Download Insurance Adjusting: Roles, Licensing, and Regulations in Texas and more Exams Finance in PDF only on Docsity! Essential Concepts and Regulations in Insurance Adjusting Insurance adjuster: Any person who, as an independent contractor, or as an employee of an independent contractor, adjustment bureau, association, insurance company or corporation, local recording agent, managing general agent, or self- insured, investigates or adjusts losses on behalf of either an insurer or a self-insured, or any person who supervises the handling of claims. Staff Adjusters: On the payroll of an insurance company and are paid a salary or by hour. Independent Adjuster: Handles claims for one or more insurance companies. They may receive a fee based on time and expense, be on the payroll as a permanent employee of an independent adjusting firm, or be paid a percentage of the loss or per diem. Public adjuster:Works on behalf of the insured in negotiating a claim settlement. Under current law in Texas, it is legal and requires another license. Worker's compensation Adjuster: This license allows a person to adjust or supervise all workers' compensation, employers liability, United States Longshore, and Harbor Works' Compensation Act, Jones Act, and all other federal acts. Property and Casualty Adjuster: This license allows a person to adjust or supervise claims in all areas of property and casualty insurance except workers' compensation. All-Lines Adjuster: This license allows a person to adjust or supervise claims in all lines of insurance included in (1) and (2). Domestic: An insurer organized, admitted, and writing insurance in Texas. Foreign: An insurer domiciled outside the state where it writes insurance. Alien: An insurance company organized and domiciled outside the US. Texas Department of Insurance: Responsible for licensing property and casualty adjusters. 10 days: How many days' advance notice is an adjuster entitled to receive in the event of a hearing with the Texas Department of Insurance. 30 hours: A licensed Property and casualty adjuster must complete how many hours of continuing education within his 2-year licensing period? AIC:Which of the following designations exempts a person from taking the property and casualty adjuster state exam? 18 years old: An individual must be what age to receive the property and casualty adjuster license? 2 hours: How many hours of ethics must a licensed adjuster complete every licensing period (2 years)? Within 30 days of the change: How soon must a licensed adjuster notify the Texas Department of Insurance (TDI) of an address change? Governor of Texas:Who appoints the commissioner of Insurance? 1 or more: How many companies might an independent adjuster represent? Insured: A public adjuster represents which of the following? Business day: This is a day other than a Saturday, Sunday, or a holiday recognized by this state. First-Party Claim: Claim made by an insured or policy holder under an insurance policy or contract or by a beneficiary named in the policy or contract. Must be paid by the insurer directly to the insured/beneficiary. Claimant: This is the person making a claim. Notice of the Claim: Any written notification provided by a claimant to an insurer that reasonably apprises the insurer of the facts relating to the claim. Within 15 days: The insurer must acknowledge receipt of the claim, commence any investigation of the claim, request from the claimant all items, statements, and forms that the insurer reasonably believes, at that time, will be required from the claimant within how many days? Within 15 business days after receiving complete information: An insurer must notify a claimant in writing of the acceptance or rejection of a claim when? Within 30 days of the date the insurer receives complete information: If an insurer has a reasonable basis to believe that a loss resulted from arson, the insurer must notify the claimant in writing of the acceptance or rejection of the claim. 15 days: In the event of a weather-related catastrophe, how long is the given extension for handling claims? 5 business days: Once the company agrees to pay the claim, it must send the check or draft within how many days? 2: How many parties does an insurance contract have?
