Current through November 25, 2024
(1) PURPOSE. This section provides limited
regulatory guidelines concerning the activities of claimant representatives.
This section also protects insurance consumers from practices that the
commissioner finds to be unfair trade practices. The commissioner finds as
unfair trade practices those practices in which a claimant representative
requires property to be repaired by a specified repair facility or contractor
for repairs, receives compensation for the referral of business to a repair
facility or contractor for repairs, operates as a repair facility or contractor
for repairs, participates in the insurance claim payments to a repair facility
or contractor for repairs, fails to disclose to the consumer the method of
compensation and fails to provide the consumer with copies of contracts entered
into between the claimant representative and consumer. This section requires a
claimant representative to disclose his or her method and manner of
compensation to the consumer and prohibits a claimant representative from
engaging in practices that create potential conflicts of interest. This section
implements and interprets s.
628.34(11) and (12), Stats. This section is in addition to,
and does not affect, s.
757.30,
Stats.
(2) SCOPE. This section
applies to all claimant representatives transacting business in this
state.
(3) DEFINITIONS. As used in
this section:
(a) "Contractor for repairs"
means the person, firm or corporation performing the repair work or furnishing
the materials for the repair work, or both, for a building, dwelling or
structure.
(b) "Claimant
representative" means any person, except an attorney licensed to practice law
in the state, who receives compensation from a claimant in exchange for
representing or advising the claimant in negotiations for the settlement of a
claim against an insurer arising out of the coverage provided by an insurance
policy. A claimant representative does not include a person whose sole service
to the claimant is to provide to the claimant an estimate or appraisal for
repairs.
(c) "Repair facility"
means the person, firm or corporation performing the repair work or furnishing
the materials for the repair work, or both, for tangible personal property
other than a building, dwelling or structure.
(4) DISCLOSURE REQUIREMENTS.
(a) No claimant representative may accept
compensation for performing services for or otherwise assisting a claimant with
an insurance claim unless, prior to performing any services and prior to the
claimant's assuming any obligation to pay for adjusting services, the claimant
representative clearly and conspicuously discloses and explains to the claimant
in writing the method and manner of receiving and accounting for compensation
for services performed.
(b) A
claimant representative shall submit to the claimant a copy of any written
contract entered into between the claimant representative and claimant within 5
working days after the contract is signed by the claimant. A claimant
representative shall commit to writing any oral agreement entered into between
the claimant representative and claimant and shall submit a copy of the writing
to the claimant within 10 working days after the agreement is made.
(5) PROHIBITED PRACTICES.
(a) No claimant representative may require
that repairs of property be performed by a specific repair facility or
contractor for repairs.
(b) No
claimant representative may receive any compensation from a repair facility or
contractor for repairs for referring business to the repair facility or
contractor for repairs.
(c) No
claimant representative may operate as a repair facility or contractor for
repairs or participate in any manner in the insurance claim payments to a
repair facility or contractor for repairs.
