NH Public Adjuster cheat sheet

Indemnity principle: a property claim restores the insured to pre-loss financial position, no better and no worse; valued-policy exceptions aside, profit from loss is not insurable.

Insurable interest must exist at the time of loss for property coverage (and at inception for life); a person with no pecuniary interest in the property cannot collect.

Utmost good faith imposes a duty of disclosure on both parties; material misrepresentation by the insured can void the policy or support rescission.

Actual cash value (ACV) = replacement cost minus depreciation; replacement cost value (RCV) pays the cost to repair or replace with new material of like kind and quality without depreciation deduction.

Coinsurance penalty formula on a property loss: recovery = (carried limit / required limit) x loss, capped at the policy limit, and only when the carried limit is below the required limit.

Deductible applies per occurrence unless the policy states otherwise; percentage deductibles (common for wind or hurricane) are calculated on the Coverage A dwelling limit, not on the loss amount.

Subrogation transfers the insured's right of recovery against a negligent third party to the insurer after payment; the insured must not impair that right by releasing the tortfeasor.

Proximate cause is the dominant, efficient cause of loss; losses are covered only when the peril is insured and no exclusion controls the chain of causation.

HO-3 (special form) covers the dwelling on an open-peril basis and personal property on a named-peril basis; HO-5 covers both structures and contents on open peril.

Coverage A is the dwelling; Coverage B is other structures (commonly 10% of Coverage A); Coverage C is personal property (commonly 50-70% of Coverage A); Coverage D is loss of use.

Loss of use pays additional living expense for the shortest reasonable time to restore the dwelling to habitable condition, plus fair rental value if the home was rented.

Commercial property forms use coinsurance clauses (80%, 90%, or 100%) and may add agreed value to suspend the coinsurance penalty when the limit is accepted at inception.

Business income (business interruption) pays net income lost plus continuing normal operating expenses during the period of restoration, beginning 72 hours after the direct physical loss under many forms.

General liability Coverage A covers bodily injury and property damage the insured is legally obligated to pay; Coverage B covers personal and advertising injury; Coverage C is medical payments.

Occurrence-based liability policies respond to injury or damage that takes place during the policy period regardless of when the claim is reported; claims-made forms respond to claims first made during the period.

Replacement cost on a dwelling typically requires repair or replacement of the damaged property as a precondition; otherwise the claim settles on an ACV basis first.

A public adjuster represents the insured for compensation; a company or independent adjuster represents the insurer, and one person may not serve both sides on the same claim.

Compensation must be a written, agreed percentage of the claim recovery or a fixed fee; the fee may not be taken from claim proceeds without the insured's written consent.

The adjuster must document the loss with photographs, inventories, receipts, and a dated damage estimate before repairs begin, because spoliation of evidence can defeat the claim.

Proof of loss is a sworn statement of the amount claimed, usually due within 60 days after the insurer's request; late or incomplete filing can prejudice the claim absent a reasonable excuse.

Ethical duties include full disclosure of the fee, no contingent interest in the loss, no unauthorized practice of law, and no misrepresentation of policy terms to the insured.

A public adjuster may not acquire an interest in the salvage or in the insured property, and may not steer the insured to a contractor in which the adjuster holds a financial interest without disclosure.

Settlement negotiations run parallel to the policy's appraisal provision, which resolves disputes over the amount of loss, not over coverage; appraisal is not a coverage remedy.

Claim file records belong to the adjuster's engagement but the insured is entitled to copies of documents the adjuster prepares and submits on the insured's behalf.

New Hampshire licenses public adjusters through the Insurance Department; a license is required before soliciting, negotiating, or settling a claim for compensation on behalf of an insured.

License applicants must satisfy prelicensing education, pass the public adjuster examination, and submit to a criminal background check; licenses renew on a multi-year cycle with continuing education.

New Hampshire RSA 402-C governs insurer receivership and proof-of-claim procedures when an insurer is declared insolvent; the New Hampshire guaranty association responds to covered claims within statutory limits.

Unfair claim settlement practices under RSA 417 include misrepresenting policy provisions, failing to investigate promptly, and refusing to pay without a reasonable basis; violations support market-conduct action.

The Insurance Commissioner may examine licensees, issue cease-and-desist orders, suspend or revoke licenses, and impose fines for violations of the insurance code.

Commissioner rules require written contracts between public adjusters and insureds, disclosure of compensation terms, and restrictions on solicitation during a declared emergency or catastrophe.

New Hampshire is a notice-prejudice state for many property claims: an insurer must show material prejudice from late notice before denying a claim solely for that reason.

Records of claim transactions must be retained for the period set by the Department and made available for examination; commingling claim funds with the adjuster's own funds is prohibited.

Indemnity principle: a property claim restores the insured to pre-loss financial position, no better and no worse; valued-policy exceptions aside, profit from loss is not insurable.

Insurable interest must exist at the time of loss for property coverage (and at inception for life); a person with no pecuniary interest in the property cannot collect.

Utmost good faith imposes a duty of disclosure on both parties; material misrepresentation by the insured can void the policy or support rescission.

Actual cash value (ACV) = replacement cost minus depreciation; replacement cost value (RCV) pays the cost to repair or replace with new material of like kind and quality without depreciation deduction.

Coinsurance penalty formula on a property loss: recovery = (carried limit / required limit) x loss, capped at the policy limit, and only when the carried limit is below the required limit.

Deductible applies per occurrence unless the policy states otherwise; percentage deductibles (common for wind or hurricane) are calculated on the Coverage A dwelling limit, not on the loss amount.

Subrogation transfers the insured's right of recovery against a negligent third party to the insurer after payment; the insured must not impair that right by releasing the tortfeasor.

Proximate cause is the dominant, efficient cause of loss; losses are covered only when the peril is insured and no exclusion controls the chain of causation.

HO-3 (special form) covers the dwelling on an open-peril basis and personal property on a named-peril basis; HO-5 covers both structures and contents on open peril.

Coverage A is the dwelling; Coverage B is other structures (commonly 10% of Coverage A); Coverage C is personal property (commonly 50-70% of Coverage A); Coverage D is loss of use.

Loss of use pays additional living expense for the shortest reasonable time to restore the dwelling to habitable condition, plus fair rental value if the home was rented.

Commercial property forms use coinsurance clauses (80%, 90%, or 100%) and may add agreed value to suspend the coinsurance penalty when the limit is accepted at inception.

Business income (business interruption) pays net income lost plus continuing normal operating expenses during the period of restoration, beginning 72 hours after the direct physical loss under many forms.

General liability Coverage A covers bodily injury and property damage the insured is legally obligated to pay; Coverage B covers personal and advertising injury; Coverage C is medical payments.

Occurrence-based liability policies respond to injury or damage that takes place during the policy period regardless of when the claim is reported; claims-made forms respond to claims first made during the period.

Replacement cost on a dwelling typically requires repair or replacement of the damaged property as a precondition; otherwise the claim settles on an ACV basis first.

A public adjuster represents the insured for compensation; a company or independent adjuster represents the insurer, and one person may not serve both sides on the same claim.

Compensation must be a written, agreed percentage of the claim recovery or a fixed fee; the fee may not be taken from claim proceeds without the insured's written consent.

The adjuster must document the loss with photographs, inventories, receipts, and a dated damage estimate before repairs begin, because spoliation of evidence can defeat the claim.

Proof of loss is a sworn statement of the amount claimed, usually due within 60 days after the insurer's request; late or incomplete filing can prejudice the claim absent a reasonable excuse.

Ethical duties include full disclosure of the fee, no contingent interest in the loss, no unauthorized practice of law, and no misrepresentation of policy terms to the insured.

A public adjuster may not acquire an interest in the salvage or in the insured property, and may not steer the insured to a contractor in which the adjuster holds a financial interest without disclosure.

Settlement negotiations run parallel to the policy's appraisal provision, which resolves disputes over the amount of loss, not over coverage; appraisal is not a coverage remedy.

Claim file records belong to the adjuster's engagement but the insured is entitled to copies of documents the adjuster prepares and submits on the insured's behalf.

New Hampshire licenses public adjusters through the Insurance Department; a license is required before soliciting, negotiating, or settling a claim for compensation on behalf of an insured.

License applicants must satisfy prelicensing education, pass the public adjuster examination, and submit to a criminal background check; licenses renew on a multi-year cycle with continuing education.

New Hampshire RSA 402-C governs insurer receivership and proof-of-claim procedures when an insurer is declared insolvent; the New Hampshire guaranty association responds to covered claims within statutory limits.

Unfair claim settlement practices under RSA 417 include misrepresenting policy provisions, failing to investigate promptly, and refusing to pay without a reasonable basis; violations support market-conduct action.

The Insurance Commissioner may examine licensees, issue cease-and-desist orders, suspend or revoke licenses, and impose fines for violations of the insurance code.

Commissioner rules require written contracts between public adjusters and insureds, disclosure of compensation terms, and restrictions on solicitation during a declared emergency or catastrophe.

New Hampshire is a notice-prejudice state for many property claims: an insurer must show material prejudice from late notice before denying a claim solely for that reason.

Records of claim transactions must be retained for the period set by the Department and made available for examination; commingling claim funds with the adjuster's own funds is prohibited.