OR Public Adjuster flashcards

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

Public adjuster definition

A licensed person who, for compensation, represents the insured in negotiating and settling a first-party property claim. The public adjuster owes the client a fiduciary duty and may not represent the insurer on the same claim.

Oregon insurance regulator

The Division of Financial Regulation within the Department of Consumer and Business Services administers Oregon's Insurance Code, licenses adjusters, investigates complaints, and imposes penalties for violations.

Nonresident adjuster licensing

A nonresident holding a comparable home-state adjuster license may qualify for Oregon licensure through reciprocity, but must still apply, pay fees, and comply with Oregon CE and conduct rules.

Continuing education requirement

Oregon licensees must complete approved continuing education each renewal cycle, including required ethics and law hours, and may only claim credit for courses approved for the license type.

License renewal cycle

Oregon adjuster licenses renew on a biennial cycle; operating after expiration without renewal is a violation subject to civil penalties and possible revocation.

Insurable interest

A lawful, substantial economic interest in the property that would be harmed by its loss. For property insurance it must exist at the time of loss, not only at application.

Indemnity principle

The insured should be restored to approximately the pre-loss financial position, no better and no worse, limited by policy limits, deductibles, and valuation method.

Actual cash value formula

ACV equals replacement cost minus depreciation. Depreciation reflects physical deterioration and obsolescence as of the loss date, applied to the damaged components.

Coinsurance penalty formula

Payment equals the carried limit divided by the required limit, multiplied by the covered loss, capped at the policy limit, then reduced by the deductible.

Percentage deductible calculation

A percentage deductible is calculated by multiplying the stated percentage by the Coverage A or building limit, not by the amount of the loss, and applies per occurrence.

Policy structure components

A property policy contains declarations, an insuring agreement, conditions, exclusions, and endorsements. Endorsements amend the base form and control over conflicting form language.

Subrogation right

After paying a claim, the insurer may pursue responsible third parties standing in the insured's shoes. The insured must not impair that right by releasing the responsible party.

HO-3 coverage structure

The HO-3 covers the dwelling on an open-peril basis and personal property on a named-peril basis. The HO-5 covers both dwelling and personal property on an open-peril basis.

Open peril versus named peril

Named-peril policies pay only for listed causes of loss. Open-peril policies pay for all direct physical loss unless excluded, and the insured must prove a covered loss occurred.

Loss of use coverage

Pays necessary increased living costs and fair rental value while the dwelling is uninhabitable due to a covered loss, subject to the policy's time and dollar limits.

Business income coverage

Pays lost net income plus continuing normal operating expenses during the period of restoration. Extra expense pays costs incurred to avoid or minimize business interruption.

Replacement cost threshold

Many forms require the insured to carry at least 80 percent of full replacement cost at the time of loss to receive full replacement cost settlement; otherwise payment is reduced.

Mortgagee clause

Gives the lender rights to loss proceeds and notice of cancellation, and the lender's interest often survives the insured's acts, subject to subrogation against the borrower.

Duties after loss

Typical duties include prompt notice, protecting property from further damage, cooperation, submitting a proof of loss if required, and submitting to examination under oath when demanded.

Claim file documentation

A complete file contains the policy and endorsements, notice of loss, contact log, inspection notes and photos, measurements, estimates, coverage analysis, and payment records.

Unfair claim settlement practices

Oregon prohibits misrepresenting policy provisions, failing to acknowledge or act promptly on communications, and failing to conduct a reasonable investigation of a claim.

Recoverable depreciation

Depreciation withheld from an ACV payment and released when the insured completes repairs and submits proof, subject to the policy's replacement cost and time conditions.

Public adjuster contract

Must be written, signed by the insured, and state the fee, services, cancellation right, and that the adjuster represents the insured only. A copy goes to the client.

Fiduciary duty of adjuster

The public adjuster must place the client's interest above the adjuster's compensation, disclose conflicts, and avoid self-dealing in the claim.

Solicitation restrictions

After a declared disaster, statutes restrict when and how public adjusters may contact claimants at or near the loss site, and fee limits may be tightened during the emergency.

Prohibited compensation practices

A public adjuster may not advance money to the insured, share fees with unlicensed persons, or accept compensation from both the insurer and the insured on the same claim.

Conflict of interest rule

A public adjuster may not represent a claimant on a claim in which the adjuster, a family member, or a business associate has a financial interest.

Confidentiality obligation

Client financial and personal information gathered during the claim may not be disclosed except as needed to adjust the claim or as required by law.

DFR complaint process

Consumers may file complaints with the DFR Consumer Advocacy Unit, which can investigate, mediate, and refer matters for enforcement action against insurers or licensees.

Appraisal versus coverage

Appraisal resolves disputes over the amount of loss, not whether coverage applies. A coverage denial is not subject to appraisal and must be challenged through other remedies.

Trust account requirement

Client funds, including claim payments held for disbursement, must be segregated from the adjuster's operating funds in a reconciled trust or escrow account.

Oregon adjuster statutes

ORS Chapter 744 governs adjuster licensing and conduct, ORS Chapter 746 contains unfair trade and claim practice provisions, and OAR Chapter 836 implements DFR rules.