Do Insurers Accept Claims Filed by Public Insurance Adjusters?

If you're having trouble with your insurance company or if your personal or professional situation makes it difficult to manage all the details, you can hire a professional to help with claims. In most U. S. states, you can hire an authorized public adjuster for a “contingent fee” (percentage) to handle your claim and negotiate a settlement on your behalf.

A public adjuster is a claims assistance professional that you can hire to represent you in the documentation and negotiation of your insurance claim. A public adjuster works exclusively for policyholders, not for insurers. When you file a homeowners insurance claim, your insurer will send an appraiser to assess the damage and determine payment for the claim. At best, payment will be based on the cost of repairing or replacing a damaged structure or property. To obtain a public insurance adjuster license, an application fee must be paid, the amount of which is determined by regulation by the commissioner.

It is essential to check references and agree on fees and conditions before entering into a contract with a public adjuster. A state organization such as the California Association of Public Insurance Adjusters, the Florida Association of Public Insurance Adjusters, or the Texas Association of Public Insurance Adjusters can guide you about one of its members. If applicable, the name of the company where the public insurance adjuster works at the time the license is issued must also be provided. The license holder cannot, without the knowledge and written consent of the insured, acquire a share in recovered property that is the subject of an adjusted claim by the license holder. A code of ethics for public insurance adjusters encourages training on ethical, legal and business principles that should govern their conduct.

Over the past two years, important changes have been made to the Florida Statutes that regulate public adjusters' activity. Material misrepresentation, with intent to deceive, of one's status as a public insurance adjuster is prohibited. Without prejudice to any authorization that the insured has granted to a public insurance adjuster, the policyholder may not sign or endorse any check or money order on behalf of an insured. The National Association of Public Insurance Adjusters (NAPIA) has an online directory of public adjusters, although membership in the Association does not prevent someone from being an authorized or qualified adjuster to process your claim. In order to obtain a non-resident public insurance adjuster license, an application fee must be paid, whose amount will be determined by regulation by the commissioner; and non-resident public insurance adjusters who hold a valid license from another state and have continuing education requirements substantially equivalent to those in this state may be exempt from any continuing education requirement. It is illegal to pay, allow or offer to pay, directly or indirectly, to someone who is not a licensed public insurance adjuster a fee, commission or other valuable consideration for referring an insured to a public insurance adjuster for entering into a contract with them or for any other purpose. The department cannot issue a public insurance adjuster license to a business entity unless at least one official, active partner or other managing person of the business entity has an individual license from the department under Section 4102.054. Public insurance adjusters must also follow recommendations on loss adjustment requests and adhere to a code of ethics.