Current through Register Vol. 35, No. 18, September 24, 2024
A.
Description of independent adjusters.
(1) An independent adjuster is a professional
who conducts investigations, verification, negotiations, and settling of claims
for or on behalf of an insurance company, a self-insured firm, or a government
agency, without being under the employment of the company, firm, or agency in
question.
(2) Independent adjusters
either are hired through a third-party firm that specializes in handling claims
or are self-employed entities. A licensed independent adjuster may be
outsourced by an insurer to handle claims in this state.
(3) Independent adjusters are generally
utilized for one of the following reasons:
(a) to assist an insurer following a major
catastrophe resulting in a manpower shortage to investigate and negotiate on
its behalf;
(b) for statutory
reasons or to comply with provisions of an insurance contract;
(c) to meet a need for special expertise;
or
(d) to deal with claims in
remote areas.
B.
Powers and responsibilities of
independent adjusters. An independent adjuster shall have the powers
granted by its principal to investigate, report upon, adjust and settle claims
on behalf of an insurer or self-insurer and have additional powers as to claims
and losses only as may be conferred by the principal.
C.
Standards of conduct of independent
adjusters. In addition to the general standards of conduct that apply to
all adjusters as set forth in 13.4.8.14 NMAC, an independent adjuster shall
also self-identify as an independent adjuster and, if applicable, identify the
adjuster's employer when dealing with any policyholder or claimant.
D.
Records of independent
adjusters.
(1) Each independent
adjuster shall keep at the business address shown on his license a record of
all transactions under the license. The records shall include:
(a) documents relating to all investigations
or adjustments undertaken, and
(b)
a statement of any fee, commission or other compensation received or to be
received by the adjuster on account of such investigation or
adjustment.
(2) The
adjuster shall make such records available for examination by the
superintendent at all reasonable times, and shall retain records as to a
particular investigation or adjustment for not less than three years after
completion of such investigation or adjustment.
(3) Failure of a licensed independent
adjuster, as determined by the superintendent after notice and an opportunity
for a hearing, to properly maintain records in accordance with this section and
make them available to the superintendent on request constitutes grounds for
the suspension of the license.
