TITLE 41

INSURANCE

CHAPTER 11

ADJUSTERS

41-1102.  "Adjuster" defined. (1) An "adjuster" is a person who, on behalf of the insurer, for compensation as an independent contractor or as the employee of such an independent contractor, or for fee or commission, investigates and negotiates settlement of claims arising under insurance contracts.

(2)  None of the following is an "adjuster" for the purposes of this chapter:

(a)  A licensed attorney at law who is qualified to practice law in this state.

(b)  The salaried employee of an authorized insurer, or group of such insurers under common control or ownership, or of a managing general agent, who adjusts losses for such insurer or insurers or for the authorized insurers represented by the general agent.

(c)  The licensed agent of an authorized insurer who, at the insurer’s request, from time to time adjusts or assists in adjustment of losses arising under policies issued by such insurer.

(d)  An individual who collects claim information from, or furnishes claim information to, claimants or those who are insured and who conducts data entry, including entering data into an automated claims adjudication system, provided that the individual is an employee of a licensed adjuster or its affiliate where no more than twenty-five (25) such persons are under the supervision of one (1) licensed adjuster or licensed agent. A licensed agent who acts as a supervisor or adjusts claims pursuant to the provisions of this paragraph is not required to also be licensed as an adjuster. For purposes of this section, "automated claims adjudication system" means a pre-programmed computer system designed for the collection, data entry, calculation and final resolution of portable electronics insurance claims that:

(i)   May only be utilized by a licensed adjuster, licensed agent or supervised individuals operating pursuant to the provisions of this paragraph;

(ii)  Must comply with all claims payment requirements of the insurance code; and

(iii) Must be certified as compliant with this section by a licensed adjuster who is an officer of a licensed business entity pursuant to the provisions of this chapter.

History:

[41-1102, added 1961, ch. 330, sec. 238, p. 645; am. 2012, ch. 226, sec. 12, p. 626.]