OK Public Adjuster cheat sheet

Indemnity: the insured is restored to approximately the pre-loss financial position, no better and no worse; valued policies are the exception.

Insurable interest requires an economic stake that would be impaired by loss; it must exist at policy inception for property coverage and at loss for life coverage.

Utmost good faith underpins representations, warranties, and concealment doctrines; material misrepresentation by the insured can void coverage.

Utmost good faith is mutual: insurers owe a duty of fair dealing and disclosure of material policy terms.

Subrogation transfers the insured's recovery rights against a negligent third party to the insurer after payment, preventing double recovery.

Actual cash value = replacement cost minus depreciation; replacement cost pays new-for-old without depreciation deduction.

Coinsurance clause: payment = (carried insurance / required insurance) x loss, capped at the policy limit; applies to underinsured partial losses.

Deductible applies per occurrence unless the policy states otherwise; percentage deductibles are computed on the Coverage A limit.

Proximate cause is the dominant, efficient cause that sets the loss in motion without which the loss would not have occurred.

Declarations page identifies named insured, policy period, limits, deductibles, forms, and endorsements in force.

Insuring agreement grants coverage; conditions set duties of both parties; exclusions remove coverage; definitions control interpretation.

Coverage triggers: occurrence policies respond to injury or damage during the policy period; claims-made policies respond to claims first made during the period.

Policy limits may be per occurrence, per item, or aggregate; aggregate limits cap total payments across the policy term.

Duties after loss commonly include prompt notice, proof of loss, protection of property, and cooperation with the investigation.

Mortgagee clause gives the lender loss-payable rights and notice of cancellation, independent of the insured's conduct.

Other insurance clauses (pro rata, excess, primary) determine how multiple policies share a single loss.

Cancellation provisions specify notice days: typically 10 days for nonpayment and 30 days for other reasons under Oklahoma law.

Liberalization clause extends automatic benefit of broadened coverage in later form editions to the current policy.

HO-3 covers the dwelling and other structures on an open-peril basis and personal property on a named-peril basis.

HO-5 covers both dwelling and personal property on an open-peril basis, subject to exclusions.

HO-2 is broad named-peril; HO-4 is renters contents; HO-6 is condominium unit-owners; HO-8 is modified coverage for older homes.

Coverage A is the dwelling; Coverage B other structures; Coverage C personal property; Coverage D loss of use; Coverage E liability; Coverage F medical payments.

Special limits apply to items such as money, jewelry theft, firearms theft, and silverware theft; scheduled endorsements lift them.

Replacement cost on dwelling requires at least 80% of full replacement cost carried at loss time; below that, settlement is the greater of ACV or the coinsurance fraction.

Loss of use pays necessary increase in living expenses and fair rental value for the shortest reasonable time to repair or relocate.

HO forms exclude earth movement, flood, ordinance or law, and neglect; endorsements can add limited back for some.

Personal property off premises is typically covered at 10% of Coverage C.

BPP form covers building and personal property; causes of loss forms (basic, broad, special) set the perils covered.

Coinsurance percentages of 80%, 90%, or 100% are common; higher coinsurance lowers the rate.

Agreed value option suspends the coinsurance requirement in exchange for a submitted value statement.

Business income pays net income plus continuing normal operating expenses during the period of restoration.

Period of restoration begins 72 hours after the physical loss for most business income forms and ends when property is repaired or replaced with reasonable speed.

Extra expense covers costs to continue operations, such as temporary relocation, without a coinsurance requirement.

Extended period of indemnity continues business income after restoration while income rebuilds.

Business income coinsurance uses the same formula as property coinsurance, applied to the annual business income exposure.

Blanket coverage applies one limit across multiple locations, easing coinsurance compliance.

Named perils must be listed to be covered; open-peril (special) forms cover all risks of direct physical loss unless excluded.

Basic form perils include fire, lightning, explosion, windstorm, hail, smoke, aircraft, vehicles, riot, vandalism, and sprinkler leakage.

Broad form adds falling objects, weight of ice/snow/sleet, water damage, and accidental discharge from plumbing or appliances.

Common exclusions: earth movement, flood, ordinance or law, neglect, intentional acts, wear and tear, and faulty workmanship.

Ordinance or law exclusion removes increased cost of complying with building codes; endorsements add limited or full coverage.

Equipment breakdown endorsement adds mechanical and electrical breakdown, otherwise excluded as a maintenance issue.

Spoilage endorsement covers perishable stock loss from equipment failure or power outage.

Flood requires a separate policy or endorsement; water damage from plumbing discharge is distinct from surface water flooding.

Sinkhole collapse may be added by endorsement in states where it is not built into the form.

Replacement cost valuation requires repair or replacement actually completed; otherwise ACV is paid initially, with holdback released after completion.

Depreciation methods include straight-line, age-life, and market-based; adjusters must document the method and useful life assumptions.

Proof of loss is a sworn statement of the amount claimed; insurers may require it within a stated period after notice.

Prompt payment statutes set deadlines after proof of loss is received; Oklahoma requires payment within 60 days of proof of loss absent a valid reason.

Betterment and matching issues affect roof and siding claims; partial replacement may leave mismatched materials.

Overhead and profit is typically owed when the scope involves three or more trades requiring a general contractor.

Actual cash value in Oklahoma is generally replacement cost less depreciation, not market value, unless the policy states otherwise.

Salvage and subrogation recoveries reduce the insurer's net loss and can affect claim settlement calculations.

Adjusters must distinguish covered damage from pre-existing conditions and long-term seepage using documentation.

The Oklahoma Insurance Department regulates insurers, producers, and adjusters under Title 36 of the Oklahoma Statutes.

Oklahoma requires insurers to acknowledge claim notice and act in good faith; the Unfair Claims Settlement Practices Act defines prohibited conduct.

Oklahoma's Valued Policy statute applies to total losses from fire on real property, requiring payment of the full policy limit.

Oklahoma prohibits unfair discrimination and rebating; producers may not offer inducements not specified in the policy.

Oklahoma requires continuing education for licensed adjusters, with hours and reporting set by the Insurance Department.

Licenses must be renewed before expiration; late renewal may require reinstatement fees or reexamination.

Oklahoma's prompt payment rule requires insurers to pay or deny a claim within 60 days after receiving proof of loss.

The Insurance Commissioner has authority to examine insurers, issue orders, and impose fines for violations.

Oklahoma's valued policy law does not apply to personal property or to losses other than fire on real property.

A public adjuster represents the insured for compensation; a company or independent adjuster represents the insurer.

Oklahoma requires public adjusters to be licensed by the Insurance Department before negotiating or settling claims for compensation.

A written contract is required, disclosing the fee or percentage and the right to rescind within a stated period.

Fees are typically a percentage of the settlement; the contract must state the basis and any minimum charge.

Public adjusters may not represent both insurer and insured on the same claim due to conflict of interest.

Solicitation during a declared disaster emergency is restricted; adjusters may not solicit at the loss scene in some circumstances.

Fiduciary duty requires prompt remittance of funds collected on behalf of the insured and accurate recordkeeping.

Adjusters must not misrepresent policy coverage, inflate damages, or alter documents; such acts support license discipline.

Continuing education and license renewal are conditions of maintaining public adjuster authority in Oklahoma.