CT Public Adjuster cheat sheet

Indemnity restores the insured to approximately the pre-loss financial position, no better and no worse; betterment is therefore deducted from a claim payment.

Insurable interest must exist at policy inception in property insurance and at the time of loss in life insurance; absence voids the contract.

Utmost good faith obliges both parties to disclose material facts; a material misrepresentation by the insured can allow rescission of the policy.

Subrogation transfers the insured's right of recovery against a negligent third party to the insurer after payment, preventing double recovery.

Actual cash value equals replacement cost minus depreciation; replacement cost pays the cost to repair or replace with new property of like kind and quality without depreciation.

Coinsurance is a property policy condition requiring the insured to carry a limit at least equal to a stated percentage of value; a lower limit reduces the loss payment proportionally.

The coinsurance formula is (limit carried divided by limit required) multiplied by the loss, capped at the policy limit; the required limit is the coinsurance percentage times the value at loss.

A deductible is the amount the insured absorbs before the insurer pays; a self-insured retention serves a similar function but the insured typically controls the defense of the claim.

A homeowners HO-3 form covers the dwelling on an open-peril basis and personal property on a named-peril basis; HO-5 covers both on an open-peril basis.

Coverage A is the dwelling, Coverage B other structures, Coverage C personal property, Coverage D loss of use, Coverage E personal liability, and Coverage F medical payments to others.

The standard fire policy and its successor forms exclude the peril of war, nuclear hazard, and intentional loss; ensuing loss from an excluded peril may still be covered if a covered peril follows.

A business income loss is measured by net income plus continuing normal operating expenses, less any reduction in expenses during the interruption period.

Commercial general liability coverage is triggered by bodily injury or property damage occurring during the policy period; occurrence forms do not cover the insured's own work.

A flood policy under the National Flood Insurance Program has a 30-day waiting period before coverage takes effect, with limited exceptions such as lender-required coverage at a new loan closing.

Workers compensation is a no-fault statutory benefit system covering medical costs and lost wages for work-related injury; the employer's liability part covers third-party suits.

An inland marine policy covers property that is mobile or in transit; a difference in conditions policy fills gaps left by a standard property form, such as flood or earthquake.

Prompt notice, prompt investigation, and prompt fair settlement are the core duties; a claim must be acknowledged and acted on within a reasonable time after notice.

The adjuster's first tasks are to verify coverage, confirm the policy was in force at the date of loss, and identify all applicable exclusions and endorsements.

Documentation should include photographs, measurements, a dated inventory of damaged property, receipts or other proof of value, and a written record of every conversation with the insured.

A proof of loss is a sworn statement of the amount claimed; the adjuster should request it in writing and note the policy deadline for submission.

Scope the damage line by line using unit costs for labor and materials, then apply depreciation for actual cash value or omit it for replacement cost, and finally apply the deductible.

When liability is unclear, an adjuster may make a reservation-of-rights or advance partial payment without waiving the insurer's right to deny the remainder.

Salvage and subrogation should be preserved: do not release damaged property or third-party recovery rights without the insurer's authorization.

A claim file must show the basis for every payment decision, including the pricing source, depreciation method, and any denial reason, so the file can withstand later review.

Connecticut public adjusters are licensed by the Connecticut Insurance Department; a license requires an application, examination, and the required fee, and must be renewed on the Department's cycle.

A public adjuster represents the insured, not the insurer, and must disclose that role in writing before entering a contract for services.

A written contract signed by the insured is required, and the compensation must be stated as a percentage of the recovery or as a fixed fee; the fee is subject to statutory limits.

Public adjusters may not solicit business at the scene of a loss before a reasonable time has passed, and may not act as both public adjuster and contractor on the same loss.

Connecticut's unfair trade practices law prohibits misrepresentation of policy terms, unreasonable delay in payment, and failure to conduct a reasonable investigation of a claim.

The Connecticut Insurance Department enforces the insurance statutes and may suspend or revoke a license for dishonest or fraudulent practices, and it accepts consumer complaints against licensees.

Records of each claim, including the contract and correspondence, must be retained for the period required by the Department and produced on request during an examination.

A public adjuster owes a fiduciary duty to the insured, meaning client funds and claim proceeds must be handled in a way that does not create a conflict of interest.

Any financial interest in a repair firm, contractor, or vendor involved in the loss must be disclosed in writing before the insured signs a contract.

An adjuster must not misrepresent the policy, the scope of damage, or the value of a claim to either the insured or the insurer.

Confidential client information may not be disclosed without authorization except as required by law or regulation.

A claim decision must rest on documented evidence; inflating a claim or accepting a knowingly inflated estimate is fraud.

Continuing education and knowledge of current policy forms and statutes are professional obligations, not optional extras.

Referrals to contractors should be offered only with disclosure that the insured may choose any contractor, and no compensation may be taken for the referral without disclosure.