NH Public Adjuster flashcards

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

Indemnity Principle

The core insurance concept that a covered loss should restore the insured to the same financial position held before the loss, neither better nor worse, preventing profit from insurance.

Insurable Interest

A pecuniary or legal relationship to property or a person that would be harmed by loss; required at policy inception for life insurance and at time of loss for property insurance.

Actual Cash Value

The settlement method calculated as replacement cost minus depreciation, reflecting the used value of damaged property at the time of loss.

Replacement Cost Value

A settlement method paying the cost to repair or replace damaged property with new material of like kind and quality, without deducting depreciation, often subject to policy limits.

Coinsurance Clause

A property policy provision requiring the insured to carry a stated percentage of the property's value; carrying less triggers a penalty reducing the claim payment proportionally.

Subrogation

The insurer's right, after paying a claim, to step into the insured's shoes and pursue recovery from the negligent third party that caused the loss.

Proximate Cause

The dominant, efficient cause of a loss that sets the chain of events in motion, used to decide whether an insured peril or an exclusion controls coverage.

Utmost Good Faith

The mutual duty of insurer and insured to deal honestly and disclose material facts; breach by the insured can support rescission or denial of a claim.

HO-3 Special Form

A homeowners form covering the dwelling and other structures on an open-peril basis while personal property is covered for named perils only.

Coverage C Personal Property

The homeowners coverage for household contents and personal belongings, typically limited to a percentage of the Coverage A dwelling limit, with special sublimits for items like jewelry.

Loss of Use Coverage

Homeowners coverage paying additional living expenses, and fair rental value where applicable, while the dwelling is uninhabitable due to a covered loss.

Business Income Coverage

Commercial coverage replacing net income lost and continuing normal operating expenses during the period of restoration following a covered direct physical loss.

Agreed Value Endorsement

A commercial property option in which the insurer accepts the stated limit as adequate value, suspending the coinsurance penalty for the policy term.

Claims-Made Policy

A liability policy responding to claims first made against the insured during the policy period, requiring retroactive date awareness and possible tail coverage.

Occurrence Policy

A liability policy responding to bodily injury or property damage that takes place during the policy period, regardless of when the claim is later reported.

Additional Living Expense

Payments for increased costs of temporary housing and living while a covered loss makes the residence uninhabitable, limited to the shortest reasonable restoration time.

Open Peril Coverage

A coverage basis insuring all risks of direct physical loss except those specifically excluded, shifting the burden to the insurer to prove an exclusion applies.

Public Adjuster Role

A licensed professional who represents the insured, not the insurer, in preparing, documenting, presenting, and negotiating a first-party property claim for compensation.

Proof of Loss

A sworn, itemized statement of the amount claimed, submitted within the period the policy or insurer requires, supporting the insured's demand for payment.

Appraisal Provision

A policy mechanism allowing either party to demand an appraisal when they disagree on the amount of loss; each selects a competent appraiser and the two choose an umpire.

Contingent Fee Disclosure

The requirement that a public adjuster disclose in writing the percentage or fixed fee charged, agreed by the insured before work begins.

Spoliation of Evidence

Loss or destruction of evidence needed to prove a claim; an adjuster must document damage thoroughly before repairs so the claim is not prejudiced.

Conflict of Interest

A situation where the adjuster's personal or financial interest, such as ownership in a repair contractor, could improperly influence claim handling and must be disclosed or avoided.

Unauthorized Practice of Law

Giving legal advice or representing an insured in legal proceedings without a law license, which a public adjuster must avoid when handling claims.

Solicitation Restrictions

Rules limiting when and how a public adjuster may contact potential clients, including heightened restrictions during declared catastrophes and emergency periods.

New Hampshire Licensing

Public adjusters must be licensed by the New Hampshire Insurance Department, meeting prelicensing education, examination, and background check requirements before representing insureds.

RSA 417 Unfair Practices

New Hampshire statutes defining unfair claim settlement practices, including misrepresenting policy provisions, failing to investigate promptly, and denying claims without reasonable basis.

Insurance Commissioner Authority

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

Guaranty Association

A statutory entity that responds to covered claims of policyholders when a licensed insurer becomes insolvent, subject to statutory limits and exclusions.

Notice-Prejudice Rule

A doctrine requiring an insurer to show material prejudice from late claim notice before denying coverage solely because notice was untimely.

Record Retention

The requirement that licensees keep claim and transaction records for the period set by the Insurance Department and make them available for examination.

Commingling Prohibition

A rule barring adjusters from mixing client claim funds with their own operating funds, protecting insureds from loss or misuse of settlement money.