N.M. Admin. Code § 13.17.2.15

Current through Register Vol. 35, No. 23, December 10, 2024

Section 13.17.2.15 - CONFLICTS OF INTEREST

A. If a dispute board member has a conflict of interest with respect to a hearing scheduled before the dispute board, a substitute shall be appointed by the chair for purposes of that particular hearing. A substitute member shall be from the same class as the member being replaced.

B. A member will be deemed to have a conflict of interest if:

(1) the member is associated with either party to the appeal;

(2) the member is a direct competitor of either party;

(3) the member is part of an affiliated group, any member of which is a direct competitor of either party; or

(4) the member has any other material conflicting interest which would call into question that member's ability to render an unbiased decision.

C. A member is associated or affiliated with a party if they are involved in a common business enterprise or if they are members of a controlled group as that term is defined by Section 851(c)(3) of the Internal Revenue Code. A member is associated with the party if there is any familial relationship between them.

D. The insurance company advisor will be deemed to have a conflict of interest only if it is one of the parties to the dispute. In the event such conflict of interest is deemed to exist for the insurance company advisor, a substitute insurance company shall be appointed by the chair to serve as the non-voting insurance company advisor for purposes of the particular hearing scheduled before the dispute board in which the conflict of interest exists.

E. A conflict of interest may be waived if, after full disclosure of the facts raising such a conflict, all parties to the appeal agree to such waiver.

F. Notwithstanding the provisions of Subsection B of this section, neither of the representatives from the office of superintendent of insurance and the advisory organization shall be deemed to have a conflict of interest with respect to any appeal brought before the dispute board based solely upon the representatives' affiliation with the advisory organization or the office of superintendent of insurance.

N.M. Admin. Code § 13.17.2.15

1-1-93; 13.17.2.15 NMAC - Rn & A, 13 NMAC 17.2.15, 5-15-01; A, 3-14-14