MO Public Adjuster flashcards

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

Missouri public adjuster licensing agency

The Missouri Department of Commerce and Insurance (DCI) licenses public adjusters under Chapter 325 RSMo, separate from producer and company adjuster authority.

Public adjuster contract rescission right

Missouri requires a written public adjuster contract with a three-business-day rescission right, license number, and fee disclosure; the insured may cancel without penalty during that period.

Missouri disaster fee cap

On claims arising from a declared disaster or emergency, a Missouri public adjuster may not charge a fee exceeding 10 percent of the insurance claim proceeds.

Missouri public adjuster continuing education

Missouri public adjusters complete 16 CE hours every two years, including at least 3 ethics hours, reported to DCI by the license expiration date.

Unlicensed adjusting consequence

Acting as a public adjuster without a Missouri license is a misdemeanor; contracts are unenforceable and the adjuster may face fines, restitution, and civil penalties.

Nonresident public adjuster reciprocity

A nonresident may obtain a Missouri public adjuster license by reciprocity if the home-state license is in good standing, with certification and fee submitted to DCI.

Change of address reporting

Missouri licensees must report a change of name or address to DCI within 30 days, and must report criminal charges and administrative actions within 30 days of disposition.

Unfair claims practices act

Missouri Sections 375.930-375.948 RSMo prohibit misrepresenting policy provisions, failing to acknowledge claims promptly, and failing to conduct a reasonable investigation of claims.

Vexatious refusal statute

Section 375.420 RSMo allows recovery of the loss plus up to 20 percent damages and attorney fees when an insurer refuses to pay without reasonable cause.

Missouri valued policy statute

Section 379.140 RSMo makes the insurer liable for the full stated policy amount on a total loss of real property, regardless of market value, absent fraudulent overstatement.

Missouri guaranty association limits

MIGA covers claims of insolvent insurers up to $300,000 per claimant for most property and liability coverages, with separate limits for workers' compensation and life/health.

Claim acknowledgment deadline

Missouri requires insurers to acknowledge notification of a claim within 10 working days and to affirm or deny coverage within a reasonable time after investigation.

Merchandising Practices Act

Chapter 407 RSMo prohibits deceptive practices in the sale and servicing of goods and services, including insurance, and allows attorney general enforcement and private consumer actions.

Written denial explanation

Missouri requires insurers to give a written explanation of the basis for denial or partial denial, citing the specific policy provisions relied upon.

Director enforcement authority

The DCI director may issue cease-and-desist orders, impose fines up to $1,000 per violation and $25,000 per course of conduct, and suspend or revoke licenses.

Coverage B limit formula

Coverage B (other structures) is typically 10 percent of the Coverage A dwelling limit; Coverage C personal property is typically 50-70 percent of Coverage A.

Actual cash value formula

ACV equals replacement cost minus depreciation. Most homeowners forms pay ACV first and release recoverable depreciation after repair or replacement is completed.

Coinsurance payment formula

Payment equals (limit of insurance divided by coinsurance requirement) times the loss, subject to the policy limit; underinsurance reduces recovery proportionally.

Percentage deductible calculation

A percentage wind or hail deductible is calculated on the Coverage A dwelling limit, not on the loss amount, and applies once per occurrence.

Appraisal provision

When the amount of loss is disputed, either party may demand appraisal; each selects a competent appraiser, who select an umpire, and the result binds only the amount of loss.

Mortgage clause

The mortgage clause names the lender as loss payee, entitling it to loss payment to the extent of its interest; the insurer may pay mortgagee and insured jointly.

Suit limitation period

Policies typically bar suit unless filed within 12 months after the loss; Missouri law may toll the period while the insurer investigates or the claim is unresolved.

Declarations page contents

The declarations page identifies the named insured, policy period, coverage limits, deductibles, and described premises; it controls over conflicting form language.

Proof of loss requirements

A sworn statement of the amount and cause of loss, typically due within 60 days of the insurer's request, supported by inventories, receipts, and estimates.

First notice of loss data

Record date and time of loss, cause, location, contacts, policy number, and total or partial status; assign a claim number and confirm coverage in writing.

Reservation of rights

A written notice that the insurer will investigate and defend while reserving the right to deny coverage later; obtain the insured's acknowledgment before proceeding.

Spoliation of evidence

Destroying or altering damaged property, photographs, or records can defeat the claim and expose the adjuster to liability; preserve all evidence until the claim closes.

Additional living expense

Loss of use coverage pays necessary increases in living costs and fair rental value during the reasonable time to repair or relocate, documented with receipts.

Business interruption calculation

Gross earnings loss equals lost net income plus continuing expenses during the period of restoration, plus extra expense, verified with financial statements and tax returns.

Subrogation preservation

Identify responsible third parties and notify the insurer promptly; the insured must cooperate and must not release liable parties, or the insurer's subrogation right is lost.

Public adjuster fiduciary duty

A public adjuster owes the insured a fiduciary duty and may not accept compensation from the insurer, contractors, or vendors on the same claim without written disclosure and consent.

Prohibited solicitation at loss

Missouri restricts soliciting a public adjuster contract at the scene of a loss before the insured has a reasonable opportunity to consult the insurer or counsel, especially within 24 hours.

Deductible advancement prohibition

A public adjuster may not advance funds to the insured or pay the insured's deductible; doing so is an illegal inducement and may violate the insurance code.

Claim file retention

Public adjusters must keep claim files, contracts, correspondence, and settlement records for at least five years after the claim closes; DCI may inspect them during an examination.

Confidentiality obligation

A public adjuster may not disclose the insured's personal, financial, or medical information without written authorization, except as required by law or to advance the claim.

Settlement authorization

A public adjuster may not settle a claim or negotiate after the insured has signed a release without the insured's written authorization for each settlement.