1) any portion of the charge for a room in
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0014| any hospital, clinic, convalescent or nursing home, extended
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0015| care facility or any similar facility in excess of the
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0016| reasonable and customary charge for semi-private
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0017| accommodations unless otherwise medically necessary;
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0018| (2) any portion of a charge or fee for any
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0019| treatments, services, products or procedures that are
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0020| experimental in nature, for research not primarily designed to
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0021| serve a medical purpose or not commonly and customarily
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0022| recognized throughout the medical profession or, in the case
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0023| of chiropractic care, not commonly and customarily recognized
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0024| throughout the chiropractic profession in the United States as
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0025| appropriate for treatment of accidental bodily injury; or
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0001| (3) that portion of any charge for services,
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0002| products or facilities that exceeds the health care provider's
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0003| reasonable and customary charge for like services, products or
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0004| facilities;
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0005| K. "medical rehabilitation" means medically
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0006| necessary rehabilitation services designed to reduce the
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0007| disability and dependence of an injured person and to restore
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0008| the person, to the extent reasonably possible, to his pre-
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0009| accident level of physical functioning;
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0010| L. "motor vehicle" means a self-propelled vehicle
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0011| of a kind required to be registered under New Mexico law for
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0012| use on public streets and highways, other than a vehicle with
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0013| three or fewer load-bearing wheels;
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0014| M. "motor vehicle insurance policy" means that
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0015| term as defined in Section 59A-7-7.1 NMSA 1978;
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0016| N. "non-economic loss" means any loss other than
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0017| economic loss, including pain, suffering, loss of enjoyment of
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0018| life, mental anguish, emotional distress and all other non-
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0019| economic damages;
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0020| O. "occupying" means to be in, upon or engaged in
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0021| the immediate act of entering into or alighting from a motor
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0022| vehicle;
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0023| P. "operation, maintenance or use" means
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0024| operation, maintenance or use of a motor vehicle as a motor
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0025| vehicle, including occupying the vehicle. "Operation,
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0001| maintenance or use" does not include:
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0002| (1) conduct in the course of the business of
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0003| repairing, servicing, washing, selling, maintaining or
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0004| manufacturing motor vehicles unless the conduct occurs off the
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0005| business premises; or
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0006| (2) conduct in the course of loading or
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0007| unloading the motor vehicle unless the conduct occurs while
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0008| engaged in the operation, maintenance or use of the vehicle;
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0009| Q. "other person responsible for maintaining
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0010| insurance coverage" means a person with a statutory or
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0011| contractual responsibility of maintaining insurance coverage
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0012| on a motor vehicle, including lessees and employees who are
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0013| responsible for insuring an employer-furnished vehicle;
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0014| R. "pedestrian" means a person not occupying a
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0015| motor vehicle;
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0016| S. "personal compensation benefits" means benefits
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0017| with an aggregate limit of at least fifteen thousand dollars
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0018| ($15,000) per person per accident for economic loss resulting
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0019| from accidental bodily injury, as follows:
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0020| (1) medical expenses;
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0021| (2) loss of income from work up to two
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0022| hundred dollars ($200) per week for not more than three years
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0023| from the date of the accident that caused the accidental
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0024| bodily injury;
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0025| (3) if the injured person is not receiving
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0001| benefits for loss of income from work, replacement services
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0002| loss up to one hundred dollars ($100) per week for not more
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0003| than three years from the date of the accident that caused the
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0004| accidental bodily injury; and
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0005| (4) a death benefit of fifteen thousand
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0006| dollars ($15,000) payable to the dependents or, if none, to
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0007| the estate of the decedent, if death occurs not more than one
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0008| year after the date of the accident causing the accidental
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0009| bodily injury;
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0010| T. "personal compensation chooser" means a
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0011| personal compensation insured or a person other than an
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0012| uninsured motorist who has not exercised his right pursuant to
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0013| Section 5 of the Personal Choice Auto Insurance Act to reject
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0014| that act's limitations on tort rights and liabilities;
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0015| U. "personal compensation insured" means:
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0016| (1) the named insured of a personal
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0017| compensation policy or a resident relative, other than a tort
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0018| chooser;
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0019| (2) a person, other than a tort chooser, who
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0020| sustains accidental bodily injury while occupying the motor
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0021| vehicle described on the declarations page of a personal
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0022| compensation policy; or
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0023| (3) with respect to accidents within New
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0024| Mexico, a pedestrian, other than a tort chooser, who sustains
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0025| accidental bodily injury through being struck by the motor
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0001| vehicle described on the declarations page of a personal
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0002| compensation policy;
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0003| V. "personal compensation policy" means an
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0004| insurance policy or qualified self-insurance plan that
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0005| provides personal compensation benefits, property damage
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0006| liability and compulsory financial responsibility coverage
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0007| applicable in jurisdictions other than New Mexico in at least
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0008| the minimum limits required by the Personal Choice Auto
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0009| Insurance Act;
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0010| W. "property damage liability" means liability
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0011| insurance coverage with a limit of at least ten thousand
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0012| dollars ($10,000) per accident, exclusive of interest and
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0013| costs, for damage to property in any one accident;
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0014| X. "replacement services loss" means expenses
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0015| reasonably incurred for ordinary and necessary services from
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0016| others in lieu of those the injured person would have
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0017| performed, not for income but for the benefit of the injured
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0018| person's family, if he had not been injured. "Replacement
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0019| services loss" does not include expenses for services
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0020| performed by any person residing in the household of the
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0021| injured person, services performed by any person related to
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0022| the injured person or services performed after the injured
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0023| person's death;
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0024| Y. "resident relative" means an individual related
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0025| to a named insured of a motor vehicle insurance policy by
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0001| blood, affinity or adoption and who customarily resides in the
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0002| same household with the named insured. An individual
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0003| customarily resides in the same household if the individual
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0004| primarily makes his home in the same family unit, even though
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0005| temporarily living elsewhere;
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0006| Z. "superintendent" means the superintendent of
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0007| insurance;
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0008| AA. "tort chooser" means a person who has
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0009| exercised his right pursuant to Section 5 of the Personal
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0010| Choice Auto Insurance Act to reject that act's limitations on
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0011| tort rights and liabilities;
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0012| BB. "tort coverage" means coverage under a motor
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0013| vehicle bodily injury and property damage liability policy in
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0014| which a tort chooser involved in an accident with a personal
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0015| compensation chooser recovers damages from the tort chooser's
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0016| own insurer for economic and non-economic loss that the tort
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0017| chooser is barred from recovering from the personal
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0018| compensation chooser. The coverage limit shall be at least
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0019| equal to the bodily injury liability limit under the policy;
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0020| and
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0021| CC. "uncompensated economic loss" means that
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0022| portion of economic loss arising out of accidental bodily
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0023| injury that exceeds the total of benefits provided by
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0024| applicable personal compensation policies and benefits
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0025| received from all other sources as reimbursement for or
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0001| arising from accidental bodily injury, other than life
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0002| insurance benefits, regardless of the nature or number of
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0003| benefit sources available or their form. "Uncompensated
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0004| economic loss" does not include:
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0005| (1) the amount of economic loss resulting
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0006| from application of a deductible under a personal compensation
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0007| policy;
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0008| (2) the amount of economic loss that would
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0009| have been covered under a personal compensation policy
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0010| providing minimum benefits that the injured person or his
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0011| resident relative was required to maintain by the Personal
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0012| Choice Auto Insurance Act but failed to maintain in effect; or
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0013| (3) the first fifteen thousand dollars
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0014| ($15,000) of economic loss sustained by a tort chooser,
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0015| regardless of whether such loss is recovered from any other
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0016| source.
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0017| Section 4. [NEW MATERIAL] MOTOR VEHICLE INSURANCE
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0018| REQUIREMENTS.--
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0019| A. Every owner or other person responsible for
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0020| maintaining insurance coverage on a motor vehicle, other than
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0021| those motor vehicles listed as exempt in Section 66-5-207 NMSA
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0022| 1978, shall be covered by a personal compensation policy
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0023| providing personal compensation benefits, property damage
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0024| liability and compulsory financial responsibility coverage
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0025| applicable in jurisdictions other than New Mexico in at least
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0001| the minimum limits required by the Personal Choice Auto
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0002| Insurance Act, unless the owner or other person responsible
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0003| for maintaining insurance coverage is a tort chooser.
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0004| B. A tort chooser is not eligible for a personal
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0005| compensation policy and shall comply with the provisions of
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0006| the Mandatory Financial Responsibility Act by obtaining a
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0007| motor vehicle bodily injury and property damage liability
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0008| policy or providing other evidence of financial
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0009| responsibility.
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0010| C. The personal compensation policy required by
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0011| this section may be provided through insurance or a qualified
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0012| plan of self-insurance approved by the superintendent. The
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0013| superintendent may approve a self-insurance plan and issue a
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0014| certificate of self-insurance if the superintendent is
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0015| satisfied that the plan is actuarially sound and will continue
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0016| to have sufficient financial assets to respond to claims.
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0017| D. The named insured of a personal compensation
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0018| policy may waive benefits for loss of income from work for an
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0019| appropriate rate reduction by completing a certification form
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0020| prescribed by the superintendent stating under oath that
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0021| neither the named insured or any resident relative has earned
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0022| income from regular employment during the past thirty days,
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0023| and that none of them expects to earn income from regular
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0024| employment for at least one hundred eighty days from the date
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0025| the certification is executed. A properly completed form
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0001| shall be conclusive proof of the insured's intent to waive
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0002| loss of income benefits.
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0003| E. Prior to the inception of a personal
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0004| compensation policy, the insurer shall offer the named insured
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0005| the additional, optional insurance coverages specified in
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0006| Subsection F of this section. A named insured's decision to
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0007| purchase or not to purchase such coverages is binding on all
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0008| insureds covered by the policy and applies to all renewals and
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0009| replacement policies until the named insured requests a
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0010| change.
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0011| F. The additional optional insurance coverages
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0012| required to be made available under a personal compensation
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0013| policy at additional cost are:
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0014| (1) personal compensation benefits covering
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0015| loss in excess of fifteen thousand dollars ($15,000) per
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0016| person, in optional increments up to not less than an
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0017| aggregate limit of one hundred thousand dollars ($100,000) per
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0018| person per accident. Except as provided in Subsection D of
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0019| this section, if the aggregate limit is one hundred thousand
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0020| dollars ($100,000) or more, the sublimit for loss of income
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0021| from work shall be not less than five hundred dollars ($500)
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0022| per week;
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0023| (2) motor vehicle bodily injury liability
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0024| insurance with a limit of not less than fifteen thousand
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0025| dollars ($15,000) per person per accident, exclusive of
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0001| interest and costs, due to accidental bodily injury and,
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0002| subject to the per-person limit, an aggregate limit of not
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0003| less than thirty thousand dollars ($30,000), exclusive of
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0004| interest and costs; and
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0005| (3) scheduled benefits coverage with limits
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0006| of at least ten thousand dollars ($10,000) per person per
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0007| accident, in optional increments up to not less than one
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0008| hundred thousand dollars ($100,000) per person per accident.
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0009| Scheduled benefits coverage shall provide benefits, payable in
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0010| addition to and without regard to any other benefits payable,
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0011| for loss from accidental bodily injury sustained by the named
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0012| insured of a personal compensation policy or a resident
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0013| relative who is not a tort chooser while engaged in the
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0014| operation, maintenance or use of a motor vehicle or as a
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0015| pedestrian. Scheduled benefits coverage shall be paid as
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0016| follows, provided that only the largest applicable benefit
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0017| shall be paid for any one person for a single accident:
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0018| (a) loss of life, the principal sum;
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0019| (b) permanent and total disability, the
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0020| principal sum;
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0021| (c) loss of two or more members, the
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0022| principal sum;
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0023| (d) loss of one member, one-half of the
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0024| principal sum;
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0025| (e) loss of thumb and index finger on
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0001| the same hand, one-fourth of the principal sum;
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0002| (f) permanent and total loss of
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0003| hearing, one-half of the principal sum;
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0004| (g) permanent and total loss of the
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0005| sense of smell or taste, one-fourth of the principal sum;
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0006| (h) loss of a finger or toe, one-eighth
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0007| of the principal sum;
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0008| (i) serious permanent disfigurement,
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0009| one-eighth of the principal sum; and
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0010| (j) permanent and total loss of use of
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0011| an internal organ, one-eighth of the principal sum.
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0012| G. As used in Paragraph (3) of Subsection F of
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0013| this section:
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0014| (1) "loss" means, with regard to a hand or
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0015| foot, permanent, complete loss of use of the hand or foot, or
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0016| actual severance of the hand or foot through or above the
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0017| wrist or ankle joints; with regard to an eye, complete,
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0018| irrecoverable loss of sight; with regard to a thumb,
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0019| permanent, complete loss of use of the thumb or actual
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0020| severance of the thumb through the proximal phalanx or
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0021| metacarpal; with regard to the index finger or any other
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0022| finger, permanent, complete loss of use of the particular
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0023| finger or actual severance of the particular finger through
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0024| the middle or proximal phalanx or metacarpal; and with regard
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0025| to any toe, actual severance through the proximal phalanx or
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0001| metacarpal of the particular toe;
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0002| (2) "member" means hand, foot or eye;
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0003| (3) "permanent and total disability" means,
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0004| for persons who have reached the age of majority or who are
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0005| working full time at the time of the accidental bodily injury,
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0006| the insured's complete inability after one year of continuous
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0007| total disability to engage in an occupation or employment for
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0008| which the insured is fitted by reason of education, training
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0009| or experience for the remainder of the insured's life. As
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0010| used in this paragraph, "continuous total disability" means
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0011| the insured's complete inability during the first year of
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0012| disability to perform every duty of the insured's occupation.
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0013| Such inability shall commence within thirty days after the
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0014| date of the accident. For persons who are both under the age
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0015| of majority and not working full time at the time of the
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0016| accidental bodily injury, "permanent and total disability"
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0017| means for two consecutive years having an abnormal
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0018| electroencephalography and abnormal brain magnetic resonance
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0019| image or the presence of seizures for two consecutive years;
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0020| and
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0021| (4) "principal sum" means the coverage limit
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0022| for scheduled benefits coverage.
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0023| H. An insurer may offer:
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0024| (1) limits higher than those required by this
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0025| section;
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0001| (2) deductible and coinsurance options for
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0002| the coverage described in Paragraph (1) of Subsection F of
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0003| this section;
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0004| (3) a limit on the coverage specified in
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0005| Paragraph (2) of Subsection F of this section on a combined
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0006| limit basis instead of a split limits basis; and
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0007| (4) coverages in addition to those required
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0008| by this section, including collision and comprehensive
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0009| physical damage.
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0010| I. Any coverages provided pursuant to this section
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0011| shall be subject to the premium rates, policy forms, terms,
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0012| limitations, conditions and exclusions approved by the
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0013| superintendent.
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0014| J. The coverages provided pursuant to this section
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0015| shall be subject to the provisions of Section 8 and Section 10
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0016| of the Personal Choice Auto Insurance Act.
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0017| K. Each insurer shall furnish the first named
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0018| insured with a card constituting evidence of financial
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0019| responsibility and proof of insurance, provided that the card
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0020| shall not be deemed to create insurance coverage if the policy
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0021| has, in fact, lapsed or been canceled on the date of the
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0022| accident. The card, insurance policy, insurance policy
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0023| binder, certificate of insurance or such other proof as may be
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0024| prescribed by the motor vehicle division of the taxation and
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0025| revenue department shall constitute sufficient proof of
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0001| insurance and evidence of financial responsibility for
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0002| purposes of New Mexico law.
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0003| Section 5. [NEW MATERIAL] RIGHT OF REJECTION--
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0004| UNIFORMITY OF CHOICE.--
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0005| A. Any person or a resident relative, including a
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0006| person who is not the owner or other person responsible for
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0007| maintaining insurance coverage on a motor vehicle, may execute
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0008| a form prescribed by the superintendent rejecting the
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0009| limitations on tort rights and liabilities of the Personal
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0010| Choice Auto Insurance Act and shall file the form with the
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0011| superintendent, who shall maintain the forms as public
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0012| records. Rejection is effective with respect to any accident
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0013| occurring after the date and time the superintendent receives
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0014| the rejection form. Rejection for a minor or incapacitated
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0015| person shall be made on his behalf by his parent or guardian
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0016| and shall remain effective until revoked or until the person
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0017| is no longer a minor or incapacitated, whichever comes first.
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0018| Completion and filing of the form prescribed by the
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0019| superintendent shall be conclusive proof that the person
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0020| completing the form made an informed and knowledgeable
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0021| decision concerning rejection. Rejection remains effective
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0022| until revoked in writing on a form prescribed by the
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0023| superintendent.
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0024| B. Each person so rejecting, if he is the owner or
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0025| other person responsible for maintaining insurance coverage on
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0001| a motor vehicle, shall maintain in effect a policy of motor
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0002| vehicle bodily injury and property damage liability insurance
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0003| with at least the minimum coverages, including tort coverage,
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0004| and limits required by the Personal Choice Auto Insurance Act
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0005| and the Mandatory Financial Responsibility Act.
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0006| C. A person who effectively rejects in compliance
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0007| with Subsections A and B of this section retains all tort
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0008| rights and tort liabilities to the extent provided in the
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0009| Personal Choice Auto Insurance Act. No such person is
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0010| entitled to collect personal compensation benefits under any
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0011| policy unless he has subsequently revoked the rejection as
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0012| provided in Subsection D of this section.
|
0013| D. Revocation of rejection forms shall be made on
|
0014| a form prescribed by the superintendent. Revocation becomes
|
0015| effective as of the date and time the superintendent receives
|
0016| it. Revocation remains effective until superseded by the
|
0017| filing of a rejection form. Regardless of the nonfiling of
|
0018| subsequent revocation forms, a person eligible for payment of
|
0019| personal compensation benefits as a named insured under a
|
0020| personal compensation policy shall be deemed to have withdrawn
|
0021| any rejection.
|
0022| E. In order to minimize conflict in choices
|
0023| between personal compensation choosers and tort choosers,
|
0024| insurers are authorized to maintain underwriting rules that
|
0025| require uniformity of choice by the named insured and all
|
- 20 -
0001| resident relatives.
|
0002| F. The superintendent shall adopt and promulgate
|
0003| rules governing:
|
0004| (1) rejection and revocation of such
|
0005| rejection pursuant to this section, including situations
|
0006| involving multiple vehicles and multiple policies in the same
|
0007| household; and
|
0008| (2) a system for maintaining and providing
|
0009| access to forms filed pursuant to this section.
|
0010| Section 6. [NEW MATERIAL] CONSUMER INFORMATION
|
0011| PROGRAM.--
|
0012| A. The superintendent shall establish and maintain
|
0013| a program to inform consumers about the comparative costs of a
|
0014| personal compensation policy and a motor vehicle bodily injury
|
0015| and property damage liability policy, including with the
|
0016| latter required minimum uninsured motorist coverage, as well
|
0017| as the benefits, rights and responsibilities under each type
|
0018| of insurance. The program shall include procedures for
|
0019| informing insureds of their right of rejection.
|
0020| B. The superintendent shall prepare a budget
|
0021| reflecting costs associated with carrying out his
|
0022| responsibilities under the Personal Choice Auto Insurance Act.
|
0023| The superintendent's budgeted costs shall be assessed annually
|
0024| to all motor vehicle insurers doing business in New Mexico pro
|
0025| rata on the basis of earned premium reported for the preceding
|
- 21 -
0001| calendar year.
|
0002| C. Any person, after being provided information in
|
0003| a form approved by the superintendent explaining the basis for
|
0004| choosing between being a personal compensation chooser and a
|
0005| tort chooser, shall be bound to the terms of the status and
|
0006| coverage chosen and is precluded from claiming liability
|
0007| against any other person based on being inadequately informed.
|
0008| Section 7. [NEW MATERIAL] APPLICATION OF PERSONAL
|
0009| COMPENSATION BENEFITS AND COVERAGES TO OTHER JURISDICTIONS.--
|
0010| A. A personal compensation policy shall pay
|
0011| personal compensation benefits for accidental bodily injury of
|
0012| a personal compensation insured sustained within the United
|
0013| States, its territories or possessions or Canada.
|
0014| B. A personal compensation policy shall, if an
|
0015| insured becomes subject to a compulsory financial
|
0016| responsibility or similar law of another jurisdiction of the
|
0017| United States, its territories or possessions or Canada,
|
0018| provide the coverage required by the law of that jurisdiction.
|
0019| Section 8. [NEW MATERIAL] PERSONS NOT ENTITLED TO
|
0020| PERSONAL COMPENSATION BENEFITS--LIMITATIONS ON PERSONAL
|
0021| COMPENSATION BENEFITS.--
|
0022| A. Notwithstanding any other provision of the
|
0023| Personal Choice Auto Insurance Act, an insurer is not
|
0024| obligated to provide personal compensation benefits for any
|
0025| injured person who:
|
- 22 -
0001| (1) was injured in a motor vehicle accident
|
0002| while committing a felony or while voluntarily operating or
|
0003| occupying a vehicle known by him to be stolen;
|
0004| (2) was injured while engaged in the
|
0005| operation, maintenance or use of a motor vehicle owned by,
|
0006| furnished to or available for the regular use of the injured
|
0007| person, or a resident relative of the injured person, if such
|
0008| motor vehicle is not covered by the policy against which a
|
0009| claim is made;
|
0010| (3) was injured as a pedestrian by a motor
|
0011| vehicle owned by, furnished to or available for the regular
|
0012| use of the injured person, or a resident relative of the
|
0013| injured person, if the motor vehicle is not covered by the
|
0014| policy against which a claim is made;
|
0015| (4) was injured as a result of his
|
0016| intentional misconduct. If a person dies as a result of his
|
0017| intentional misconduct, the insurer is not obligated to
|
0018| provide the person's dependents and estate his personal
|
0019| compensation benefits;
|
0020| (5) was an uninsured motorist at the time of
|
0021| the accident causing the injuries. As used in this paragraph,
|
0022| "uninsured motorist" means a person who is the owner of or
|
0023| other person responsible for maintaining insurance coverage on
|
0024| a motor vehicle pursuant to the Personal Choice Auto Insurance
|
0025| Act but who has failed to maintain the coverage;
|
- 23 -
0001| (6) was injured while operating or occupying
|
0002| a motor vehicle involved in an organized race or speed
|
0003| contest; or
|
0004| (7) is a tort chooser.
|
0005| B. There shall be no coverage for the named
|
0006| insured or any resident relative under a personal compensation
|
0007| policy while operating or occupying a self-propelled vehicle
|
0008| with three or fewer load-bearing wheels.
|
0009| C. An insurer shall not be obligated to pay
|
0010| personal compensation benefits, other than medical payments,
|
0011| to or on behalf of any injured person who was driving under
|
0012| the influence of intoxicating liquor or drugs.
|
0013| D. Nothing in this section bars an insurer from
|
0014| providing personal compensation benefits for any injured
|
0015| person, otherwise excluded by this section, if the policy
|
0016| clearly states that it provides the coverage.
|
0017| Section 9. [NEW MATERIAL] PAYMENT OF PERSONAL
|
0018| COMPENSATION BENEFITS.--Personal compensation benefits are
|
0019| payable to any one of the following:
|
0020| A. the injured person;
|
0021| B. the parent or guardian of the injured person,
|
0022| if the injured person is a minor or incapacitated;
|
0023| C. a dependent or the personal representative of
|
0024| the estate of the injured person; or
|
0025| D. any person providing medical or other health
|
- 24 -
0001| care services, products or facilities for which payment is
|
0002| due.
|
0003| Section 10. [NEW MATERIAL] PRIORITY OF BENEFITS.--
|
0004| A. Personal compensation policies are liable to
|
0005| pay personal compensation benefits in the following order of
|
0006| priority up to their respective coverage limits:
|
0007| (1) the personal compensation policy covering
|
0008| a motor vehicle involved in the accident, if the injured
|
0009| person was engaged in the operation, maintenance or use of the
|
0010| motor vehicle or was a pedestrian injured by the motor vehicle
|
0011| at the time of the accident;
|
0012| (2) any personal compensation policy under
|
0013| which the injured person is a named insured;
|
0014| (3) any personal compensation policy under
|
0015| which the injured person is a resident relative; and
|
0016| (4) any personal compensation policy under
|
0017| which the injured person qualifies as a personal compensation
|
0018| insured other than as described in Paragraphs (1) through (3)
|
0019| of this subsection.
|
0020| B. Subject to the payment priorities in Subsection
|
0021| A of this section, if a personal compensation insured is
|
0022| entitled to benefits under more than one personal compensation
|
0023| policy or coverage, the maximum recovery shall not exceed the
|
0024| amount payable under the personal compensation policy with the
|
0025| highest limit.
|
- 25 -
0001| C. If two or more insurers are obligated to pay
|
0002| personal compensation benefits at the same priority, the
|
0003| insurer against whom the claim is first made shall pay the
|
0004| claim up to that insurer's policy limits as if wholly
|
0005| responsible and may thereafter recover contribution pro rata
|
0006| on the basis of coverage limits from any other insurer at the
|
0007| same priority level.
|
0008| D. For purposes of payment of personal
|
0009| compensation benefits only, an unoccupied, parked motor
|
0010| vehicle is not a motor vehicle involved in an accident unless
|
0011| it was parked in such a way as to cause unreasonable risk of
|
0012| injury.
|
0013| Section 11. [NEW MATERIAL] COORDINATION OF BENEFITS.--
|
0014| The personal compensation insurer has the primary obligation
|
0015| to indemnify its personal compensation insured who sustains
|
0016| accidental bodily injury; provided that personal compensation
|
0017| benefits are excess over and shall not duplicate the amount of
|
0018| benefits an injured person recovers, or is entitled to
|
0019| recover, under a state or federal workers' compensation law or
|
0020| similar occupational injury law, based on the same accidental
|
0021| bodily injury.
|
0022| Section 12. [NEW MATERIAL] LIMITATIONS ON TORT RIGHTS
|
0023| AND LIABILITIES--CLAIMS FOR UNCOMPENSATED ECONOMIC LOSS.--
|
0024| A. Except as provided otherwise in Subsection C or
|
0025| D of this section:
|
- 26 -
0001| (1) no person, other than a tort chooser,
|
0002| shall have a cause of action in tort or otherwise for
|
0003| accidental bodily injury caused in whole or in part by the
|
0004| operation, maintenance or use of a motor vehicle subject to
|
0005| the Personal Choice Auto Insurance Act, other than for
|
0006| uncompensated economic loss; and
|
0007| (2) a tort chooser shall have no cause of
|
0008| action in tort or otherwise against a personal compensation
|
0009| chooser for accidental bodily injury caused in whole or in
|
0010| part by the operation, maintenance or use of a motor vehicle
|
0011| subject to the Personal Choice Auto Insurance Act, other than
|
0012| for uncompensated economic loss.
|
0013| B. Subject to the provisions of Subsection A of
|
0014| this section and except as provided otherwise in Subsection C
|
0015| or D of this section, an uninsured motorist shall not have a
|
0016| cause of action to recover damages resulting from an accident
|
0017| arising out of the operation, maintenance or use of a motor
|
0018| vehicle from a personal compensation chooser or a tort chooser
|
0019| for:
|
0020| (1) the first fifteen thousand dollars
|
0021| ($15,000) of economic loss resulting from accidental bodily
|
0022| injury; or
|
0023| (2) the first ten thousand dollars ($10,000)
|
0024| of property damage.
|
0025| C. As used in this section, "uninsured motorist"
|
- 27 -
0001| means a person who is the owner of or other person responsible
|
0002| for maintaining insurance coverage on a motor vehicle subject
|
0003| to the insurance requirements of the Personal Choice Auto
|
0004| Insurance Act, but who fails to maintain the minimum required
|
0005| coverages.
|
0006| D. Any person shall have a cause of action under
|
0007| common law tort principles for economic and non-economic loss
|
0008| against any other person who causes accidental bodily injury
|
0009| or motor vehicle property damage while committing a felony or
|
0010| while driving under the influence of intoxicating liquor or
|
0011| drugs. Insurers are prohibited from paying the damages
|
0012| assessed against an insured pursuant to this subsection,
|
0013| except for economic loss.
|
0014| E. Any person shall have a cause of action under
|
0015| common law tort principles for economic and non-economic loss
|
0016| resulting from accidental bodily injury or property damage
|
0017| caused by intentional misconduct of another person. Insurers
|
0018| are prohibited from paying damages assessed against an insured
|
0019| pursuant to this subsection.
|
0020| F. Nothing in this section is intended to limit
|
0021| any cause of action in tort or otherwise against a person
|
0022| other than an individual who is engaged in the operation,
|
0023| maintenance or use of a vehicle at the time of an accident.
|
0024| Section 13. [NEW MATERIAL] CLAIMS FOR UNCOMPENSATED
|
0025| ECONOMIC LOSS--SETTLEMENT PERIOD--ATTORNEY FEES.--
|
- 28 -
0001| A. Any claimant seeking recovery for uncompensated
|
0002| economic loss from another person, as authorized by the
|
0003| Personal Choice Auto Insurance Act, shall make demand for
|
0004| settlement in writing, accompanied by supporting documentation
|
0005| and all relevant bills and employer records, to the person or
|
0006| the person's insurer at least thirty days before filing any
|
0007| lawsuit seeking damages against the person. The person
|
0008| against whom the claim is made or his insurer shall reply in
|
0009| writing to the demand prior to the last day of the settlement
|
0010| period, or the person shall be deemed to have made no offer.
|
0011| If any applicable statute of limitation would otherwise run
|
0012| during the thirty-day settlement period, that statute of
|
0013| limitation shall be tolled until the end of the second
|
0014| business day after the last day of the settlement period. The
|
0015| thirty-day settlement period shall begin to run on the day the
|
0016| written demand is mailed or otherwise delivered.
|
0017| B. If the claimant is unable to reach an agreement
|
0018| with the person against whom the claim is made or the person's
|
0019| insurer by the last day of the settlement period, the claimant
|
0020| shall be entitled to file a lawsuit seeking uncompensated
|
0021| economic loss based on common law tort principles. If the
|
0022| claimant is deemed the prevailing party in the lawsuit as
|
0023| provided in this subsection, he shall, in addition to any
|
0024| damages awarded, be awarded reasonable attorney fees, not to
|
0025| exceed one-third of the gross amount of the recovery,
|
- 29 -
0001| exclusive of interest and court costs; provided that if the
|
0002| gross recovery exceeds one hundred thousand dollars
|
0003| ($100,000), the maximum fee shall be limited to one-third of
|
0004| the amount up to one hundred thousand dollars ($100,000) plus
|
0005| fifteen percent of the amount in excess of one hundred
|
0006| thousand dollars ($100,000). The claimant shall be deemed to
|
0007| be the prevailing party if he is awarded damages, exclusive of
|
0008| interest and court costs, in an amount equal to or greater
|
0009| than the midpoint between the last written demand made during
|
0010| the settlement period by the claimant and the last written
|
0011| offer made during the settlement period by the person against
|
0012| whom the claim is made or the person's insurer.
|
0013| C. Nothing in this section shall be deemed to
|
0014| prohibit the parties from compromising a claim at any time by
|
0015| mutual agreement.
|
0016| Section 14. [NEW MATERIAL] RIGHT OF SUBROGATION--
|
0017| CONDITIONS.--An insurer shall be subrogated, to the extent of
|
0018| any personal compensation benefits paid, to all of the rights
|
0019| of its insured with respect to an accident caused, in whole or
|
0020| in part, by the fault of any person who is not a personal
|
0021| compensation chooser.
|
0022| Section 15. [NEW MATERIAL] PAYMENT OF INSURANCE
|
0023| BENEFITS--CAUSES OF ACTION.--
|
0024| A. No offset shall be allowed against personal
|
0025| compensation benefits due based on the value of a cause of
|
- 30 -
0001| action until after a monetary recovery is made. After
|
0002| recovery is made, a deduction from future benefits may be made
|
0003| in no more than the amount of the net recovery, exclusive of
|
0004| attorney fees, expenses and costs incurred in effecting the
|
0005| recovery.
|
0006| B. If personal compensation benefits have been
|
0007| received, the insurer may require the recipient to repay, out
|
0008| of such recovery, an amount equal to the personal compensation
|
0009| benefits received but not more than the net recovery,
|
0010| exclusive of attorney fees, expenses and costs incurred in
|
0011| effecting the recovery. Any remainder of the net recovery
|
0012| shall be credited periodically against loss as it accrues,
|
0013| until an amount equal to the net recovery has been deducted.
|
0014| The insurer shall have a lien on the recovery equal to net
|
0015| personal compensation benefits received.
|
0016| C. Recovery on a cause of action shall not operate
|
0017| to reduce personal compensation benefit coverage limits, which
|
0018| shall be paid out in full to the extent economic loss exceeds
|
0019| the amount of recovery.
|
0020| Section 16. [NEW MATERIAL] PERSONAL COMPENSATION
|
0021| BENEFITS--PROMPT PAYMENT.--
|
0022| A. Personal compensation benefits shall be paid as
|
0023| loss accrues. Loss accrues when medical expense, loss of
|
0024| income from work or replacement services loss occurs or when
|
0025| the injured person dies. Notwithstanding any provision of the
|
- 31 -
0001| New Mexico Insurance Code, personal compensation benefits for
|
0002| accrued losses are overdue if not paid within thirty days
|
0003| after the insurer receives reasonable proof of the fact and
|
0004| the amount of loss; provided that an insurer may accumulate
|
0005| claims for periods not exceeding thirty days, in which case
|
0006| benefits are not overdue if paid within twenty days after the
|
0007| last day of the period of accumulation. If reasonable proof
|
0008| is not supplied as to the entire claim, the amount that is
|
0009| supported by reasonable proof shall be paid promptly as
|
0010| provided in this subsection, and any part of the remainder of
|
0011| the claim that is later supported by reasonable proof shall be
|
0012| paid promptly in the same manner.
|
0013| B. For the purpose of calculating the extent to
|
0014| which personal compensation benefits are overdue, payment
|
0015| shall be treated as made on the date a draft or other valid
|
0016| instrument is placed in the United States mail in a properly
|
0017| addressed postpaid envelope or, if not mailed, on the date of
|
0018| personal delivery to the insured.
|
0019| C. Notwithstanding any provision of the New Mexico
|
0020| Insurance Code, if an insurer is found after an administrative
|
0021| hearing by the superintendent or upon review by a court of
|
0022| competent jurisdiction to be in violation of this section, the
|
0023| exclusive remedy shall be the recovery of the personal
|
0024| compensation benefits and interest at a rate of twelve percent
|
0025| a year beginning from the date the benefits were due, together
|
- 32 -
0001| with reasonable attorney fees, expenses and costs. In the
|
0002| event of an insurer's willful or wanton failure to comply with
|
0003| this section, the recovery shall be three times the amount of
|
0004| the personal compensation benefits that are overdue, together
|
0005| with attorney fees, expenses and costs.
|
0006| Section 17. [NEW MATERIAL] ASSIGNMENT OR GARNISHMENT--
|
0007| PERSONAL COMPENSATION BENEFITS EXEMPT.--
|
0008| A. Personal compensation benefits are exempt from
|
0009| garnishment, attachment, execution or any other process or
|
0010| claim to the extent that wages or earnings are exempt under
|
0011| any applicable law.
|
0012| B. An agreement for assignment of any right to
|
0013| personal compensation benefits payable in the future shall be
|
0014| unenforceable except to the extent that:
|
0015| (1) benefits are for the cost of medical or
|
0016| other health care services, products or facilities provided or
|
0017| to be provided by the assignee; or
|
0018| (2) benefits for loss of income from work or
|
0019| replacement services loss are assigned for payment of alimony,
|
0020| maintenance or child support.
|
0021| Section 18. [NEW MATERIAL] LIMITATION OF ACTIONS.--
|
0022| A. Subject to the arbitration provisions in
|
0023| Section 24 of the Personal Choice Auto Insurance Act, if no
|
0024| personal compensation benefits have been paid, an action
|
0025| therefor may not be commenced against the insurer later than
|
- 33 -
0001| two years after the date of the accident causing the injuries.
|
0002| B. Subject to the arbitration provisions in
|
0003| Section 24 of the Personal Choice Auto Insurance Act, if
|
0004| personal compensation benefits have been paid, an action for
|
0005| recovery of further personal compensation benefits may be
|
0006| commenced no later than two years after the date of the last
|
0007| payment of personal compensation benefits; provided that no
|
0008| action for personal compensation benefits shall be commenced
|
0009| against an insurer more than four years after the date of the
|
0010| accident.
|
0011| C. The statute of limitations period for personal
|
0012| injury provided in Section 37-1-8 NMSA 1978 shall, for a cause
|
0013| of action for uncompensated economic loss under the Personal
|
0014| Choice Auto Insurance Act, commence on the day after the
|
0015| insured has incurred economic loss in excess of fifteen
|
0016| thousand dollars ($15,000) or the insured has exhausted his
|
0017| policy limits, whichever is earlier.
|
0018| Section 19. [NEW MATERIAL] MENTAL AND PHYSICAL
|
0019| EXAMINATIONS.--
|
0020| A. If the mental or physical condition of an
|
0021| injured person is material to any claim that has been or may
|
0022| be made for personal compensation benefits, the injured
|
0023| person, upon request of an insurer, shall submit to reasonable
|
0024| mental or physical examination by a health care provider
|
0025| designated by the insurer at a reasonably convenient time and
|
- 34 -
0001| location, subject to rules, if any, adopted and promulgated by
|
0002| the superintendent. The cost of any such examination shall be
|
0003| borne by the insurer and shall not be charged against or
|
0004| operate to reduce benefit limits.
|
0005| B. If an insurer has requested in writing that an
|
0006| injured person submit to mental or physical examination
|
0007| pursuant to Subsection A of this section and the person
|
0008| refuses to comply, the insurer may, upon at least thirty days'
|
0009| prior written notice to the insured, suspend all future
|
0010| personal compensation benefits and cease payment of any
|
0011| incurred but unpaid portion of bills for services, which such
|
0012| examination is intended to verify as medically necessary,
|
0013| until the injured person complies with the request.
|
0014| Section 20. [NEW MATERIAL] EMPLOYER AND PROVIDER
|
0015| REQUIREMENTS--MEDICAL EXPENSE REVIEW.--
|
0016| A. Upon request of an insurer, an employer shall
|
0017| furnish a statement of the work record and earnings of an
|
0018| injured person who has filed a claim for personal compensation
|
0019| benefits. The statement shall cover the period specified by
|
0020| the insurer and may include the one-year period before, and
|
0021| the entire period after, the date of the accident.
|
0022| B. To ensure that the treatment and expenses are
|
0023| both reasonable and necessary, insurers may review or obtain a
|
0024| review of treatment and expenses prior to, during and after
|
0025| the course of treatment of an injured person.
|
- 35 -
0001| C. Every medical or other health care provider
|
0002| providing, before or after an injury upon which a claim for
|
0003| personal compensation benefits is based, any services,
|
0004| products or facilities in relation to that or any other
|
0005| injury, or in relation to a condition claimed to be connected
|
0006| with that or any other injury, shall, upon request of the
|
0007| insurer against whom the claim has been made, furnish the
|
0008| insurer a written report of the history, condition, treatment
|
0009| and dates and costs of treatment of the injured person. The
|
0010| information shall be provided with a declaration that the
|
0011| services, products or facilities rendered were reasonable and
|
0012| necessary with respect to the injury sustained and shall
|
0013| identify which expenses were incurred as a result of the
|
0014| injury. Each medical or other health care provider shall also
|
0015| produce in a timely manner and permit the inspection and
|
0016| copying of its records regarding such history, condition,
|
0017| treatment and the dates and costs thereof. The person
|
0018| providing the declaration required under this section shall
|
0019| attest to it as follows: "I declare that I have read the
|
0020| foregoing and the facts alleged are true, to the best of my
|
0021| knowledge and belief.". The cost of obtaining the information
|
0022| and records required by this subsection shall be borne by the
|
0023| insurer and shall not be charged against or operate to reduce
|
0024| benefit limits.
|
0025| D. No cause of action for violation of the
|
- 36 -
0001| physician-patient privilege or invasion of the right of
|
0002| privacy shall exist against any medical or other health care
|
0003| provider complying with the provisions of this section, but
|
0004| the insurer is responsible for ensuring the confidentiality of
|
0005| the records in the hands of its officers, employees and
|
0006| agents.
|
0007| E. A dispute regarding the right to the discovery
|
0008| of facts about an injured person by the insurer may be
|
0009| resolved through arbitration as provided in Section 24 of the
|
0010| Personal Choice Auto Insurance Act or in court proceedings.
|
0011| Section 21. [NEW MATERIAL] ASSIGNED CLAIMS PLAN.--
|
0012| A. Insurers, other than self-insurance plans,
|
0013| authorized to provide insurance under the Personal Choice Auto
|
0014| Insurance Act shall organize, participate in and maintain an
|
0015| assigned claims plan to provide benefits equivalent to the
|
0016| minimum personal compensation benefits required by that act to
|
0017| an injured person covered by that act if the person is not a
|
0018| tort chooser or a resident relative of an uninsured motorist
|
0019| as defined in Paragraph (5) of Subsection A of Section 8 of
|
0020| that act and if:
|
0021| (1) personal compensation benefits are
|
0022| unavailable, for a reason other than as specified in Section 8
|
0023| of that act; or
|
0024| (2) personal compensation benefits are
|
0025| unavailable because of the insolvency of an insurer for whose
|
- 37 -
0001| covered claims the New Mexico property and casualty insurance
|
0002| guaranty association is not responsible.
|
0003| B. The assigned claims plan shall adopt bylaws and
|
0004| rules, and enter into necessary agreements for the operation
|
0005| of the plan and the equitable distribution of costs, as
|
0006| approved by the superintendent.
|
0007| C. Any claim brought through the assigned claims
|
0008| plan shall be assigned to an insurer in accordance with the
|
0009| plan's bylaws and rules. Upon such assignment, the insurer
|
0010| shall have the rights and obligations it would have had if,
|
0011| prior to such assignment, it had issued a personal
|
0012| compensation policy providing the minimum personal
|
0013| compensation coverage required by law.
|
0014| D. Any person accepting personal compensation
|
0015| benefits under the assigned claims plan shall have the rights
|
0016| and obligations the person would have had under a personal
|
0017| compensation policy issued to him providing the minimum
|
0018| personal compensation coverage required by law.
|
0019| E. Benefits available through the assigned claims
|
0020| plan shall be reduced to the extent that benefits covering the
|
0021| same loss are available from other sources, regardless of the
|
0022| nature or number of benefit sources available and regardless
|
0023| of the nature or form of the benefits. The plan coverage
|
0024| shall be deemed secondary to those sources.
|
0025| F. The assigned claims plan and the insurer to
|
- 38 -
0001| whom the claim is assigned are subrogated, to the extent of
|
0002| personal compensation benefits paid for a loss, to all of the
|
0003| rights of the claimant against any person liable for the loss
|
0004| and against any insurer, its successor in interest or any
|
0005| other person or organization legally obligated to provide
|
0006| personal compensation benefits to the injured person for the
|
0007| loss.
|
0008| Section 22. [NEW MATERIAL] INCENTIVES FOR INSUREDS.--
|
0009| Each insurer shall adopt an actuarially sound program that
|
0010| provides incentives to a personal compensation chooser in the
|
0011| form of increased benefits, reduced premiums or other methods
|
0012| to:
|
0013| A. purchase motor vehicles equipped with automatic
|
0014| seat and harness belts or air bags, but the incentives shall
|
0015| not include a provision for a loss of coverage or benefits for
|
0016| failure to use the devices; and
|
0017| B. have medical expense benefits delivered by a
|
0018| managed care program designated by the insurer, but only the
|
0019| actual cost of the benefits to the insurer shall be charged
|
0020| against the policy limits.
|
0021| Section 23. [NEW MATERIAL] RULES.--The superintendent
|
0022| may adopt and promulgate rules necessary to provide for the
|
0023| effective implementation and administration of the Personal
|
0024| Choice Auto Insurance Act that are consistent with its
|
0025| purposes.
|
- 39 -
0001| Section 24. [NEW MATERIAL] ARBITRATION.--
|
0002| A. Any dispute with respect to personal
|
0003| compensation benefits between an insurer and an injured
|
0004| person, or the dependents or estate of such person, may be
|
0005| submitted to arbitration pursuant to the provisions of this
|
0006| section if the insurer and the person agree. Only the dispute
|
0007| that the parties have agreed to arbitrate may be addressed by
|
0008| the arbitration.
|
0009| B. Upon agreement for arbitration, the parties may
|
0010| agree on a single arbitrator or, if no such agreement can be
|
0011| reached, each party shall select a competent arbitrator, and
|
0012| the two arbitrators so named shall select a third arbitrator.
|
0013| If unable to agree on the third arbitrator within thirty days,
|
0014| either party may request a judge of the district court in the
|
0015| county in which the arbitration is pending to select the third
|
0016| arbitrator. The written decision of the arbitrator, or any
|
0017| two arbitrators if a panel of three is used, shall be binding
|
0018| on each party.
|
0019| C. The cost of any arbitrator or any expert
|
0020| witness selected by one party shall be paid by that party.
|
0021| The cost of any arbitrator agreed upon by the parties or their
|
0022| arbitrators and other expenses of arbitration shall be shared
|
0023| equally by both parties.
|
0024| D. The arbitration shall take place in the county
|
0025| in which the insured resides unless the parties agree to
|
- 40 -
0001| another location. The Rules of Civil Procedure and Rules of
|
0002| Evidence for the District Courts shall apply.
|
0003| Section 25. [NEW MATERIAL] OUT-OF-STATE VEHICLES.--
|
0004| A. Each insurer doing business in New Mexico shall
|
0005| file with the superintendent, as a condition of its continued
|
0006| transaction of business, a form approved by the superintendent
|
0007| declaring that any contract of primary motor vehicle
|
0008| insurance, wherever issued, covering the operation,
|
0009| maintenance or use of a motor vehicle shall be deemed, while
|
0010| the motor vehicle is in New Mexico, to provide at least the
|
0011| minimum benefits required for a personal compensation policy
|
0012| by the Personal Choice Auto Insurance Act. The insured under
|
0013| any such policy is deemed to have elected coverage under a
|
0014| personal compensation policy, and to have accepted the
|
0015| limitations on tort rights and liabilities of the Personal
|
0016| Choice Auto Insurance Act.
|
0017| B. The provisions of this section do not apply to
|
0018| any named insured who, prior to a motor vehicle accident
|
0019| within New Mexico, has become a tort chooser pursuant to
|
0020| Section 5 of the Personal Choice Auto Insurance Act. With
|
0021| respect to such a tort chooser, the bodily injury and property
|
0022| damage liability limits of the policy shall be operative,
|
0023| subject to conformance with the Mandatory Financial
|
0024| Responsibility Act.
|
0025| Section 26. Section 59A-7-7 NMSA 1978 (being Laws 1984,
|
- 41 -
0001| Chapter 127, Section 113) is amended to read:
|
0002| "59A-7-7. "VEHICLE" INSURANCE DEFINED.--"Vehicle"
|
0003| insurance is insurance covering:
|
0004| A. physical damage. Insurance against loss of or
|
0005| damage to any land vehicle or aircraft or any draft or riding
|
0006| animal resulting from or incident to ownership, maintenance or
|
0007| use of any such vehicle, aircraft or animal;
|
0008| B. public liability and property damage.
|
0009| Insurance against any hazard or cause, and against any loss,
|
0010| liability or expense resulting from or incident to ownership,
|
0011| maintenance or use of any such vehicle, aircraft or animal;
|
0012| C. cargo. Insurance against loss of or damage to
|
0013| property contained in a vehicle or being loaded or unloaded
|
0014| therein or therefrom or incident to the ownership, maintenance
|
0015| or use of any such vehicle, aircraft or animal; [and]
|
0016| D. medical payments. Insurance for payment on
|
0017| behalf of the injured party or for reimbursement of the
|
0018| insured for payment, irrespective of legal liability of the
|
0019| insured, of medical, hospital, surgical and disability
|
0020| benefits, to persons injured and funeral and death benefits to
|
0021| dependents, beneficiaries or personal representatives of
|
0022| persons killed as the result of an accident, resulting from or
|
0023| incident to ownership, maintenance or use of any such vehicle,
|
0024| aircraft or animal. Such coverage shall not be deemed to be
|
0025| "health" insurance for purposes of the Insurance Code; and
|
- 42 -
0001|
|
0002| E. the risks and providing the benefits
|
0003| described in the Personal Choice Auto Insurance Act."
|
0004| Section 27. A new Section 59A-7-7.1 NMSA 1978 is enacted
|
0005| to read:
|
0006| "59A-7-7.1. [NEW MATERIAL] "MOTOR VEHICLE INSURANCE
|
0007| POLICY" DEFINED.--"Motor vehicle insurance policy" means a
|
0008| policy of vehicle insurance that covers self-propelled
|
0009| vehicles of a kind required to be registered under New Mexico
|
0010| law for use on public streets and highways and:
|
0011| A. shall include either:
|
0012| (1) a motor vehicle bodily injury and
|
0013| property damage liability policy in compliance with the
|
0014| Mandatory Financial Responsibility Act, together with
|
0015| uninsured motorist coverage, subject to the provisions of
|
0016| Section 66-5-301 NMSA 1978 permitting the insured to reject
|
0017| the coverage; or
|
0018| (2) a personal compensation policy as defined
|
0019| in the Personal Choice Auto Insurance Act; and
|
0020| B. may include:
|
0021| (1) physical damage coverage;
|
0022| (2) medical payments coverage; and
|
0023| (3) other coverages that the insured and the
|
0024| insurer agree to include within the policy."
|
0025| Section 28. Section 59A-32-3 NMSA 1978 (being Laws 1984,
|
- 43 -
0001| Chapter 127, Section 521) is amended to read:
|
0002| "59A-32-3. PURPOSE OF ASSIGNED RISK PLAN.--The purpose
|
0003| of the assigned risk plan is to provide for the equitable
|
0004| distribution and apportionment among insurers authorized to
|
0005| transact in this state the business of [automobile and]
|
0006| personal compensation, motor vehicle bodily injury, property
|
0007| damage liability and physical damage insurance, of insurance
|
0008| afforded applicants who are in good faith entitled to, but who
|
0009| are unable to procure, such insurance through ordinary
|
0010| methods."
|
0011| Section 29. Section 59A-32-5 NMSA 1978 (being Laws 1984,
|
0012| Chapter 127, Section 523) is amended to read:
|
0013| "59A-32-5. REQUIREMENTS OF ASSIGNED RISK PLANS.--[Any
|
0014| such] An agreement or plan for the assignment of risks
|
0015| involving [automobile and] personal compensation, motor
|
0016| vehicle bodily injury, [and] property damage liability and
|
0017| physical damage insurance shall include provision for:
|
0018| A. reasonable rules governing the equitable
|
0019| distribution of risks by direct insurance, reinsurance or
|
0020| otherwise, and by the assignment of risks to insurers
|
0021| participating in the plan;
|
0022| B. rates and reasonable rate modifications,
|
0023| which shall be applicable to such risks and which shall not be
|
0024| excessive, inadequate or unfairly discriminatory;
|
0025| C. the coverage limits [of liability which]
|
- 44 -
0001| that any insurer to [whom] which a risk is assigned
|
0002| shall be required to assume; and
|
0003| D. a method whereby applicants for insurance,
|
0004| persons insured and insurers under the plan may have a hearing
|
0005| on grievances and the right to appeal from the decision on
|
0006| [any such] a grievance to the superintendent."
|
0007| Section 30. Section 59A-32-6 NMSA 1978 (being Laws 1984,
|
0008| Chapter 127, Section 524) is amended to read:
|
0009| "59A-32-6. REVIEW OF PROPOSED ASSIGNED RISK PLANS.--
|
0010| Every [such] plan for the assignment of risks involving
|
0011| [automobile and] personal compensation, motor vehicle
|
0012| bodily injury, [and] property damage liability and physical
|
0013| damage insurance shall be filed in writing with the
|
0014| superintendent. The superintendent shall review the plan as
|
0015| soon as reasonably possible after filing, to determine whether
|
0016| or not it meets the requirements of Section [523 of this
|
0017| article] 59A-32-5 NMSA 1978. Each plan shall be on file
|
0018| with the superintendent for a waiting period of thirty
|
0019| [(30)] days before it becomes effective, unless sooner
|
0020| approved in writing. Unless disapproved in writing by the
|
0021| superintendent within the thirty [(30)] day waiting period,
|
0022| a plan shall be deemed approved and shall become effective
|
0023| upon the expiration of that period."
|
0024| Section 31. Section 59A-32-8 NMSA 1978 (being Laws 1984,
|
0025| Chapter 127, Section 526) is amended to read:
|
- 45 -
0001| "59A-32-8. FAILURE TO FILE PLAN--ASSIGNED RISK PLAN
|
0002| PRESCRIBED.--If no plan [which] that meets the
|
0003| requirements of Section [523 of this article above] 59A-32-
|
0004| 5 NMSA 1978 has been filed with the superintendent within
|
0005| ninety [(90)] days after [June 30, 1959] the effective
|
0006| date of the Personal Choice Auto Insurance Act, or within the
|
0007| period stated in [any] an order [which] that
|
0008| disapproves an existing plan, the superintendent may formulate
|
0009| and prescribe a plan [which] that does meet [such]
|
0010| those requirements, after hearing or consultation with
|
0011| insurers authorized to transact in this state the business of
|
0012| [automobile and] personal compensation, motor vehicle
|
0013| bodily injury, [and] property damage liability and physical
|
0014| damage insurance. When [any] a plan [or plans] or
|
0015| amendment [thereto] to it has [or have] been approved or
|
0016| prescribed, no insurer to which [such] the plan is
|
0017| applicable shall thereafter issue [any] a policy of
|
0018| [such] insurance, or undertake to transact [such] business
|
0019| in this state, unless the insurer participates in [such]
|
0020| the plan."
|
0021| Section 32. Section 66-5-208 NMSA 1978 (being Laws 1978,
|
0022| Chapter 35, Section 282, as amended) is amended to read:
|
0023| "66-5-208. EVIDENCE OF FINANCIAL RESPONSIBILITY--AMOUNTS
|
0024| AND CONDITIONS.--["Evidence of financial responsibility"] As
|
0025| used in the Mandatory Financial Responsibility Act, "evidence
|
- 46 -
0001| of financial responsibility" means:
|
0002| A. evidence of the ability to respond in damages
|
0003| for liability, on account of accidents occurring subsequent to
|
0004| the effective date of the evidence, arising out of the
|
0005| ownership, maintenance or use of a vehicle of a type subject
|
0006| to registration under the laws of New Mexico, in the following
|
0007| amounts:
|
0008| [A. twenty-five thousand dollars ($25,000)]
|
0009| (1) fifteen thousand dollars ($15,000) because of bodily
|
0010| injury to or death of one person in [any one] a single
|
0011| accident;
|
0012| [B.] (2) subject to [this] the limit
|
0013| for one person, [fifty thousand dollars ($50,000)] thirty
|
0014| thousand dollars ($30,000) because of bodily injury to or
|
0015| death of two or more persons in [any one] a single
|
0016| accident;
|
0017| [C.] (3) ten thousand dollars ($l0,000)
|
0018| because of injury to or destruction of property of others in
|
0019| [any one] a single accident; and
|
0020| [D.] (4) if evidence is in the form of a
|
0021| surety bond or a cash deposit, the total amount shall be
|
0022| [sixty thousand dollars ($60,000)] forty thousand dollars
|
0023| ($40,000); or
|
0024| B. evidence of a valid personal compensation
|
0025| policy as specified in the Personal Choice Auto Insurance
|
- 47 -
0001| Act."
|
0002| Section 33. Section 66-5-209 NMSA 1978 (being Laws 1978,
|
0003| Chapter 35, Section 283, as amended) is amended to read:
|
0004| "66-5-209. MEANING OF "JUDGMENT".--["Judgment"] As
|
0005| used in the Mandatory Financial Responsibility Act,
|
0006| "judgment" means any judgment [which] that becomes final
|
0007| by expiration without appeal of the time within which an
|
0008| appeal might have been perfected or by final affirmation on
|
0009| appeal rendered by a court of competent jurisdiction of any
|
0010| state or of the United States, upon a cause of action, as
|
0011| limited by the Personal Choice Auto Insurance Act, arising
|
0012| out of the ownership, maintenance or use of any motor vehicle
|
0013| of a type subject to registration [under] pursuant to the
|
0014| laws of New Mexico, for damages, including damages for care
|
0015| and loss of services, because of bodily injury to or death of
|
0016| any person or for damages because of injury to or destruction
|
0017| of property, including [the] its loss of use, [thereof]
|
0018| or upon a cause of action on an agreement of settlement for
|
0019| such damages. "Judgment" does not include any amount
|
0020| recoverable as uncompensated economic loss pursuant to the
|
0021| Personal Choice Auto Insurance Act."
|
0022| Section 34. Section 66-5-215 NMSA 1978 (being Laws 1978,
|
0023| Chapter 35, Section 298, as amended) is amended to read:
|
0024| "66-5-215. PAYMENTS SUFFICIENT TO SATISFY REQUIREMENTS.--
|
0025| A. Judgments herein referred to shall, for the
|
- 48 -
0001| purpose of the Mandatory Financial Responsibility Act only, be
|
0002| deemed satisfied when:
|
0003| (1) [twenty-five thousand dollars
|
0004| ($25,000)] fifteen thousand dollars ($15,000) has been
|
0005| credited upon any judgment or judgments rendered in excess of
|
0006| that amount because of bodily injury to or death of one person
|
0007| as the result of any one accident;
|
0008| (2) subject to the limit of [twenty-five
|
0009| thousand dollars ($25,000)] fifteen thousand dollars
|
0010| ($15,000) because of bodily injury to or death of one person,
|
0011| the sum of [fifty thousand dollars ($50,000)] thirty
|
0012| thousand dollars ($30,000) has been credited upon any
|
0013| judgment [or judgments] rendered in excess of that amount
|
0014| because of bodily injury to or death of two or more persons as
|
0015| the result of any one accident; or
|
0016| (3) ten thousand dollars ($l0,000) has been
|
0017| credited upon any judgment [or judgments] rendered in excess
|
0018| of that amount because of injury to or destruction of property
|
0019| of others as a result of any one accident.
|
0020| B. However, payments made in settlements of any
|
0021| claims because of bodily injury, death or property damage
|
0022| arising from the accident shall be credited in reduction of
|
0023| the amounts provided for in this section."
|
0024| Section 35. Section 66-5-224 NMSA 1978 (being Laws 1978,
|
0025| Chapter 35, Section 309, as amended) is amended to read:
|
- 49 -
0001| "66-5-224. ACT NOT TO AFFECT OTHER POLICIES.--
|
0002| A. The Mandatory Financial Responsibility Act does
|
0003| not apply to or affect policies of motor vehicle insurance
|
0004| [against liability which] that may now or hereafter be
|
0005| required by any other law of New Mexico, except the Personal
|
0006| Choice Auto Insurance Act, and such policies, if they contain
|
0007| an agreement or are endorsed to conform with the requirements
|
0008| of the Mandatory Financial Responsibility Act, may be
|
0009| considered as evidence of financial responsibility [under]
|
0010| pursuant to that act.
|
0011| B. The Mandatory Financial Responsibility Act does
|
0012| not apply to or affect policies insuring solely the insured
|
0013| named in the policy against liability resulting from the
|
0014| maintenance or use by persons in the insured's employ or on
|
0015| his behalf of motor vehicles not owned by the insured."
|
0016| Section 36. Section 66-5-226 NMSA 1978 (being Laws 1955,
|
0017| Chapter 182, Section 330, as amended) is amended to read:
|
0018| "66-5-226. CASH DEPOSIT AS EVIDENCE.--Evidence of
|
0019| financial responsibility may be demonstrated by the
|
0020| certificate of the state treasurer that the person named in
|
0021| the certificate has deposited with him [sixty thousand
|
0022| dollars ($60,000)] forty thousand dollars ($40,000) in
|
0023| cash."
|
0024| Section 37. Section 66-5-301 NMSA 1978 (being Laws 1978,
|
0025| Chapter 35, Section 325, as amended) is amended to read:
|
- 50 -
0001| "66-5-301. INSURANCE AGAINST UNINSURED AND UNKNOWN
|
0002| MOTORISTS--REJECTION OF COVERAGE BY THE INSURED.--
|
0003| A. No motor vehicle [or automobile] bodily
|
0004| injury and property damage liability policy [insuring
|
0005| against loss resulting from liability imposed by law for
|
0006| bodily injury or death suffered by any person and for injury
|
0007| to or destruction of property of others arising out of the
|
0008| ownership, maintenance or use of a motor vehicle] shall be
|
0009| delivered or issued for delivery in New Mexico with respect to
|
0010| any motor vehicle registered or principally garaged in New
|
0011| Mexico unless coverage is provided therein or supplemental
|
0012| thereto in minimum limits for bodily injury or death and for
|
0013| injury to or destruction of property as set forth in Section
|
0014| 66-5-215 NMSA 1978 and such higher limits as may be desired by
|
0015| the insured, but up to the limits of liability specified in
|
0016| bodily injury and property damage liability provisions of the
|
0017| insured's policy, for the protection of persons insured
|
0018| thereunder who are legally entitled to recover damages from
|
0019| owners or operators of uninsured motor vehicles because of
|
0020| bodily injury, sickness or disease, including death, and for
|
0021| injury to or destruction of property resulting therefrom
|
0022| according to the rules and regulations promulgated by, and
|
0023| under provisions filed with and approved by, the
|
0024| superintendent of insurance.
|
0025| B. The uninsured motorist coverage described in
|
- 51 -
0001| Subsection A of this section shall include underinsured
|
0002| motorist coverage for persons protected by an insured's
|
0003| policy. For the purposes of this subsection, "underinsured
|
0004| motorist" means an operator of a motor vehicle with respect to
|
0005| the ownership, maintenance or use of which the sum of the
|
0006| limits of liability under all bodily injury liability
|
0007| insurance applicable at the time of the accident is less than
|
0008| the limits of liability under the insured's uninsured motorist
|
0009| coverage. [No motor vehicle or automobile liability policy
|
0010| sold in New Mexico shall be required to include underinsured
|
0011| motorist coverage until January 1, 1980.] A personal
|
0012| compensation insured under the Personal Choice Auto Insurance
|
0013| Act is not an underinsured motorist except to the extent a
|
0014| claim is made for uncompensated economic loss against the
|
0015| motorist, as provided in that act, that exceeds the coverage
|
0016| limit under the personal compensation policy.
|
0017| C. Unless a named insured makes an express
|
0018| election to stack uninsured motorist coverage limits for two
|
0019| or more motor vehicles by adding such limits together, the
|
0020| limits shall not be stacked. An insurer shall notify its
|
0021| policyholders in writing that they may elect to stack
|
0022| uninsured motorist coverage limits.
|
0023| [C.] D. The uninsured motorist coverage shall
|
0024| [provide an exclusion] exclude coverage of not more than
|
0025| the first [two hundred fifty dollars ($250)] five hundred
|
- 52 -
0001| dollars ($500) of loss resulting from injury to or
|
0002| destruction of property of the insured in any one accident
|
0003| and may exclude coverage of punitive or exemplary damages.
|
0004| The named insured shall have the right to reject uninsured
|
0005| motorist coverage [as] described in [Subsections A and B
|
0006| of] this section [provided that] but, unless the named
|
0007| insured requests [such] that coverage in writing, [such
|
0008| coverage] it need not be provided in or supplemental to a
|
0009| renewal policy where the named insured has rejected the
|
0010| coverage in connection with a policy previously issued to him
|
0011| by the same insurer.
|
0012| E. Uninsured motorist coverage for injury to or
|
0013| destruction of property extends only to the vehicle described
|
0014| in the policy and to property not otherwise insured carried in
|
0015| or upon the vehicle."
|
0016| Section 38. TEMPORARY PROVISION--TRANSITION OF RENEWAL
|
0017| POLICIES.--Each motor vehicle insurance policy in effect on
|
0018| the effective date of the Personal Choice Auto Insurance Act
|
0019| shall become subject to the provisions of that act on its
|
0020| first succeeding renewal date. At least thirty days before
|
0021| the policy renewal date, the motor vehicle insurer shall
|
0022| notify the policyholder of the new limitations on tort rights
|
0023| and liabilities and shall provide information on obtaining the
|
0024| appropriate form to reject the limitations. At that time, the
|
0025| motor vehicle insurer shall also afford the policyholder the
|
- 53 -
0001| opportunity to purchase the optional coverages specified in
|
0002| Section 4 of the Personal Choice Auto Insurance Act. If the
|
0003| policyholder does not request any optional coverage prior to
|
0004| the renewal date of the policy and does not inform the insurer
|
0005| that he is a tort chooser, the policy shall be reissued as a
|
0006| personal compensation policy with personal compensation
|
0007| benefits equal to the medical payments coverage previously
|
0008| selected by the insured, but in no event less than fifteen
|
0009| thousand dollars ($15,000). If the insurer does not offer
|
0010| personal compensation benefits in an amount equal to the
|
0011| insured's previous medical payments limit, then the insurer
|
0012| shall provide the available limit that is nearest, but not
|
0013| less than, the previous medical payments limit. All other
|
0014| coverages previously purchased by a named insured shall remain
|
0015| in effect; provided that motor vehicle insurers may delete any
|
0016| coverage that would substantially duplicate personal
|
0017| compensation benefits, including uninsured motorist coverage
|
0018| and disability coverage. If the policyholder requests any
|
0019| optional coverage, the requested coverage shall be effective
|
0020| on the reissue date of the policy if the request is received
|
0021| by the motor vehicle insurer prior to the renewal date of the
|
0022| policy. If received on or after the reissue date, the
|
0023| requested coverage shall be effective at 12:01 a.m. on the day
|
0024| after the request is received.
|
0025| Section 39. TEMPORARY PROVISION--COST SAVINGS TO
|
- 54 -
0001| CONSUMERS.--
|
0002| A. Each insurer that writes motor vehicle
|
0003| insurance policies shall file policy forms and rates for
|
0004| personal compensation policies and motor vehicle bodily injury
|
0005| and property damage liability policies, including tort
|
0006| coverage, with the superintendent of insurance no later than
|
0007| sixty days before the effective date of the provisions of the
|
0008| Personal Choice Auto Insurance Act, for review and approval
|
0009| pursuant to Chapter 59A, Article 17 NMSA 1978.
|
0010| B. Each insurer's statewide average premium for a
|
0011| personal compensation policy with minimum required benefits
|
0012| during the first year following the effective date of the
|
0013| Personal Choice Auto Insurance Act shall be at least thirty
|
0014| percent less than the insurer's statewide average premium for
|
0015| calendar year 1997 for mandatory insurance coverage, unless
|
0016| the insurer first demonstrates at a rate hearing that such a
|
0017| decrease will result in inadequate rates. For the purposes of
|
0018| this subsection, "mandatory insurance coverage" means the
|
0019| minimum limits for bodily injury and property damage liability
|
0020| set forth in Section 66-5-215 NMSA 1978 immediately prior to
|
0021| the effective date of this act and the minimum uninsured and
|
0022| underinsured motorist coverage set forth in Section 66-5-301
|
0023| NMSA 1978.
|
0024| C. Prior to the effective date of the provisions
|
0025| of the Personal Choice Auto Insurance Act, the superintendent
|
- 55 -
0001| of insurance may adopt and promulgate rules, approve proposed
|
0002| policy forms and review and approve insurance rates for
|
0003| coverages to be made available pursuant to that act.
|
0004| Section 40. SEVERABILITY.--
|
0005| A. Except as provided otherwise in Subsection B of
|
0006| this section, if any provision of the Personal Choice Auto
|
0007| Insurance Act or the application thereof to any person,
|
0008| organization or circumstance is held to be unconstitutional or
|
0009| otherwise invalid, the remainder of that act and the
|
0010| application of such provision to other persons or
|
0011| circumstances shall not be affected.
|
0012| B. If Section 12 of the Personal Choice Auto
|
0013| Insurance Act is found to be unconstitutional or invalid, in
|
0014| whole or in part, it is to be conclusively presumed that the
|
0015| legislature would not have enacted the remainder of this act
|
0016| without those limitations and that act shall not be severable
|
0017| and shall be invalid.
|
0018| Section 41. EFFECTIVE DATE.--The effective date of the
|
0019| provisions of:
|
0020| A. Sections 1 through 38 of this act is July 1,
|
0021| 1999; and
|
0022| B. Sections 39 and 40 of this act is July 1, 1998.
|
0023|
|
0024|
|