PA Public Adjuster flashcards
PA Public Adjuster · Build recall with a focused review session.
32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Actual cash value
- Replacement cost minus depreciation for age, wear, and obsolescence; the policy may define a different valuation method, so read the valuation condition.
- Replacement cost coverage
- Pays to repair or replace damaged property with new property of like kind and quality, subject to policy limits and conditions such as completing repairs within a stated period.
- Coinsurance formula
- Recoverable loss equals the lesser of the policy limit or the limit carried divided by the required limit, multiplied by the loss, then minus the deductible.
- Duties after loss
- Policy conditions typically require prompt notice, protection of property from further damage, an inventory, cooperation, and a sworn proof of loss when the insurer requests it.
- Subrogation
- After paying a claim, the insurer may pursue third parties responsible for the loss; the insured must not impair those recovery rights and may need to cooperate.
- Public adjuster license
- Pennsylvania requires a license from the Insurance Department before a person may solicit or adjust first-party claims for compensation on behalf of an insured.
- License renewal
- Public adjuster licenses in Pennsylvania are renewed biennially; renewal requires continuing education, fees, and evidence of good standing under Department requirements.
- Continuing education
- Pennsylvania public adjusters must complete Department-approved continuing education hours each renewal cycle, including ethics, and must retain certificates in case of audit.
- Surety bond
- Act 21 requires a public adjuster to maintain a surety bond filed with the Department, protecting the public against improper acts; the Department sets the amount and procedure.
- Change of address
- A licensed public adjuster must notify the Pennsylvania Insurance Department of a change of address or name within the period set by Department regulation.
- Act 21 of 2012
- Pennsylvania's Public Adjuster Licensing Act; it requires licensing, sets contract and conduct rules, and authorizes the Insurance Department to discipline public adjusters.
- 72-hour solicitation bar
- Act 21 generally prohibits a public adjuster from soliciting an insured for a contract during the first 72 hours after a loss; emergency mitigation duties may differ.
- Three-business-day rescission
- The insured may cancel a public adjuster contract within three business days after signing by written notice; the contract must disclose this right.
- Fiduciary duty
- A public adjuster owes the insured loyalty and good faith, must act in the insured's interest, and may not represent the insurer or an adverse party on the same claim.
- Prohibited rebate
- A public adjuster may not offer or accept undisclosed rebates, kickbacks, or inducements to obtain or keep adjuster business; compensation must be disclosed in the contract.
- First notice of loss
- The initial report to the insurer; record date, time, cause, location, policy number, contact persons, and immediate mitigation steps taken or needed.
- Mitigation duty
- The insured must take reasonable steps to prevent further damage after a loss, such as tarping a roof or shutting off water, and document the steps and costs.
- Examination under oath
- A sworn interview conducted by the insurer during claim investigation; the insured answers under oath and may be required to produce documents under policy conditions.
- Proof of loss
- A sworn statement from the insured stating the amount claimed and supporting facts; the policy sets the deadline and required contents, and it is not a final settlement.
- Chain of custody
- A documented record of who collected, handled, stored, and transferred evidence or damaged items, used to show that evidence has not been altered.
- Roofing square
- A roofing unit equal to 100 square feet of roof area; roof area is measured in squares for estimating materials, labor, and waste.
- Water damage categories
- Category 1 is clean water, Category 2 is grey water with some contamination, and Category 3 is black water containing harmful pathogens; category affects remediation.
- Depreciation
- An estimate of value lost from age, wear, use, or obsolescence; actual cash value equals replacement cost minus depreciation under many policies.
- Additional living expense
- Coverage for necessary increased costs of temporary housing, meals, and similar living expenses when a covered loss makes the residence uninhabitable, subject to policy limits and time.
- Line-item estimate
- A repair estimate organized by trade and item, showing quantities, unit prices, labor, materials, overhead, profit, tax, and permits so each cost can be verified.
- Waste factor
- An allowance added to material quantities for cutting, breakage, and installation loss; roofing waste often ranges from 10 to 15 percent depending on roof complexity.
- Contents inventory
- A room-by-room list of damaged personal property with description, quantity, age, condition, original cost, replacement cost, and supporting photos or receipts.
- Supplement request
- A documented request to add omitted or newly discovered damage, code-required work, or pricing differences to the insurer's estimate after the initial scope.
- Public adjuster contract
- A written agreement between an insured and a licensed public adjuster that identifies the loss, scope of services, compensation, term, and the insured's cancellation rights.
- Contingent compensation
- A fee calculated as a percentage of the insurance settlement; the contract must state the percentage and how it applies to different claim payments.
- Unfair trade practice
- A deceptive or unfair act in insurance, such as misrepresenting coverage, pressuring an insured, or soliciting after a loss in violation of Act 21.
- Consumer complaint
- An insured may file a complaint about a public adjuster with the Pennsylvania Insurance Department, which may investigate conduct and impose discipline for Act 21 violations.