OH Public Adjuster flashcards

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Ohio public adjuster license

A license issued by the Ohio Department of Insurance authorizing a person to represent insureds in negotiating and settling claims for compensation. Separate licenses are required for individuals and business entities.

Prelicensing education requirement

Ohio requires 24 hours of approved prelicensing education for public adjusters, including at least 3 hours of ethics, before taking the licensing exam.

Continuing education hours

Ohio public adjusters must complete 24 hours of continuing education every two years, including 3 hours of ethics and at least 12 hours in claims or adjusting topics.

License renewal cycle

Ohio public adjuster licenses expire on the last day of February of odd-numbered years. Renewal applications and fees must be submitted before expiration to avoid a lapsed license.

Surety bond requirement

Ohio public adjusters must maintain a $20,000 surety bond or errors and omissions policy and file proof of coverage with the Department of Insurance.

Grounds for license discipline

Obtaining a license by fraud, misappropriating funds, rebating, sharing commissions with unlicensed persons, or demonstrating incompetence or untrustworthiness are grounds for discipline.

Contract rescission right

An insured may cancel a public adjuster contract within three business days after signing by written notice, and the adjuster must refund any fee paid.

Nonresident reciprocity

A nonresident may obtain an Ohio public adjuster license by holding a substantially similar license in a reciprocal state or by passing the Ohio exam, plus paying the fee.

Indemnity principle

Insurance restores the insured to approximately the same financial position after a loss, not better. Actual cash value equals replacement cost minus depreciation.

Replacement cost value

The cost to repair or replace damaged property with new materials of like kind and quality without deducting depreciation. Many policies require actual repair or replacement before payment.

Insurable interest

A financial interest in the property that must exist at the time of loss. A person with no financial interest cannot collect under the policy.

Duties after loss

Typical insured duties include prompt notice, protecting property from further damage, preparing an inventory, cooperating with investigation, and submitting a proof of loss within the policy time limit.

Coinsurance clause

A commercial property provision that reduces the claim payment if the insured carries less than the required percentage of insurance to value, calculated as carried insurance divided by required insurance times the loss.

Hurricane deductible

A separate deductible expressed as a percentage of the dwelling limit, not the claim amount, that applies to hurricane or wind losses as defined in the policy.

Additional living expense coverage

Pays necessary increases in living costs while the residence is uninhabitable due to a covered loss, typically subject to a time period and a percentage of Coverage A.

Common homeowners exclusions

Earth movement, flood, ordinance or law, intentional loss, neglect, and wear and tear are commonly excluded. Flood coverage requires a separate NFIP or private flood policy.

Proof of loss

A sworn statement by the insured stating the amount claimed and supporting facts. The adjuster reviews it for accuracy and completeness before submission to the insurer.

Claim investigation sequence

Acknowledge the claim, inspect the loss location, photograph and measure damage, obtain a reservation of rights if coverage is uncertain, and document every contact with the insured and insurer.

Actual cash value calculation

Determine replacement cost using current pricing, subtract depreciation based on age and condition, and apply the deductible. Document the depreciation method used.

Appraisal provision

When the insurer and insured disagree on the amount of loss, each selects a competent appraiser, and the appraisers select an umpire. The umpire's award is binding only if the appraisers agree.

Prompt payment requirement

After receipt of a satisfactory proof of loss, the insurer must pay the claim within the time required by state law, such as 30 days in Ohio for first-party claims, or explain the delay in writing.

Subrogation

The insurer's right to pursue a responsible third party after paying a claim. The insured must not release or impair the insurer's subrogation rights without consent.

Claim file documentation

A complete claim file contains the policy, field notes, photographs, estimates, correspondence, proof of loss, and payment ledger. Incomplete documentation is a common source of disputes.

Salvage and debris removal

The adjuster documents salvage value and coordinates disposal. Debris removal costs are often subject to a separate limit or sublimit in the policy.

Fiduciary duty

A public adjuster represents the insured, not the insurer, and must act in the insured's best interest and disclose any conflict of interest.

Prohibited solicitation

Soliciting a client during a declared emergency at the loss site, using false or misleading advertising, and misrepresenting the adjuster's authority are prohibited practices.

Unfair trade practices

Misrepresentation of policy terms, failure to acknowledge communications promptly, refusal to pay without a reasonable investigation, and offering inducements not in the policy are unfair trade practices.

Fee disclosure

The public adjuster must provide a written contract stating the fee or percentage before performing services. Ohio caps fees at 10% of the claim payment, or 20% for declared emergency claims.

Records retention

Public adjusters must keep claim files and contract records for at least five years after the claim is closed and make them available to the Department of Insurance upon request.

Consumer complaint process

A consumer may file a complaint with the Ohio Department of Insurance, which may investigate, hold a hearing, and impose penalties including license suspension or revocation and fines.

Unlicensed adjusting penalty

Operating without a public adjuster license is a misdemeanor and may result in civil penalties and permanent denial of a license. Each act may be a separate violation.

Privacy of personal information

Public adjusters must safeguard nonpublic personal information and may not disclose it without the insured's authorization except as required by law or necessary to adjust the claim.