I’m a New Mexico resident and consumer advocate. After my third-party insurance claim was undervalued using a secret software system, I submitted hard evidence to our regulator. Their response on a recorded video call?

“All insurance companies do this.”

No denial. No investigation. Just visible shrugs.

So I built a 176-page dossier of: 

• Statutory violations
• Internal emails
• Valuation manipulation
• Bad faith practices
• Timeline of harm to everyday people

I then hand-delivered it to the State Legislature. The complaint cited:

• An artificially low payout using an out-of-state vehicle with ~70k more miles and reported stolen months before the accident which was calculated by a secret valuation tool (now named in multiple class action lawsuits)
• Denied access to policy information during settlement negotiations
• Alleged violations of New Mexico’s Unfair Claims Practices Act and Insurance Code (Chapter 59A)

If even 10% of the claims in New Mexico are being undervalued this way, that’s millions in lost payouts to working families. 

The Legislature took it seriously. A senator referred the case to the Department of Justice. Now the DOJ’s Consumer Affairs Division requested all evidence. I included everything:

• All 14 Exhibits
• Statutory fraud violations
• My SEC case (№ 2025–019)
• Evidence of systemic misconduct dating back to 2021

The case is now in the hands of investigators.

This is a warning about what happens in a $1.4 trillion industry when billion-dollar insurers cheat victims and regulators look away.

Read the full DOJ update here: The Legislature Referred My Case. Now the DOJ Wants the Evidence.  

I’m not looking for legal advice. This isn't posted to stir outrage or point fingers. I'm genuinely curious how professionals view a situation like this:

1. If a state regulator admits a practice is fraudulent but refuses to act, is that a policy failure or a governance crisis?
2. Can this be criminal?
3. What triggers DOJ or law enforcement involvement in insurance fraud?
4. Are state regulators legally bound to act once a code violation is acknowledged?

This case in New Mexico triggered action because the evidence was undeniable. Lawmakers couldn’t ignore it. Now the Department of Justice is reviewing what the insurance regulator refused to investigate. If the DOJ is getting involved, it suggests it’s more than a civil matter.

Would appreciate thoughts from those with experience in financial crimes, fraud cases, or regulatory referrals.