GA Public Adjuster flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Public adjuster license type

A distinct Georgia license class authorizing representation of insureds in first-party claims; it is separate from agent, broker, counselor, and company or independent adjuster licenses.

License term and expiration

Georgia public adjuster licenses run for two years and expire on the last day of the licensee's birth month; renewal requires continuing education and a fee before expiration.

Continuing education requirement

Public adjusters complete 24 credit hours per two-year term, including at least 3 hours of ethics, using courses approved by the Georgia Department of Insurance.

Grounds for discipline

Misrepresentation, fraudulent claims, rebating, commingling claim funds, failure to remit proceeds to the insured, and felony convictions involving dishonesty support fines, suspension, or revocation.

Nonresident public adjuster

A nonresident must hold a like license in the home state or qualify under reciprocity; Georgia may require the Georgia examination when no reciprocal license exists.

Appeal of Commissioner order

After notice and hearing, an adverse order may be appealed to the superior court of the licensee's county of residence within the statutory period.

Indemnity principle

Insurance restores the insured to the pre-loss financial position, no better and no worse; recovery is the lesser of the policy limit or the actual loss.

Insurable interest timing

For property insurance, insurable interest must exist at the time of loss; for life insurance, it must exist at policy inception.

Replacement cost versus ACV

Replacement cost is the cost to repair or replace with like kind and quality; actual cash value is replacement cost minus depreciation, paid first with recoverable depreciation held back.

Coinsurance formula

Payment equals (limit carried divided by limit required) times the loss, capped at the policy limit; an 80% clause on a $1,000,000 building requires $800,000 of coverage.

Deductible application

The deductible is subtracted from the loss before coinsurance and limits apply; percentage wind or hail deductibles may be calculated on the dwelling limit instead of the loss.

HO coverage letters

Coverage A is the dwelling, B other structures, C personal property, and D loss of use; Coverage C is capped as a percentage of Coverage A with sublimits on jewelry and cash.

Business income coverage

Pays net income loss plus continuing operating expenses during the period of restoration; extra expense coverage pays costs to avoid or minimize business interruption.

Standard fire policy baseline

Georgia requires standard fire policy provisions as a baseline for property coverage, including covered perils, exclusions, duties after loss, appraisal, and suit limitation.

First steps after loss

Secure the site, photograph and document damage, obtain the policy, and give the insurer prompt written notice of loss before detailed negotiation begins.

Proof of loss

A sworn statement of the amount claimed with supporting documentation, due within the period set by the policy, commonly 60 days after the insurer's request.

Duties after loss

Protect property from further damage, keep records, cooperate with the investigation, submit to examination under oath if required, and provide requested documents.

Appraisal provision

Each party selects a competent appraiser, the appraisers choose an umpire, and agreement by any two sets the amount of loss; appraisal does not decide coverage.

Xactimate estimating

A line-item pricing system used to estimate damage; adjusters distinguish repair versus replacement, code upgrades, general contractor overhead and profit, and debris removal.

Salvage and subrogation

The insurer may take salvage after paying a total loss; subrogation lets the insurer pursue a negligent third party while the insured recovers the deductible and uninsured portion.

Bad-faith claim remedies

Georgia prompt-pay rules require timely acknowledgment and action; unreasonably delayed or denied claims expose insurers to remedies under O.C.G.A. Title 33, Chapter 34.

Adjuster compensation limits

Compensation is limited by statute and contract; the written agreement must disclose the fee percentage or method and the insured's rescission right.

Fiduciary duty to insured

A public adjuster must place the insured's interest above the adjuster's own and may not accept compensation from an insurer or contractor for the same loss.

Solicitation restrictions

Georgia restricts soliciting at the scene of a loss before the insured is notified of the right to representation and bars door-to-door solicitation during declared emergencies.

Written contract requirement

The contract must be written, signed by the insured, state the fee or percentage, and disclose the cancellation right; missing disclosures make it unenforceable.

Emergency fee cap

Georgia limits a public adjuster's compensation on claims arising from a declared state of emergency and bars fees on amounts recovered without the adjuster's help.

Prohibited adjuster conduct

Misrepresenting policy terms, promising a specific settlement, advancing funds to the insured, and charging a fee before the claim is paid are prohibited.

Unfair settlement practices

Misrepresenting policy provisions, failing to investigate promptly, refusing to pay without reasonable basis, and failing to explain a denial are unfair claim settlement practices.

Consumer rights

The insured may be represented, receive a copy of the policy, and receive claim proceeds promptly; adjusters may not commingle claim funds with personal funds.

Reporting violations

Violations may be reported to the Georgia Department of Insurance, which may investigate, fine, suspend, or revoke; deceptive practices may also violate the Fair Business Practices Act.

Record retention

Claim files, including the contract, correspondence, and settlement documents, must be retained for the period required by the Department and produced during examinations.

Georgia Insurance Commissioner

The elected Commissioner of Insurance administers licensing, examinations, and enforcement under O.C.G.A. Title 33, including public adjuster licensing and discipline.