New Mexico Administrative Code
Title 13 - INSURANCE
Chapter 1 - INSURANCE GENERAL PROVISIONS
Part 3 - PRIVACY OF NONPUBLIC PERSONAL INFORMATION
Section 13.1.3.18 - EXCEPTIONS TO NOTICE AND AUTHORIZATION REQUIREMENTS FOR DISCLOSURE OF NONPUBLIC PERSONAL INFORMATION FOR PROCESSING AND SERVICING TRANSACTIONS

Universal Citation: 13 NM Admin Code 13.1.3.18

Current through Register Vol. 35, No. 6, March 26, 2024

A. Exceptions for processing transactions at consumer's request. The requirements for initial notice in paragraph (2) of subsection A of 13.1.3.8 NMAC, for notice and authorization in 13.1.3.11 NMAC and 13.1.3.14 NMAC, and service providers and joint marketing in 13.1.3.17 NMAC do not apply if the licensee discloses nonpublic personal information only to the extent necessary to effect, administer or enforce a transaction that a consumer requests or authorizes, or in connection with:

(1) Servicing or processing an insurance product or service that a consumer requests or authorizes;

(2) Maintaining or servicing the consumer's account with a licensee, or with another entity as part of a private label credit card program or other extension of credit on behalf of such entity;

(3) A proposed or actual securitization, secondary market sale (including sales of servicing rights) or similar transaction related to a transaction of the consumer; or

(4) Reinsurance or stop loss or excess loss insurance.

B. "Necessary to effect, administer or enforce a transaction" means that the disclosure is:

(1) Required, or is one of the lawful or appropriate methods, to enforce the licensee's rights or the rights of other persons engaged in carrying out the financial transaction or providing the product or service; or

(2) Required, or is a usual, appropriate or acceptable method:
(a) To carry out the transaction or the product or service business of which the transaction is a part, and record, service or maintain the consumer's account in the ordinary course of providing the insurance product or service;

(b) To administer, adjust, manage, or service benefits or claims relating to the transaction or the product or service business of which it is a part;

(c) To provide a confirmation, statement or other record of the transaction, or information on the status or value of the insurance product or service to the consumer or the consumer's agent or broker;

(d) To accrue or recognize incentives or bonuses associated with the transaction that are provided by a licensee or any other party;

(e) To underwrite insurance at the consumer's request;

(f) To perform the following insurance functions: policy placement or issuance, account administration, detecting, reporting, investigating or preventing actual or potential fraud, material misrepresentation or criminal activity, processing premium payments, processing insurance claims, administering insurance benefits (including utilization review activities), loss control, risk management, case management, disease management, quality assurance, quality improvement, performance evaluation, provider credentialing verification, peer review activities, participating in research projects, grievance procedures; internal administration of compliance, managerial, and information systems; policyholder service functions; auditing; reporting; database security; administration of consumer disputes and inquiries; external accreditation standards; the replacement of a group benefit plan or workers compensation policy or program; activities in connection with a sale, merger, transfer or exchange of all or part of a business or operating unit; any activity that permits disclosure without authorization pursuant to the federal Health Insurance Portability and Accountability Act privacy rules promulgated by the U.S. Department of Health and Human Services; disclosure that is required, or is one of the lawful or appropriate methods, to enforce the licensee's rights or the rights of other persons engaged in carrying out a transaction or providing a product or service that a consumer requests or authorizes; and any activity otherwise permitted by law, required pursuant to governmental reporting authority, or to comply with legal process; or

(g) In connection with the authorization, settlement, billing, processing, clearing, transferring, reconciling or collection of amounts charged, debited or otherwise paid using a debit, credit or other payment card, check or account number, or by other payment means; the transfer of receivables, accounts or interests therein; or the audit of debit, credit or other payment information.

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