CT Public Adjuster key terms

A licensed professional hired by an insured, not the insurer, to prepare, document, and negotiate a first-party property claim in exchange for a fee or percentage of the settlement.

A financial stake in property such that the insured suffers genuine economic loss if it is damaged or destroyed; it must exist at the time of loss for a claim to be payable.

The core idea that insurance restores the insured to roughly the same financial position held before a loss, neither profiting the insured nor penalizing them beyond the deductible.

A valuation method equal to replacement cost minus depreciation, reflecting what the damaged property was worth just before the loss occurred.

The amount needed to repair or rebuild damaged property with new materials of like kind and quality at current prices, without subtracting depreciation.

The reduction in property value caused by age, wear and tear, or obsolescence, used to convert replacement cost into actual cash value.

An improvement in the property's condition resulting from repairs using newer or superior materials; insurers may withhold the added value so the insured does not profit from a loss.

A property policy provision requiring the insured to carry coverage equal to a stated percentage of property value, with a penalty reduction of the claim if underinsured at loss time.

The ratio of the policy limit carried to the true replacement cost of the insured property; carrying too little invites coinsurance penalties or inadequate recovery.

The amount of each covered loss the insured must absorb before the insurer pays; it may be a flat dollar figure or a percentage of the dwelling limit.

The maximum amount an insurer will pay for a covered loss under a given coverage part, as shown on the declarations page.

The opening section of a policy listing insured names, property address, coverage limits, deductibles, forms attached, and the effective policy period.

A written amendment attached to a policy that adds, deletes, or alters coverage terms; it controls over conflicting language in the base form.

A policy provision that removes specified perils, property, or circumstances from coverage, such as earth movement, flood, or intentional acts.

A distinct section of a property policy insuring a particular interest, such as the dwelling, other structures, personal property, loss of use, or liability.

A specific cause of loss, such as fire, windstorm, hail, or theft; policies may cover named perils only or insure against risk of direct physical loss.

A policy that pays only when a loss is caused by one of the perils expressly listed in the contract, placing the burden on the insured to show the cause fits.

An open-peril policy covering risks of direct physical loss unless the cause is specifically excluded, shifting the analysis to whether an exclusion applies.

The dominant, efficient cause that sets a loss in motion without which the damage would not have occurred, used to trace coverage through a chain of events.

A situation where a covered and an excluded peril act together to produce one loss; courts and policy language determine whether any recovery is allowed.

The increased likelihood of loss or inflated claiming that arises when insurance reduces the financial consequences of careless or dishonest conduct by an insured.

A sworn statement by the insured detailing the amount, date, cause, and supporting documentation of a claim, typically required within a policy-specified deadline.

A formal, recorded questioning of the insured under oath, conducted under policy cooperation provisions, to verify facts and documents supporting a claim.

The negotiated resolution of a claim in which the insurer agrees to pay a stated amount for covered damage, documented in a written settlement agreement or release.

A policy provision allowing the insured and insurer to each select a competent appraiser when they dispute the amount of loss, with an umpire resolving differences.

The organized record of a claim, including photographs, inventories, estimates, correspondence, and reports, that supports the amount claimed and the adjustment process.

The identification and measurement of all property affected by a loss, distinguishing genuinely damaged items from pre-existing conditions or unrelated defects.

An insurer's unreasonable or improper handling of a claim, such as unjustified delay or denial, which may expose it to liability beyond policy limits.

Statutorily prohibited insurer conduct in claims handling, including misrepresenting policy provisions, failing to investigate promptly, and offering unreasonably low settlements.

The legal obligation of a public adjuster to act in the insured's best interest, handling client funds and information with loyalty, honesty, and care.

A circumstance in which a public adjuster's personal, financial, or business interests could improperly influence advice or representation given to a client.

The written statement of a public adjuster's fee, typically a percentage of the settlement, provided to the client before a contract is signed.

The state agency that licenses insurers, producers, and public adjusters, enforces insurance statutes, and reviews market conduct and consumer complaints.

The credential issued by the Connecticut Insurance Department authorizing a person to act as a public adjuster, contingent on application, examination, and good standing.

Mandatory periodic coursework licensees complete to maintain an active public adjuster license and stay current on law, ethics, and adjusting practice.

Intentional deception for financial gain in an insurance transaction, such as exaggerating damage or submitting altered documents, which may void coverage and carry criminal penalties.

The obligation of a party to establish a fact by evidence; the insured generally must show a covered loss occurred, while the insurer must prove an exclusion applies.

An endorsement that pays a stated percentage above the dwelling limit, such as 125 percent, to cover rebuilding costs driven up by demand after a widespread catastrophe.