NE Public Adjuster flashcards

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

Public Adjuster

A licensed professional who represents an insured, not an insurer, and is compensated by the insured to prepare, file, and negotiate a first-party property insurance claim.

Nebraska Department of Insurance

The state agency headed by the Director that licenses adjusters, examines insurer conduct, investigates complaints, and imposes discipline for violations of the Nebraska Insurance Code.

Unfair Trade Practices Act

Nebraska statute at Neb. Rev. Stat. section 44-1521 et seq. that prohibits misrepresentation, false advertising, coercion, and unfair claim settlement practices by insurers and licensees.

Unfair Claim Settlement Practice

Insurer conduct such as failing to acknowledge communications, refusing to pay without reasonable investigation, or offering substantially less than the claim value later recovered.

Company Adjuster

An adjuster employed by or contracted with an insurer to investigate and settle claims on the insurer's behalf; owes duties to the insurer, not the insured.

Cease and Desist Order

An enforcement action the Nebraska Director may issue to stop unlicensed activity or prohibited conduct, often paired with fines or license suspension.

Licensee Record Production

The obligation of a licensed adjuster to keep claim and contract records and produce them to the Nebraska Department of Insurance on request during an examination.

Public Adjuster License

The credential required before an individual may solicit, negotiate, or settle an insured's property claim for compensation in Nebraska.

Written Adjuster Contract

A signed agreement identifying the insured, property, loss, services, and the fee rate or method, and disclosing that the adjuster represents the insured.

Right to Cancel

The insured's statutory right to rescind the public adjuster contract within a stated period after signing; notice of the right must appear in the contract.

Fee Disclosure

The contract requirement that the adjuster state the exact commission or fee percentage and how it is calculated before any work is performed.

Character and Fitness Review

The licensing review of an applicant's criminal history, honesty, and financial responsibility to determine suitability to hold a public adjuster license.

Claim Proceeds Interest

A public adjuster may not acquire ownership of or an interest in the insured's claim proceeds beyond the fee stated in the written contract.

License Lapse

The status when a license expires for failure to renew or complete continuing education; the holder may not solicit or negotiate claims until reinstated.

Coverage A Dwelling

The policy coverage insuring the residential structure itself, subject to its own limit and typically the basis for coinsurance calculations.

Replacement Cost

The amount needed to repair or replace damaged property with new materials of like kind and quality, without deduction for depreciation.

Actual Cash Value

Replacement cost minus depreciation; the standard valuation method when replacement cost coverage is not purchased or a policy endorsement limits payment.

Coinsurance Clause

A provision requiring the insured to carry insurance equal to a stated percentage of replacement cost, or the claim payment is reduced proportionally.

Loss of Use Coverage

Coverage for additional living expenses and fair rental value when a covered loss makes the dwelling uninhabitable during repairs.

Mortgage Clause

A policy provision giving the lender rights to claim proceeds and requiring the insured and insurer to cooperate with the lender's loss payment process.

Proof of Loss

A sworn, signed statement detailing the amount claimed and supporting facts, typically due within the period stated in the policy after the insurer requests it.

First Notice of Loss

The initial report of a claim to the insurer that starts the investigation, triggers claim numbering, and sets deadlines for acknowledgment and response.

Quantity Takeoff

A measurement of damaged areas and materials, such as square footage of roofing or wallboard, used with unit costs to build a repair estimate.

Depreciation Schedule

A table assigning useful life to building components; applied to replacement cost to derive the depreciation deduction and the actual cash value.

Overhead and Profit

Markup added to repair estimates when multiple trades are involved, covering contractor supervision, business expenses, and expected profit.

Appraisal Provision

A policy clause allowing the insurer and insured, when they disagree on the amount of loss, to each select a competent appraiser to determine the amount.

Contemporaneous Documentation

Photographs, measurements, moisture readings, and notes recorded at the time of inspection to preserve evidence and support the claimed scope of damage.

Fiduciary Duty

The public adjuster's obligation of loyalty, honesty, and full disclosure to the insured, including disclosure of all compensation and conflicts of interest.

Claim Inflation

Deliberately overstating damage amounts or submitting false or altered documents to an insurer; a prohibited act subject to license discipline and criminal referral.

Loss Scene Solicitation

Approaching an insured at the scene of a loss before the insured has a reasonable chance to contact the insurer or an attorney; prohibited conduct.

Fee Splitting

Sharing adjuster compensation with unlicensed persons or paying referral fees to contractors or others for claim referrals; prohibited practice.

Confidentiality Duty

The adjuster may not disclose an insured's private claim information without authorization or legal compulsion, except as needed to handle the claim.

Conflict of Interest Disclosure

The requirement to reveal any financial interest in a repair contractor or vendor and to avoid steering repairs for personal gain.