Current through all regulations passed and filed through September 16, 2024
(A) Purpose
The purpose of this rule is to safeguard the interest of the
public by regulating the conduct of public insurance adjusters.
(B) Authority
This rule is promulgated pursuant to the authority vested in
the superintendent under Chapter 3951. and section
3901.041
of the Revised Code.
(C)
Prohibited activities
No public insurance adjuster or public insurance
adjuster agent shall:
(1) Engage in any manner or degree, for
compensation of any kind, in the business of repairing, remodeling, or
replacing damaged or destroyed property, real or personal, which damage or
destruction is covered by a policy of insurance; nor have any direct or
indirect interest in, nor receive compensation of any kind from any person,
firm, association, partnership, or corporation which is engaged in such
business;
(2) Attempt in any manner
to solicit a loss during the progress of a fire or while the fire department or
any of its representatives are in any manner engaged at the damaged premises;
nor in any way interfere with the performance of the duties of an investigator
of the state fire marshal's office, an investigator of any fire department, or
a law enforcement official of this state or of any political subdivision
thereof;
(3) Give or offer to give
to an insured or
that person's representative any portion of the
adjuster's fee or anticipated settlement of the claim for loss or damage as an
inducement to secure a contract for the adjustment of a loss;
(4) Represent
that public
insurance adjuster to be an adjuster for or a representative of any
insurance company, a fire investigator, or a person connected with any fire
department or law enforcement agency;
(5) Compensate any person to act on
that
person's behalf in the solicitation, negotiation, or settlement of a
claim unless such person is licensed as a public insurance adjuster or a public
insurance adjuster agent;
(6) Make
an inventory or estimate of loss or damage other than that which is fair and
honest; and
(7) Own or acquire any
direct or indirect financial interest in any property, real or personal, which
is the subject of a loss adjusted by that public insurance
adjuster; nor have any direct or indirect financial interest in the sale
of any salvage of any property which is the subject of a loss adjusted by
that public
insurance adjuster.
(D) Records of adjuster
Every public insurance adjuster shall keep a full record of
that perons's transactions as an adjuster for the
previous three years and such records shall be open at all times to the
inspection of the superintendent of insurance or
the
superintendent's representative. Such records shall show for each loss
adjusted by the
public insurance adjuster:
(1)
The name of the insured;
(2) The
date, location, and the public insurance adjuster's estimate of the amount of
loss;
(3) The name of the insurer
or insurers which issued any policy covering the loss which was the subject of
the adjustment;
(4) The amount of
coverage, the expiration date, and the number of each policy of insurance
covering such loss;
(5) An itemized
statement of all recoveries by the insured from all sources with regard to such
loss;
(6) The names and addresses
of any person or persons soliciting the adjustment on behalf of the public
insurance adjuster and the date and time when solicited;
(7) The total compensation received by the
public insurance adjuster for the adjustment of the loss;
(8) Copies of any agreements between the
public insurance adjuster and the insured; and
(9) Names and addresses of all contractors
who performed or contracted to perform work of any kind on the damaged or
destroyed property prior to settlement of the claim.
(E) Contract requirements
(1) No public insurance adjuster shall use in
that
person's business as a public insurance adjuster a contract whereby an
insured engages or employs the public insurance adjuster to perform the
functions specified in division (A) of section
3951.01
of the Revised Code until thirty days after the form of such contract has been
filed with the superintendent of insurance, unless within such time the
superintendent gives the public insurance adjuster written approval for the use
of such form. If the superintendent finds within such thirty-day period that
the form filed contains any language which is prohibited by any law of this
state, including any rule of the superintendent, or that it is inconsistent,
ambiguous, misleading, deceptive, or likely to mislead an insured, the
superintendent will give written notice of such finding to the public insurance
adjuster who filed the form, and the public insurance adjuster shall thereafter
not use such form.
(2) Every such
contract must conspicuously set out the fee of the public insurance adjuster
for the adjustment services to be rendered the insured pursuant to the
contract.
(F)
Restriction on insurers
(1) No insurer
authorized to issue the types of insurance policies set forth in division (B)
of section
3951.01
of the Revised Code shall:
(a) Recognize a
public insurance adjuster as a party interested in the proceeds of any
insurance settlements arising from such policies or negotiate an insurance
settlement with a public insurance adjuster representing an insured unless such
public insurance adjuster has been duly licensed as a public insurance adjuster
by the department of insurance.
(b)
Negotiate an insurance settlement with a representative of an insured, other
than a licensed public insurance adjuster, unless such representative has been
duly appointed as such by a court of law or is one of those persons enumerated
in division (E) of section
3951.01
of the Revised Code.
(2)
Each insurance company referred to in paragraph (F)(1) of this rule shall keep
a record of each insurance loss and/or settlement wherein the insured was
represented by a public insurance adjuster. Such record shall include a copy of
the public insurance adjuster's certificate of authority.
(G) Suspension or revocation
The superintendent of insurance may suspend, revoke, or refuse
to renew the license of a public insurance adjuster or public insurance
adjuster agent found to be in violation of this rule. Such suspension,
revocation, or refusal to renew shall be in addition to, not a substitution
for, the penalties provided in section
3951.99 of the Revised
Code.
(H) Severability
If any paragraph, term or provision of this rule is adjudged
invalid for any reason, the judgment shall not affect, impair or invalidate any
other paragraph, term or provision of this rule, but the remaining paragraphs,
terms and provisions shall be and continue in full force and effect.
