REGULATIONS QUESTIONS &
ANSWERS(RATED A+)
License Display - ANSWERThe adjuster must exhibit his license to the an insured, a
claimant, a witness, a
potential witness or any other informant with whom he may deal in the course of
investigating
or adjusting any claim.
Decision regarding coverage, acceptance, denial or payment of a claim Time Limit -
ANSWERThe adjuster must communicate the the results of the investigation within
30 days of receipt.
Unless otherwise provided by law, every insurer must pay all or part of the claim
within: - ANSWER5 working days from date of agreement with an insured or
claimant.
Delay Letter - Time Limit - ANSWERThe insurer shall, within 30 days from the date
of the delay letter, and every 30 days thereafter,
send a letter setting forth the specific reasons for the continued delay in the claim
settlement
process
License Renewal - ANSWERLicense will expire on October 1st of the second
calendar year after its issue.
Temporary Adjusters License - ANSWERIn the event of an emergency, the
commissioner may issue a temporary license that is good for one year.
Continuing Education - ANSWEREvery two years, 60 days before renewing their
license, an adjuster must must have completed 20 hours of Continuing Education.
Disciplinary Actions - ANSWERCease and Desist Order
Suspension or Revocation
Penalties and Fines
Cease and Desist Order - ANSWERthe Commissioner may issue and serve upon
that person a statement of the charges and a notice of a hearing to be held.
, Notice must be given at least 10 days before the hearing date.
After the hearing, if the Commissioner finds the the adjuster's acts and practices to
be in violation of the law, he will issue a cease and desist order to stop the the
method of the adjusters competition, act or practice.
Penalty for Violating Cease and Desist Order - ANSWERIf any person violates a
cease and desist
order issued by the Commissioner, he may suspend, revoke, or refuse to renew the
license of that person.
The Commissioner may also impose an administrative penalty of up to $2,500 for
each method of competition, act, or practice found to be in violation.
Suspension or Revocation - ANSWERAfter the hearing, the Commissioner may
suspend or revoke the adjuster's license or subject him to an administrative fine not
to
exceed $2,500.
The aggrieved may appeal in accordance with state code.
Penalties and Fines - ANSWERIf an adjuster misrepresents his identity he will
be guilty of a misdemeanor if a natural person, or guilty of a felony if any other
person;
and
be subject to suspension or revocation of his license and a fine not to exceed $2,500
for
each violation.
Unfair Claim Settlement Practices by Insurers - ANSWERMisrepresenting pertinent
facts related to coverage
Failing to acknowledge and act promptly when a claim arrises.
Failing to implement reasonable standards when promptly investigating a claim.
Failing to affirm or deny coverage within a reasonable time after proof of loss was
submitted.
Failure of an insurer to maintain a complete record of all complaints which it has
received, whether or not they were deemed valid
Knowingly underestimating the value of any claim by an insurer or by an adjuster
representing the insurer.
Adjustment and Payment of Loss - ANSWERThe company shall begin the
adjustment of the loss within 15 days after receipt of notice of
loss. The amount of loss under a fire insurance policy shall be due and payable in 60
days