Management Changes to the New Mexico Patient’s Compensation Fund

In 1976, the State of New Mexico enacted the Medical Malpractice Act, “to promote the health and welfare of the people of New Mexico by making available [insurance] for healthA stethoscope next to a gavel signifying medical malpractice case care providers in New Mexico.”

Any person who brings a medical malpractice claim against a participating medical provider or hospital is limited to a recovery of $600,000 plus the costs medical care and related benefits. The Act requires participating providers and hospitals to have insurance to pay the first $200,000 of any claim, with the remainder coming from the “Patient’s Compensation Fund.”

The Patient’s Compensation Fund is overseen by the State Superintendent of Insurance, who in the past had hired a private adjuster to review and evaluate any medical claims for both settlement and trial. For about the past 10 years, it was one person who adjusted every claim for the Fund.

There is Now New Management of the NM Patient's Compensation Fund

At the end of 2019, this person retired, and the Superintendent of Insurance retained Integrion Group, Inc., a corporation in Arizona and New Mexico that specializes in third-party claims administration and claims adjusting. They are owned by New Mexico Mutual, the state’s largest workers’ compensation provider.

Integrion Group, Inc. has multiple individuals who will administer and adjust claims for the Fund. It is too soon to know how this may impact settlement conferences and the litigation of claims against participating medical providers or hospitals, injecting an extra layer of uncertainty at a time when the Courts and the community are working through the changes to daily life from COVID-19.

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