New Mexico Administrative Code
Title 13 - INSURANCE
Chapter 4 - LICENSING OF INSURANCE PROFESSIONALS
Part 8 - PUBLIC, STAFF AND INDEPENDENT ADJUSTERS
Section 13.4.8.14 - CONDUCT OF ADJUSTERS
Universal Citation: 13 NM Admin Code 13.4.8.14
Current through Register Vol. 35, No. 18, September 24, 2024
A. Standards of conduct. All adjusters shall adhere to the following standards of conduct:
(1) An adjuster shall
not permit an unlicensed employee or representative of the adjuster to conduct
business for which a license is required pursuant to the Insurance
Code.
(2) An adjuster shall be
honest and fair in all communications with the insured, the insurer and the
public.
(3) An adjuster shall give
prompt, knowledgeable service and courteous, fair and objective treatment at
all times.
(4) An adjuster shall
not give legal advice, and shall not deal directly with any policyholder or
claimant who is represented by legal counsel without the consent of the legal
counsel involved.
(5) An adjuster
shall comply with all local, state and federal privacy and information security
laws, if applicable.
(6) An
adjuster shall not pay a commission, service fee or other valuable
consideration to a person for investigating or settling claims in this state if
that person is required to be licensed pursuant to the Insurance Code and is
not so licensed.
(7) An adjuster
shall not undertake the adjustment of any claim if the adjuster is not
competent and knowledgeable as to the terms and conditions of the insurance
coverage or which otherwise exceeds the adjuster's experience. An adjuster
shall obtain competent technical assistance, when necessary to help handle
claims and losses outside the adjuster's area of expertise.
(8) An adjuster shall disclose to an insured
if the adjuster has any interest or will be compensated by any construction
firm, salvage firm, building appraisal firm, motor vehicle repair shop or any
other business entity that performs any work in conjunction with damages caused
by the insured loss.
B. Conduct prohibited.
(1) An
adjuster shall not represent an insured on a claim or charge a fee to an
insured while representing the insurance carrier against which the claim is
made.
(2) An adjuster shall not
advance money to any potential client or insured.
(3) An adjuster shall not adjust a loss
related to physical damage of a property on which the adjuster also acts as or
is employed as any type of contractor or otherwise provides building repairs or
products of any type for compensation, or is a controlling person in a business
relating to such contracting, regardless of whether the contractor is a
licensed adjuster.
(4) An adjuster
shall avoid any direct or indirect financial interest of a claim adjusted by
the adjuster other than the salary, fee, commission or other consideration
established in a written contract, unless, in the case of a public adjuster,
full written disclosure has been made to the insured.
(5) An adjuster shall avoid conflicts of
interest, including acquiring any interest in salvaged property or
participating in any way, directly or indirectly, in the reconstruction,
repair, or restoration of damaged property that is the subject of a claim
adjusted, unless, in the case of a public adjuster, full written disclosure has
been made to the insured and written permission has been obtained from the
insured.
(6) In those instances in
which an adjuster who is also a contractor is performing either as an adjuster
or as a contractor on behalf of an insured, the adjuster shall provide the
insured with a disclaimer, on a form promulgated by the superintendent and
signed by the adjuster, indicating in which of these two capacities the
adjuster is serving the insured and affirming that the adjuster is not serving
the insured in the other capacity. The adjuster shall retain copies of such
signed disclaimers and make them available to the superintendent upon the
superintendent's request.
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