RHODE ISLAND ADJUSTER LICENSING INFORMATION

License Types

Effective January 1, 2015: the Rhode Insurance Claim Adjuster statute has been amended. R.I. Gen. Laws § 27-10 now provides that Rhode Island will issue three distinct adjuster licenses. Those licenses are (1) company adjuster (2) independent adjuster and (3) public adjuster. All persons applying for an adjuster license after January 1, 2015 will select from one of these three categories and apply for that license type.

Independent Adjuster

§ 27-10-1.1. Definitions: (f) "Independent adjuster" means a person who:

(1) Is an individual who contracts for compensation with insurers or self-insurers as an independent contractor; or

(2) Investigates, negotiates, or settles property, casualty, or workers' compensation claims for insurers or for self-insurers as an independent contractor.

Independent Adjusters are licensed in Rhode Island.
License type: Individual and Business Entity

Public Adjuster

§ 27-10-1.1. Definitions: (i) "Public adjuster" means any person who, for compensation or any other thing of value on behalf of the insured:

(1) Acts or aids, solely in relation to first-party claims arising under insurance contracts that insure the real or personal property of the insured, other than automobile, on behalf of an insured in negotiating for, or effecting the settlement of, a claim for loss or damage covered by an insurance contract;

(2) Advertises for employment as a public adjuster of insurance claims or solicits business or represents himself or herself to the public as a public adjuster of first-party insurance claims for losses or damages arising out of policies of insurance that insure real or personal property; or

(3) Directly or indirectly solicits business, investigates or adjusts losses, or advises an insured about first-party claims for losses or damages arising out of policies of insurance that insure real or personal property for another person engaged in the business of adjusting losses or damages covered by an insurance policy, for the insured.

Public Adjusters are licensed in Rhode Island.
License type: Individual and Business Entity

Company Adjuster

§ 27-10-1.1. Definitions. [Effective January 1, 2015.]

(c) "Company adjuster" means a person who:

(1) Is an individual who contracts for compensation with insurers or self-insurers as an employee; and

(2) Investigates, negotiates, or settles property, casualty, or workers' compensation claims for insurers or for self-insurers as an employee.

Emergency licenses

Emergency licenses ( § 27-10-8. ) (Effective January 1, 2015)

(a) In the event of a declared catastrophe, an insurer shall notify the department, via an application for temporary emergency licensure, of each individual, not already licensed in the state where the catastrophe has been declared, who will act as an emergency company or independent adjuster on behalf of the insurer.

(b) A person who is otherwise qualified to adjust claims, but not already licensed in this state where the catastrophe has been declared, may act as an emergency company or independent adjuster and adjust claims, if, within five (5) days of deployment to adjust claims arising from the declared catastrophe, the insurer notifies the department by providing the following information in a format prescribed by the insurance commissioner:

(1) Name of the individual;

(2) Social security number of individual;

(3) Name of insurer the company or independent adjuster will represent;

(4) Effective date of the contract between the insurer and company or independent adjuster, if applicable;

(5) Catastrophe or loss control number;

(6) Catastrophe event name; and

(7) Other information the department deems necessary.

(c) An emergency company or independent adjuster's license shall remain in force for a period not to exceed ninety (90) days, unless extended by the department.

(d) Any person licensed as an emergency company or independent adjuster must comply with all laws of this state in the same manner as if he or she had been issued a company or independent adjuster and both he or she and the insurer for whom the adjuster is working are responsible in the same manner as they would be if the adjuster was a fully licensed adjuster.

(e) There is no fee payable to the state for the licensing of the emergency adjuster. However, in order to assist in the performance of the department's duties, the department may contract with non-governmental entities, including the NAIC, its affiliates, or subsidiaries, to perform any ministerial functions related to licensing that the department may deem appropriate and the applicant is responsible for the fee associated with these services as determined by the department.

(f) Public adjusters are not eligible for licensing under this section.

Veteran's license

Veteran's license § 27-10-4

The commissioner shall issue a license as an insurance claim adjuster, other than for life and accident and health insurance, without the payment of a fee, to any honorably discharged soldier, sailor, or marine who has at any time served the United States in time of war, and who shall present proof that he or she is the person who served and provides the certificate of his or her honorable discharge.

Exclusions

§ 27-10-2. Persons exempt. [Effective January 1, 2015.]

The provisions of this chapter shall not apply to the following:

(1) An attorney at law admitted to practice in this state, acting in his or her professional capacity as an attorney;

(2) Either an insurance producer of a domestic insurance company or an insurance producer duly licensed by the insurance commissioner, when the insurance producer adjusts, or assists in the adjustment of, claims arising only under policies of insurance or fidelity or surety bonds negotiated, solicited, or effected by him or her or by the insurance producer, whether the insurance producer is a person, partnership, or corporation, for which he or she acts;

(3) A person who negotiates or settles claims arising under a life or health insurance policy or an annuity contract;

(4) A person employed only for the purpose of obtaining facts surrounding a loss or furnishing technical assistance to a licensed adjuster, including photographers, estimators, private investigators, engineers, and handwriting experts;

(5) An individual who is employed to investigate suspected fraudulent insurance claims but who does not adjust losses or determine claims payments;

(6) A person who solely performs executive, administrative, managerial, or clerical duties, or any combination thereof, and who does not investigate, negotiate, or settle claims with policyholders, claimants, or their legal representative;

(7) A licensed health care provider or its employee who provides managed care services as long as the services do not include the determination of compensability;

(8) A managed care organization or any of its employees or an employee of any organization providing managed care services so long as the services do not include the determination of compensability;

(9) A person who settles only reinsurance or subrogation claims;

(10) A person who investigates, negotiates, or settles life, accident and health, annuity, or disability insurance claims;

(11) An individual employee, under a self-insured arrangement, who adjusts claims on behalf of their employer;

(12) A person authorized to adjust workers' compensation or disability claims under the authority of a third-party administrator (TPA) license pursuant to chapter 20.7 of title 27;

(13) A person who adjusts claims for portable electronic insurance offered pursuant to chapter 2.7 of title 27

Licensing Requirements

Requirements

To become a licensed Rhode Island insurance adjuster, individuals must:
•       Be 18 years of age or more.
•       Obtain a Criminal Background Check, unless already licensed in a reciprocal state.
•       New York residents must submit fingerprint cards.
•       Massachusetts residents must complete a CORI request form (Criminal Offender Record Information).
•       In the event of a catastrophe, Rhode Island will issue a temporary emergency Adjuster license, valid for 60 days. Applicants will only be granted this emergency license if they have adjusting experience and are represented by a licensed RI adjuster or insurer, acting as their employer.
•       Resident applicants applying for an initial Public Adjuster license on January 1, 2015 or later will have to pass the Public Adjuster exam. Rhode Island will issue a nonresident public adjuster license to a non-resident licensed in their “DHS”.

§ 27-10-2. License required. [Effective January 1, 2015.]

(a) A person shall not act or hold himself out as a public, company or independent adjuster in this state unless the person is licensed in accordance with this chapter.

(b) A person licensed as a public adjuster shall not misrepresent to a claimant that he or she is an adjuster representing an insurer in any capacity, including acting as an employee of the insurer or acting as an independent adjuster.

§ 27-10-3. Issuance of license. [Effective January 1, 2015.]

(a) The insurance commissioner may issue to any person a license to act as either a public adjuster; company adjuster; or independent adjuster once that person files an application in a format prescribed by the department and declares under penalty of suspension, revocation, or refusal of the license that the statements made in the application are true, correct, and complete to the best of the individual's knowledge and belief. Before approving the application, the department shall find that the individual:

(1) Is at least eighteen (18) years of age;

(2) Is eligible to designate this state as his or her home state;

(3) Is trustworthy, reliable, and of good reputation, evidence of which shall be determined by the department;

(4) Has not committed any act that is a ground for probation, suspension, revocation, or refusal of a professional license as set forth in § 27-10-12;

(5) Has successfully passed the examination for the line(s) of authority for which the person has applied;

(6) Has paid a fee of one hundred and fifty dollars ($ 150).

(b) A Rhode Island resident business entity acting as an insurance adjuster may elect to obtain an insurance adjusters license. Application shall be made using the uniform business entity application. Prior to approving the application, the insurance commissioner shall find both of the following:

(1) The business entity has paid the appropriate fees.

(2) The business entity has designated a licensed adjuster responsible for the business entity's compliance with the insurance laws and rules of this state.

(c) The department may require any documents reasonably necessary to verify the information contained in the application.

Reciprocity and Non Residents

As of January 1, 2015 Non-Resident Adjuster licenses will be reciprocal with all states. Individual licenses will be issued based on reciprocity of the licensee’s “DHS” (DesignatedHome State). The licensee will be issued a Rhode Island license based on the type of adjuster license and “LOA” (Lines of Authority) held in the DHS.

Applicants are exempt from taking the Rhode Island exam only if they are licensed in their home state and their home state is one of the following reciprocal states: Connecticut, Kentucky, Maine, Michigan, New Hampshire, North Carolina, Oklahoma, South Carolina, Texas, Vermont, or Wyoming.

RHODE ISLAND Non-Resident Licensing for Individual & Business Entity: http://www.nipr.com/state_rules/nrl/ri_nrl.htm

Reciprocity with Texas license

Reciprocal with Texas License? Yes.

Rhode Island only grants reciprocity to those holding a Texas resident license.

Pre Licensing Education

§ 27-10-6. Minimum percentage of licensed adjusters : Examination of applicants

Any person who desires to act as an insurance claim adjuster or who is employed by an insurance company doing business in the state of Rhode Island and desires to act within the state as an insurance adjuster shall make a written application to the insurance commissioner for a license to engage in this type of business. All insurance claims adjusters and those employed by insurance companies in the state of Rhode Island as of January 1, 1976, who hold current and valid licenses including all persons engaged in the business of public adjusting as of June 12, 1985 shall automatically qualify for a license to handle the various lines of business for which they are qualified. Insurance claim adjusters who have less than one year's experience adjusting claims shall be classified as trainees and it will be necessary for them to obtain a license to adjust claims in the state of Rhode Island in accordance with the provisions of this section. No insurance company shall have more than twenty-five percent (25%) of its insurance claim adjusters in a trainee classification where that adjusting force consists of at least ten (10) people; this shall not apply to company training programs to qualify personnel in other jurisdictions. A minimum of seventy-five percent (75%) of the insurance claim adjusters in any claims office shall be licensed insurance claim adjusters in the state of Rhode Island. The commissioner shall subject the applicant to a written examination as to his or her competency to act as an insurance claim adjuster. These examinations shall be conducted at the discretion of the commissioner, but in no event less than quarterly.

§ 27-10-6. Examination. [Effective January 1, 2015.]

(a) The department shall subject the applicant to a written examination as to his or her competency to act as an insurance claim adjuster. The examination shall test the knowledge of the individual concerning the duties and responsibilities of an adjuster and the insurance laws and regulations of this state.

(b) The department may make arrangements, including contracting with an outside testing service, for administering examinations and collecting a nonrefundable fee for the examination.

(c) Each individual applying for an examination shall remit a non-refundable fee as prescribed by the department.

(d) An individual who fails to appear for the examination as scheduled or fails to pass the examination shall reapply for an examination and remit all required fees and forms before being rescheduled for another examination.

(e) The department may accept successful completion of an examination administered by a federal entity in substitute for a state examination for the crop line of authority for company/independent adjusters.

§ 27-10-7. Exemptions from examination. [Effective January 1, 2015.]

(a) An individual who applies for an adjuster license in this state who was previously licensed as an adjuster in another state based on an adjuster examination shall not be required to complete the examination. This exemption is only available if the person is currently licensed in that state, or if the application is received within twelve (12) months of the cancellation of the applicant's previous license and if the prior state issues a certification that, at the time of cancellation, the applicant was in good standing in that state or the state's database records or records maintained by the NAIC, its affiliates, or subsidiaries, indicate that the adjuster is or was licensed in good standing.

(b) A person licensed as an adjuster in another state based on an adjuster examination who moves to this state shall make application within ninety (90) days of establishing legal residence to become a resident licensee. No examination shall be required of that person to obtain an adjuster license.

How to Apply

§ 27-10-5.License. [Effective January 1, 2015.]

(a)Unless denied licensure, persons who have met the requirements of § 27-10-3 shall be issued either a public, company, or independent adjuster license.

(b) A company or independent adjuster may qualify for a license in one or more of the following lines of authority:

(1) Property and casualty;

(2) Workers Compensation; or

(3) Crop.

(c) An individual may not hold both a public adjuster and a company or independent adjuster license at the same time.

(d)An adjuster license shall remain in effect unless probated, suspended, revoked, or refused as long as a biennial application for renewal and fee set forth in § 27-10-3(a)(6) is paid and all other requirements for license renewal are met by the due date; otherwise, the license expires.

(e) An adjuster whose license expires may, within twelve (12) months of the renewal date, be reissued an adjuster license upon receipt of the renewal request, as prescribed by the department. However, a penalty in the amount of fifty dollars ($ 50.00) in addition to the renewal fee shall be required to reissue the expired license.

(f) An adjuster who is unable to comply with license renewal procedures and requirements due to military service, long-term medical disability, or some other extenuating circumstance may request a waiver of same and a waiver of any examination requirement, fine, or other sanction imposed for failure to comply with renewal procedures.

(g) An adjuster shall be subject to chapters 9.1 and 29 of title 27.

(h) The adjuster shall inform the department by any means acceptable of any change in resident or business address(es) for the home state or in legal name within thirty (30) days of the change.

(i) In order to assist in the performance of the department's duties, the department may contract with non-governmental entities, including the National Association of Insurance Commissioners (NAIC), its affiliates or subsidiaries, to perform any ministerial functions, including the collection of fees and data, related to licensing that the insurance commissioner may deem appropriate.

§ 27-10-5. Application for license : Accompanying papers

An application by a person applying for the first time for a license to act as an insurance claim adjuster, shall be on a form furnished by the insurance commissioner and provide all of the information required by the insurance commissioner for licensing.

Maintaining Your License

Renewal

Licenses will expire after two years.

Continuing Education

No Continuing Education is required.

License Termination or Lapse

License renewal will be processed through www.nipr.com and CLM Tracker. The Insurance Division will mail out renewal notices with specific instructions 60 days prior to your license expiration date.

§ 27-10-11. Penalty for violations. [Effective January 1, 2015.]

Any person who acts as an adjuster, other than for life and accident and health insurance, without holding a current, valid license as provided in this chapter, or shall act in any manner in the negotiation of any insurance claim agreement in violation of any provision of this chapter shall be punished by an order to cease and desist such practices and fine or other penalty in accordance with the standards of § 42-14-16.

§ 27-10-12. Enforcement

The insurance commissioner shall enforce the provisions of this chapter and shall have the authority to promulgate all reasonable rules and regulations necessary to effect and to enforce the purposes and provisions of this chapter.

§ 27-10-12. License denial, non-renewal, or revocation. [Effective January 1, 2015.]

(a) The insurance commissioner may place on probation, suspend, revoke, or refuse to issue or renew an adjuster's license or may levy a civil penalty in accordance with § 42-14-16 or any combination of actions for any one or more of the following causes:

(1) Providing incorrect, misleading, incomplete, or materially untrue information in the license application;

(2) Violating any insurance laws, or violating any regulation, subpoena, or order of the insurance commissioner or of another state's insurance commissioner;

(3) Obtaining or attempting to obtain a license through misrepresentation or fraud;

(4) Improperly withholding, misappropriating, or converting any monies or properties received in the course of doing insurance business;

(5) Intentionally misrepresenting the terms of an actual or proposed insurance contract or application for insurance;

(6) Having been convicted of a felony;

(7) Having admitted, or been found to have committed, any insurance unfair trade practice or insurance fraud;

(8) Using fraudulent, coercive, or dishonest practices; or demonstrating incompetence, untrustworthiness or financial irresponsibility in the conduct of business in this state or elsewhere;

(9) Having an insurance license, or its equivalent, denied, suspended, or revoked in any other state, province, district, or territory;

(10) Forging another's name to an application for insurance or to any document related to an insurance transaction;

(11) Cheating, including improperly using notes or any other reference material, to complete an examination for an insurance license;

(12) Knowingly accepting insurance business from an individual who is not licensed but who is required to be licensed by the department;

(13) Failing to comply with an administrative or court order imposing a child support obligation; or

(14) Failing to pay state income tax or comply with any administrative or court order directing payment of state income tax.

(b) In the event that the action by the department is to deny an application for or not renew a license, the department shall notify the applicant or licensee and advise, in writing, the applicant or licensee of the reason for the non-renewal or denial of the applicant's or licensee's license. The applicant or licensee may make written demand upon the department within ten (10) days for a hearing before the department to determine the reasonableness of the insurance commissioner's action. The hearing shall be held pursuant to the Administrative Procedures Act, chapter 35 of title 42.

(c) The license of a business entity may be suspended, revoked, or refused if the department finds, after hearing, that an individual licensee's violation was known, or should have been known, by one or more of the partners, officers, or managers acting on behalf of the business entity and the violation was neither reported to the department nor corrective action taken.

(d) In addition to, or in lieu of, any applicable denial, suspension or revocation of a license, a person may, after hearing, be subject to a civil fine according to § 42-14-16.

(e) The department shall retain the authority to enforce the provisions of and impose any penalty or remedy authorized by this chapter and § 42-14-16 against any person who is under investigation for, or charged with, a violation of this chapter or title even if the person's license has been surrendered or has lapsed by operation of law.

§ 27-10-13.Rules and regulations. [Effective January 1, 2015.]

The insurance commissioner shall have the authority to promulgate all reasonable rules and regulations necessary to effect and to enforce the purposes and provisions of this chapter. Included within this authority is the power to set standards for public adjuster fees, the terms of the contract between a public adjuster and a consumer, and requirements for escrow accounts held by public adjusters for funds held on behalf of others.

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