Claims Handling Practices and Ethics
Standards of conduct
Mississippi adjusters must handle claims in good faith and fair dealing. The Mississippi Unfair Trade Practices Act (Miss. Code Ann. § 83-5-33 et seq.) prohibits misrepresentation of policy provisions, unreasonable delay or refusal to pay, failure to investigate promptly, coercion, and failure to explain the basis for denial. Public adjusters owe a fiduciary duty to the insured: place the insured's interest above the fee, avoid conflicts, and do not represent the insurer on the same loss. Keep a contemporaneous claim file with dates, contacts, photographs, estimates, and settlement rationale.
Timelines and communication
Acknowledge the claim promptly, investigate within a reasonable time, and give written status updates when the claim remains open. Do not settle without authority or misstate coverage. Explain partial denials and request missing information in writing. Protect personal information; do not post claim details or photographs on social media without authorization. Do not communicate with a represented claimant about the subject of representation without consent. Fee agreements must comply with the public adjuster contract rules, and funds held for a client must not be commingled with business funds.
Worked example
An adjuster learns that a policyholder has hired counsel. The adjuster calls the policyholder directly to discuss the settlement without counsel's consent. Even if the adjuster's intent is to "speed things up," this is an ethics and legal violation. The correct step is to direct all communications to counsel, document the contact, and continue the investigation through permitted channels.
Traps
- Promising a specific settlement amount before completing the investigation.
- Using a release that is broader than the claim being settled.
- Mixing claim files with marketing or personal records.
- Treating a missed internal deadline as harmless when the policy has a suit-limitation period.