DE Public Adjuster cheat sheet

Delaware public adjusters are licensed by the Delaware Department of Insurance; a public adjuster represents the insured for compensation when negotiating a first-party property claim.

An applicant must be at least 18 years old, pass the required examination unless exempt, submit fingerprints for a criminal background check, and pay the applicable license fee.

A surety bond or proof of financial responsibility is required as a condition of licensure; the bond protects policyholders against misconduct, not the insurer.

Pre-licensing education is required before examination; the license is issued for a defined term and renewed with continuing education and fee payment.

A public adjuster license is separate from producer (agent/broker) and company-adjuster authority; holding one does not authorize the others.

Nonresident applicants may qualify through reciprocity or a nonresident license application; a designated home-state license and good standing are typical prerequisites.

Grounds for denial or discipline include fraudulent statements on the application, conviction of a crime involving dishonesty, prior license revocation, and unpaid judgments.

A public adjuster may not split fees with an unlicensed person or pay commissions to anyone for soliciting claim adjustment business.

Coverage analysis starts with the insuring agreement, then exclusions, then exceptions to exclusions, then policy conditions; the burden of proving a loss falls within coverage is on the insured.

Replacement cost pays the cost to repair or replace with new property of like kind and quality; actual cash value is replacement cost less depreciation.

Coinsurance applies where a policy requires insurance to at least a stated percentage of value; a penalty reduces recovery when the limit carried is below that percentage.

A deductible is subtracted from the loss before applying coinsurance calculations and any limit-of-liability cap.

Business income coverage responds to lost net income plus continuing normal operating expenses during the period of restoration caused by covered physical damage.

Ordinance or law coverage addresses the increased cost of complying with current building codes during repair; it is excluded unless endorsed.

Matching and undamaged-property questions turn on policy language and applicable law; cosmetic damage alone is not automatically compensable.

A proof of loss is a sworn statement of the amount claimed; the policy conditions set the deadline and the consequences of failure to submit.

The adjuster's core tasks are investigation, valuation, coverage determination, and documentation; each conclusion should be traceable to evidence in the claim file.

Damage estimating commonly uses unit-cost line items for labor, materials, and equipment, plus general contractor overhead and profit where multiple trades are involved.

Depreciation is calculated per component using age and expected useful life; recoverable depreciation is released after repair or replacement is completed and documented.

Documentation standards include photographs, measurements, moisture readings, weather data, receipts, and contractor bids retained in the claim file.

A sworn proof of loss, if required, states the amount claimed and is supported by the estimate and supporting documents; it is not a waiver of coverage disputes.

Settlement negotiation should be documented with dates, offers, counteroffers, and the basis for each figure to preserve the record for appraisal or litigation.

Appraisal is a contractual dispute-resolution process for the amount of loss, not for coverage questions; each side selects a competent appraiser.

Prompt communication duties run both ways: the insured must give notice of loss, and the adjuster must keep the insured informed of material developments.

The Delaware Department of Insurance, headed by the Insurance Commissioner, regulates insurers, producers, and adjusters and enforces the state Insurance Code.

Unfair claim settlement practices include misrepresenting policy provisions, failing to act promptly on communications, and refusing to pay without a reasonable investigation.

Insurers must acknowledge claim communications and conduct investigations within reasonable timeframes; unreasonable delay can constitute a violation.

The Commissioner may examine licensees, issue orders, impose fines, suspend or revoke licenses, and require restitution for violations.

Rate and form filings are regulated; a policy provision that conflicts with mandatory statutory requirements is unenforceable to that extent.

Insurer insolvency is handled through guaranty association mechanisms that pay covered claims up to statutory limits.

Records of claim transactions must be maintained and made available for examination; falsifying claim records is a violation.

Hearings and appeals follow the administrative process set by statute and regulation, with judicial review available after exhaustion of remedies.

A public adjuster owes a fiduciary duty to the insured; any conflict of interest must be disclosed and avoided where it would compromise representation.

A written contract is required, and it must state the compensation method, the insured's right to cancel within the statutory period, and the scope of services.

Solicitation during a declared emergency or at the site of a loss is restricted; unsolicited door-to-door solicitation of catastrophe victims is prohibited.

The adjuster may not advance funds to an insured in a way that creates an improper financial interest in the claim or settlement proceeds.

Misrepresenting the adjuster's authority, the insurer's obligations, or the value of a claim is a deceptive practice subject to discipline.

Commingling claim settlement funds with the adjuster's own funds is prohibited; client funds must be handled through proper accounts.

Confidentiality applies to the insured's personal and financial information; disclosure is limited to what is necessary to adjust the claim.

Referral fees to unlicensed persons and fee-splitting with non-licensees are prohibited; compensation may only be paid to licensed adjusters.

Delaware's Unfair Trade Practices Act prohibits misrepresentation, false advertising, and unfair claim settlement practices by licensees.

A consumer complaint filed with the Department of Insurance can trigger investigation; licensees must respond truthfully and completely.

Statutory cancellation and nonrenewal notice rules protect consumers; misstating those rights to an insured is a deceptive act.

Public adjuster compensation is limited to a stated percentage of the recovery and must be disclosed in the written contract before services begin.

Records retention and audit cooperation are consumer-protection requirements, because they allow regulators to verify fair claim handling.

Disciplinary sanctions can include fines, license suspension or revocation, restitution, and cease-and-desist orders.

Advertising by a public adjuster must not imply affiliation with an insurer, the state, or any government agency.

Failure to maintain licensure while adjusting claims is both a licensing violation and an unfair practice exposing the adjuster to civil liability.

Continuing education hours must be completed each renewal cycle, including any ethics or law hours the Department requires.

License status must be current and active whenever the adjuster negotiates or settles a claim for compensation.

Change of address, name, or business affiliation must be reported to the Department within the required timeframe.

Appointment or registration with an insurer or adjusting firm may be required before the adjuster can act on that entity's claims.

Criminal convictions and administrative actions must be disclosed on applications and renewals; nondisclosure is itself a violation.

Reciprocity with other states depends on the home state's license type and standing; a lapsed home license defeats nonresident eligibility.

Supervision and training requirements apply to newly licensed adjusters in some circumstances; unlicensed assistants may not negotiate claims.

Renewal late fees and reinstatement rules apply after expiration; practicing on an expired license is unlicensed activity.