20-321. Definitions
In this article, unless the context otherwise requires:
1. " Adjuster" :
(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.
Section: Previous 20-299 20-300 20-301 20-302 20-311 20-311.01 20-311.02 20-321 20-321.01 20-321.02 20-331 20-331.01 20-332 20-333 20-336 NextLast modified: October 13, 2016