LA Public Adjuster cheat sheet

Public adjusters are licensed by the Louisiana Department of Insurance (LDI); the Insurance Code is Title 22 of the Louisiana Revised Statutes and rules are in LAC Title 37, Part XI.

A public adjuster represents the insured only, for compensation, in first-party property claims; the insurer's representative is a company or independent adjuster, not a public adjuster.

Louisiana licenses adjusters under R.S. 22:1661 et seq.; a public adjuster license authorizes negotiation and settlement of claims on behalf of insureds for a fee, commission, or other compensation.

Licensees owe duties to the commissioner: notify LDI of address/name changes within the statutory period, respond to LDI inquiries, and keep records available for examination.

Continuing education: Louisiana adjusters must complete 24 credit hours every two years, including at least 3 hours of ethics; public adjusters must also satisfy any public-adjuster-specific CE required by rule.

Unfair trade practice provisions (R.S. 22:1961 et seq.) apply to adjusters: misrepresentation of policy provisions, unreasonable delay, and failure to act promptly on communications are prohibited.

Louisiana's Hurricane Katrina-era rules established standards for claim handling timeliness and documentation; the Insurance Code requires prompt investigation and good-faith communication of claim status.

Insurance fraud is criminal under R.S. 22:1921 et seq.; a public adjuster who knowingly submits or assists in a false or inflated claim risks license revocation and criminal referral.

LDI may fine, suspend, revoke, or refuse to renew a license after notice and hearing; emergency suspension is available where the public interest requires immediate action.

To be licensed, an applicant must pass the Louisiana public adjuster exam, submit fingerprints for a criminal background check, and meet character and fitness standards.

A public adjuster license is a separate license class from company/independent adjuster; holding one does not authorize acting under the other.

Nonresident public adjusters may qualify under reciprocity or by meeting Louisiana's nonresident requirements, including home-state licensure in good standing.

A written contract is required before a public adjuster may represent an insured; the contract must state the fee or commission, the services, and the insured's right to cancel.

Fees are typically a percentage of the settlement and must be disclosed in writing; charging, dividing, or accepting fees not disclosed in the contract is prohibited.

A public adjuster may not solicit a client at the scene of a loss or during a declared emergency in a manner prohibited by Louisiana law or emergency orders.

A public adjuster may not represent both the insured and the insurer on the same claim, and may not act on a claim where the adjuster has a conflict of interest.

Appointment/registration with the insurer is not required for public adjusters as it is for company and independent adjusters; the public adjuster's authority comes from the insured's written contract.

License renewal requires timely filing, fee payment, CE compliance, and no disqualifying enforcement action; practicing on a lapsed license is a violation.

Indemnity principle: the insured should be restored to pre-loss condition, no better; coverage is limited by policy limits, deductibles, and valuation method.

Replacement cost value (RCV) pays the cost to repair or replace with new material of like kind and quality; actual cash value (ACV) is RCV minus depreciation.

Coinsurance clauses on commercial property require the insured to carry a limit at least equal to the coinsurance percentage times the property's value at loss, or a penalty applies.

A deductible is subtracted before applying the limit; some policies have separate wind/hail and named-storm deductibles expressed as a percentage of the dwelling limit.

Named-peril policies cover only listed causes of loss; all-risk/open-peril policies cover all risks except exclusions, with the burden on the insurer to prove an exclusion applies.

Common exclusions include flood (federal NFIP or private flood coverage required), earth movement, ordinance or law, intentional loss, and neglect.

Business interruption covers lost income and continuing expenses during the period of restoration, subject to a waiting period and a limit.

Liability coverage (Coverage E personal liability; commercial general liability) pays sums the insured is legally obligated to pay for bodily injury or property damage, plus defense costs.

Louisiana's valued policy law (R.S. 22:1318) applies to total losses of real property under fire policies: the insured recovers the policy limit for a total loss, subject to statutory conditions.

Claim process: notice of loss, acknowledgment, investigation, damage evaluation, coverage determination, payment or denial, and documentation of the file.

Document the loss with photographs, measurements, diagrams, and a room-by-room inventory; date and label all evidence and preserve originals.

Scope the damage using recognized estimating standards (unit-cost line items for labor, material, and equipment) and separate covered from non-covered damage.

Apply the policy's valuation method: RCV requires a holdback for recoverable depreciation released when replacement is completed within the policy period.

Determine cause and origin before pricing; concurrent causation, faulty workmanship, and long-term seepage issues affect coverage.

Preserve the insured's duties after loss: prompt notice, protection of property from further damage, cooperation, proof of loss, and submission to examination under oath.

Louisiana requires prompt, good-faith handling; unreasonable delay or failure to communicate claim status can expose the insurer to statutory penalties and bad-faith damages.

Use qualified experts (engineers, contractors, accountants) for causation and valuation; document their credentials and the basis of their opinions.

Maintain a claim diary and written correspondence log; every payment, holdback, and denial should be traceable to a policy provision.

Fiduciary duty: the public adjuster owes loyalty to the insured and must not accept compensation from any party other than the insured without full written disclosure.

Prohibited conduct includes misrepresentation of policy coverage, false or inflated claims, forgery, and knowingly submitting unsupported damage estimates.

Written contract requirements: identify the insured and the loss, describe services, state compensation clearly, and include the statutory right to rescind/cancel.

No advance fees or compensation for services not performed unless the contract and Louisiana law permit; fees must be earned and disclosed.

Solicitation restrictions: no door-to-door solicitation during a declared emergency in prohibited areas, and no misleading advertising or use of titles implying official authority.

Confidentiality: claim information and personal data of the insured must be protected and used only for the claim.

Conflicts: a public adjuster may not represent a party with an adverse interest in the same claim or acquire an interest in the insured's property.

Recordkeeping: retain contracts, correspondence, estimates, and settlement records for the period required by LDI rule and make them available on request.

Violations may result in license suspension or revocation, fines, restitution, and referral for criminal prosecution for fraud.