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  • Claims Magazine is providing the following free guidelines and regulations in order to help adjusting professionals stay abreast of each state’s unique property and casualty claim-handling requirements. Each guideline features an explanation of the act to be performed, compliance timeframes for each act, and hyperlinked references to each state's insurance code. The links were compiled by compiled by Lynch & Associates, www.northlaw.com. We hope you find them useful and informative. Please note that these guidelines were updated in 2010, but occassional changes in each state's code are to be expected. These guidelines should be used as a reference only, and do not supercede each state's published regulations.

    Just Looking for Each State's Deadline for Acknowledging Receipt of a Claim? Download PDF

    List of State Guidelines:

  • By Brian S. Goodman,  Esq., NAPIA Counsel, HODES, PESSIN & KATZ, P.A.
    Friday, October 7, 2011

    As the end of the year approaches, activity in the state legislatures is just heating up. In the coming term, many local legislators will be focusing on issues related to public adjusting. We know for a fact that bills are currently under consideration in Pennsylvania, and there is expected to be an added regulation addressed in Indiana focusing on the Unauthorized Practice of Public Adjusting. The Alabama legislature convenes in early 2012, and we are working diligently to th ensure that Alabama becomes the 45state to license public adjusters.

    If any NAPIA member hears of legislative activity in their particular state, please make us aware of this as soon as possible. Often, issues come up that touch on our profession, and the sooner we know about these the better.

    We are working hard with able counsel and lobbyists to protect the profession and to ensure the proper and ethical practice of public insurance adjusting. Gone are the days when public adjusters flew “under the radar;” we are now an accepted and respected player in the insurance industry and claims process. This gives all of us all the more reason to stay on top of legislative enactments and to insist that our craft is practiced in an ethical and proper manner.

    I will be talking about ethics and legislative issues in greater detail at the upcoming  First Party Claims Conference  in Providence, Rhode Island. We hope to see many of you there.

  • The American Association of Public Insurance Adjusters is busy getting the word out about how hiring a public insurance adjuster can add value to a policyholder’s insurance claim. AAPIA prides itself on being a professional organization representing public adjusters from all over the United States. AAPIA sponsors educational, social, and networking programs throughout the year.

    Recently, Gene Veno, the President of the American Association of Public Insurance Adjusters, was interviewed about the role of a public adjuster and the value a claims professional can add to a property damage claim when that professional is working on behalf of the policyholder.

    It is still not uncommon for me to hear from policyholders that they only became aware of the services a public adjuster can provide after they had a negative experience during an insurance claim and turned to a public adjuster for help. But the work of public adjusters is most valuable if people are aware of them early in the claims process. Individuals, families, condominium associations and businesses that suffer losses need to know that in most states they have the ability to hire their own adjuster to help navigate the claim process. As Veno explains in the interview, 44 states now have licensed public adjusters available to policyholders.

    One of the ways AAPIA is spreading the word is by doing radio and podcast interviews to educate the public. You may recognize Merlin Law Group’s very own Sean Shaw in the blogtalk radio show Legislative Wrap up with AAPIA's Gene Veno. AAPIA also interviewed Florida public adjuster, Dick Tutwiler, of Tutwiler & Associates.

    The AAPIA website provides many great resources for those who want to stay informed on issues relating to public adjusting.

    In prior posts, Chip Merlin has detailed some of the work AAPIA has been involved in during the last year.

    Take a listen to AAPIA’s The Value of Hiring a Public Adjuster:

  • Based out of Chicago since 1916, Carter J. Auslander and Associates is a licensed and credentialed public adjusting firm. This family owned business takes great pride in the four generations of claims processing skill and expertise. Mr. Carter J. Auslander began his work at Hoffberg, Spak & Associates in 1980. The firm later became known as Theodore Spak & Associates, and is now known as Carter J. Auslander and Associates. Using extra care and dedication, Carter and his son, Russ Auslander, have helped policyholders throughout the United States with various types of losses.

    Carter Auslander paid great attention to detail and thoroughly investigated the damage to adjust the Hurricane Katrina damage at the historic Latrobe building.

    Carter Auslander provided a detailed account of the Hurricane claim he handled at a historical property called “Latrobe’s,” and both the trial and appellate court that heard the issues relating to the loss have provided detailed opinions. Royal Cloud Nine, LLC, purchased insurance from Lafayette Insurance to cover Latrobe’s, a “historical architectural gem,” in New Orleans. Latrobe’s on Royal is one of New Orleans most architecturally significant buildings, and is located in the heart of the enchanting French Quarter. Designed by the “Father of American architecture,” Benjamin Henry, Latrobe’s building was originally intended to house the Louisiana State Bank Now, this stunning building is used for exquisite special events and celebrations. But this classic property suffered damage as a result of Hurricane Katrina. Lafayette Insurance Company eventually accepted coverage for the loss, but the claim assessment was wholly inadequate.

    The insured retained Carter J. Auslander and Associates. Auslander described Latrobe’s as a first class property that was impeccably maintained. But after Hurricane Katrina, Lafayette failed to properly pay the claim. The carrier did not come to inspect and adjust the loss with the necessary objective to properly indemnify the insureds. In February 2006, Lafayette sent an expert to inspect and evaluate the damages to the property, including the roof damage. Lafayette’s expert indicated that he believed that roof was damaged and submitted to Lafayette an estimate for repair and an estimate for replacement. Lafayette disregarded the reports. On behalf of Royal Cloud Nine, Auslander presented the claim with a complete estimate for the property damage, including an estimate for the replacement of the slate roof. The independent adjuster hired by Lafayette also submitted an estimate for roof damage, but Lafayette ignored all submissions.

    David Connor, the head of Lafayette claims, ordered a third estimate. The new expert submitted an estimate of damages for the roof, but the expert did not properly evaluate the damages.

    Mr. Lehman did not physically walk on the roof, but inspected it from a manlift from which much of the damage to the roof, particularly, the hairline cracks, were not visible. Mr. Lehman prepared a roofing estimate to make spot repairs with gray slate totaling only $5,500 that did not include the carriage house, nor did it include any warranty of the work performed

    It was obvious that the carrier was looking only to give a band-aid remedy to the insured after two of its own representatives’ recommendations were dismissed.

    Since Lafayette was ignoring its own experts, Auslander knew he had to present more information detailing damages and highlighting the significance of the historical nature of the property. Auslander was able to present documentation from the Vieux Carre Commission about the property. The Vieux Carré Commission’s task is to protect, preserve, and maintain the distinct architectural, historic character, and zoning integrity of Latrobe’s and other historical buildings. The Commission’s position was that Latrobe’s roof had to be replaced with genuine slate. The revised estimate presented by Auslander totaled $487, 723.70. Finally, at the end of June 2006, Lafayette sent its first payment on this claim, but despite having been advised in detail of the damages, it only paid $61,403.33. Lafayette classified this payment as the settlement.

    Ultimately, Royal Cloud Nine had to file suit against Lafayette for the damages. The Court found that it was improper for Lafayette to specifically reject its own adjuster’s submission of the damages and that it acted arbitrarily and capriciously in disregarding the roofing estimates in favor of the much lower and unreasonable estimate of $5500.00.

    The trial court ordered Lafayette to pay Royal’s Hurricane Katrina damages.

    • It awarded replacement of the interior damage, as provided in the claim presentation provided by Auslander.
    • Lafayette was also ordered to pay for the replacement cost of the exterior damages presented in Auslander’s revised estimate (presented with the information for the standards for historical building repairs) and for the replacement of the slate roof as presented in Auslander’s claim package.
    • Lafayette was ordered to pay a penalty of $247,784.80, plus interest for withholding payment after the proof of loss was submitted.
    • Royal Cloud was awarded Attorneys’ fees and costs
    • All costs were taxed against Lafayette
    • Royal Cloud was also awarded judicial interest.


    Lafayette appealed the trial court’s judgment. The appellate court affirmed the majority of the order but amended the judgment to give Lafayette a credit for the deducible and reduced the attorney fee percentage, It also awarded Royal Cloud interest from the date of the judgment and an additional $62,400.00 for roof damages.

  • An Orleans Parish attorney is facing disciplinary charges after he allegedly notarized four Hurricane Katrina insurance lawsuits, which were filed by a public adjuster without an attorney's license.

    The Louisiana Attorney Disciplinary Board (LADB) filed formal charges against Derek Russ for "aiding another in the unauthorized practice of law," "conduct involving misrepresentation" and "conduct prejudicial to the administration of justice."

    LADB Chair Anthony Dunbar, attorney member Glen Adams and public member Roy Richardson filed the report to the Board on March 2.

    The misconduct occurred in August and September 2007 when public adjustor S. Roy Ellison filed four suits on behalf of residents with insurance claims following hurricane Katrina.

    Russ, then working as a clerk in the First City Court, notarized affidavits on four suits Ellison filed and three Power of Attorney and Declaration of Representative forms without witnessing the parties sign.

    The LADB committee found that Russ did not receive compensation for notarizing the affidavits and notarized documents without all parties present because of "his concern that a two-year prescriptive period for such claims was about to expire."

    The committee believes Russ "is remorseful for these errors" and found that he was compliant in their investigation.

    Russ "has the potential to be a productive member of the Bar [and the Committee] finds a public reprimand to be the appropriate sanction."

  • Public Insurance Adjusters Are the People's 'Good Guys'
    By David Beasley, Sunshine State News

    Click here for full article.

  • A CONCURRENT RESOLUTION

    To create an advisory committee to study the feasibility of authorizing public adjusters to

    charge consumers on a contingency fee basis for loss adjustment services.

    WHEREAS, public adjusters are professional authorities on loss adjustments who

    assist policyholders by analyzing damages, assembling claims support data, and reviewing

    the policyholder's coverage for a full analysis and adjustment of a claim; and

     

    The entire resolution appears attached to this posting.

  • The Senate has passed the Dodd-Frank financial services reform package that will have some impact on the insurance industry and add involvement by the federal government in the state-based insurance regulatory system.

    The 2,300-page bill, which passed the Senate by a 60 to 39 margin yesterday, aims to address regulatory weaknesses blamed for the 2008 financial crisis. It gives regulators broad authority to rein in banks, limit risk-taking by financial firms and supervise previously unregulated trading. It also makes it easier to liquidate large, financially interconnected institutions, and it creates a new consumer protection bureau to guard against lending abuses.

    The National Association of Surplus Lines Offices (NAPSLO) hailed the passage of the bill as a "big win," after several provisions were included to modernize the surplus lines industry.

    Those changes would speed up and ease access to the surplus lines markets by consumers, and reduce administrative compliance issues by establishing that only the home state of the insurer can regulate multi-state transactions.

    "These surplus lines reforms represent a nearly decade-long industry effort spearheaded by NAPSLO to modernize and reform surplus lines regulation. With the legislation now approved by Congress, we look to the states to implement its provisions in the way Congress intends and bring about, on a nationwide basis, the anticipated efficiencies in surplus lines regulation and tax payment mechanisms the legislation promises," NAPSLO President Marshall Kath said.

    Ken A. Crerar, president of The Council of Insurance Agents & Brokers, echoed those statements, adding "passage of this bill is important not only for (agents) but also for their commercial clients… Now that multi-state surplus lines placements will be subject to regulatory oversight by a single state, a substantively streamlined process will be created for commercial consumers, regulators, insurers and brokers. This change will provide for a uniform approach to regulating the surplus lines market and once signed into law, will go a long way to addressing long-time marketplace problems."

    The bill also establishes a federal office of insurance (FIO), which will increase the federal government's role in addressing insurance-related issues.

    David A. Sampson, president and CEO of the Property Casualty Insurers Association of America (PCIAA), said that the final version of the bill contained a number of changes that would lessen the impact of federal oversight of the state-regulated insurance system, but also said "deep concern(s)" remained over the impact of the legislation.

    "It is important to note that this is still only the midpoint for financial services reform. We have a long road ahead of us as we move into the rule development phase," Sampson said. "We look forward to working with regulators to preserve a strong and stable insurance marketplace to protect home, auto and business owners."

    Leigh Ann Pusey, president and CEO of the American Insurance Association (AIA), said the completed bill "largely recognizes that property and casualty insurers do not pose systemic risk," which she called "a meaningful acknowledgment for the many policyholders that rely upon our low-risk business model to provide them security in times of uncertainty."

    Pusey also said the bill "takes necessary steps to prevent insurers from being lumped into many of the new 'bank-focused' provisions. This, too, is a substantial recognition of the insurance business model."

    President Obama is expected to sign the bill.

  • Allied Insurance, based in Des Moines, Iowa, announced new changes to its commercial quoting process that it says will allow independent agents to write business insurance quicker and easier. Among the new features:

        * 25 percent - 45 percent of previously asked commercial application questions have been eliminated (depending on the specific business-owners-product program);
        * Elimination of up to six supplemental applications;
        * Addition of clearer questions to improve underwriting efficiency and turnaround times.

    Allied Insurance President W. Kim Austen said the "changes reflect direct feedback from our agents, so we felt compelled to take steps that make Allied easier to do business with."

    Allied Insurance has also recently announced significant product changes with expanded coverage options and is now offering coverage enhancement endorsements for a wide range of industries and products.

    With a new application process for premier business owners and business auto, independent agents will be better equipped to meet their clients' needs with superior service and coverage from Allied, the company said.

    Allied operates in 34 states through a network of independent agents with regional offices in Denver, Colo.; Des Moines, Iowa; Lincoln, Neb.; Gainesville, Fla; and Sacramento, Calif. Allied has been a member of the Nationwide family of companies since 1998, and is responsible for Nationwide's independent agency system.

  • Regardless of the state you are licensed to work, you need to know that many new laws are being "proposed" all across the nation where the Public Insurance Adjuster is licensed. We mention this to our members so that they can be made aware of what is happening and what you can do to get involved with your profession. AAPIA is your advocate on a national level - we monitor all state legislatures and regulations as they appear and immediately review and comment on the efficacy and impact it may have on your profession.

  • The Louisiana State Assembly recently passed a concurrent resolution calling for the creation of an Advisory Committee to study the Public Insurance Act. AAPIA President Gene G. Veno was appointed to serve on this advisory committee that must complete its report no later than February 1, 2011
     

  • 2010 Bill Text LA H.B. 1475

    VERSION-DATE: May 7, 2010

    SYNOPSIS: AN ACT

    To amend and reenact R.S. 22:1703(A), relative to public adjuster fees; to require public adjuster contracts to be in writing and signed by the parties; to authorize a public adjuster to charge a certain percentage fee for their services; and to provide for related matters.

     

    The digest printed below was prepared by House Legislative Services. It

    constitutes no part of the legislative instrument. The keyword, one-liner,

    abstract, and digest do not constitute part of the law or proof or indicia of

    legislative intent. [R.S. 1:13(B) and 24:177(E)]

    Schroder

    HB No. 1475

    Abstract: Allows a public adjuster to charge a specific percentage fee.

    Present law provides that a public adjuster may charge the insured a reasonable fee. Further, provides that a public adjuster cannot solicit for or enter into any contract or arrangement between an insured and a public adjuster that provides for payment of a fee to the public adjuster which is contingent upon, or calculated as a percentage of, the amount