New York Codes, Rules and Regulations
Title 11 - INSURANCE
Chapter II - Agents, Brokers And Adjusters
Part 25 - Public Adjusters
Section 25.12 - Payment of losses
Universal Citation: 11 NY Comp Codes Rules and Regs ยง 25.12
Current through Register Vol. 46, No. 39, September 25, 2024
(a)
(1) When a claim is settled where the insured
is represented by a public adjuster, the insurer shall follow the direction of
the insured, subject to the interests of any loss payee or mortgagee, as to who
shall be named on the insurer's check or checks by following the instructions
in a direction to pay letter signed by the insured and filed with the insurer.
The insurer shall not accept the direction to pay letter unless the letter is
signed by the first named insured with regard to commercial claims and by all
named insureds with regard to non-commercial claims, and the letter is
consistent with Form 4 in section
25.13(d) of this
Part.
(2) Upon the written
direction of the insured, the insurer shall make its check payable to both the
public adjuster and the insured, or to the public adjuster named as a payee,
but not in excess of the amount of the public adjuster's fee, as indicated in
the written compensation agreement signed by the party to be charged and filed
with the insure r, less any referral fee set forth in a disclosure statement
made pursuant to section
25.6(e)(4) of
this Part. The balance of the proceeds shall be made payable to the insured or
any loss payee or mortgagee, or both, whichever is appropriate. If an insured
does not submit a direction to pay letter to the insurer, then the insurer
shall not make any check payable to the public adjuster.
(3) Any payment made to a public adjuster
shall be only for those elements of the claim for which the public adjuster
represents the insured.
(4) A
direction to pay letter shall be valid for any payment made pursuant to a claim
unless revoked by the insured. A direction to pay letter shall be revocable by
any named insured at any time prior to the insurer issuing a check. If an
insured revokes a direction to pay letter, then the revocation shall be in
writing and signed by the insured. The insured shall submit the revocation to
the insurer and provide the public adjuster with a copy.
(5) A public adjuster shall not condition
doing business with an insured on the insured signing a direction to pay letter
that directs the insurer to name the public adjuster on the check.
(b) Any mediation, arbitration, or litigation proceeding involving a dispute regarding a loss in this State between an insured and a public adjuster initiated by a public adjuster shall be filed and held in this State and shall be subject to the laws of this State.
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