20-321 - Definitions
In this article, unless the context otherwise requires:
(a) Means any person who for compensation, fee or commission either:
(i) Adjusts, investigates or negotiates settlement of claims arising under property
and casualty insurance contracts on behalf of either the insurer or the insured.
(ii) Holds oneself out to perform a service listed in item (i) of this subdivision.
(b) Does not include:
(i) A licensed attorney-at-law who is qualified to practice law in this state.
(ii) A salaried employee of an insurer or of a managing general agent. For the
purposes of this item, "salaried employee" means an employee whose compensation is not
contingent on the outcome of a claim determination.
(iii) A licensed insurance producer who adjusts or assists in adjustment of losses
arising under policies procured through the insurance producer.
(iv) An employee of a political subdivision who adjusts or assists in the
adjustment of losses arising under policies covering the political subdivision or persons
indemnified by the political subdivision.
(v) An independent contractor retained by a licensed adjuster or a person listed in
items (i) through (iv) of this subdivision for the sole purpose of providing technical
assistance in connection with a claim. Independent contractors may include photographers,
estimators, engineers, private detectives or handwriting experts.
(vi) An individual who collects claim information from or furnishes claim
information to insureds or claimants and who conducts data entry, including entering data
into an automated claims adjudication system, if no more than twenty-five persons, as
described in this item, are under the supervision of a single licensed adjuster or
licensed producer. A licensed insurance producer who is supervising or adjusting claims
pursuant to this item is not required to be licensed as an adjuster.
(vii) Registered third-party administrators and their employees who are engaged in
administering accident and health or life insurance claims.
2. "Automated claims adjudication system" means a preprogrammed computer system
that is designed for the collection, data entry, calculation and final resolution of
portable consumer electronic products insurance claims and that:
(a) May be used only by a licensed adjuster, a licensed producer or supervised
individuals operating pursuant to this paragraph.
(b) Must comply with all claims payment requirements under this title and be
certified as compliant by a licensed adjuster.
3. "Portable consumer electronic products" means electronic devices and related
accessories that are portable in nature.