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Publicly adapting profession When insured persons are busy professionals, they simply do not have the time or patience to deal with the details of first-party protection. The general insurance adjuster is available to help the insured to present a claim to the insurer. In most states, the general insurance adjuster is licensed by the state insurance department. The insurer's adjuster is often asked to handle a general insurance adjuster. The contact between the general insurance adjuster and the insurer's adjuster is often controversial because the general insurance adjuster wants to justify his contingency fee to the insured. Both must work towards the same goal: payment of correct and complete compensation to the insured. Public Adjusters claim that they, mostly for good reason, are professionals who are employed exclusively by a policyholder who has maintained an insured first-party loss. The public adjuster handles all the details of the claim and works closely with the insured to provide as fair and fast a solution as possible. A public adjustment should immediately inspect the claim site, analyze the claims, collect claims support data, review the insured's coverage, determine current compensation costs and serve exclusively the client, not the insurance company while working ethically with the insurer's adjustment. The National Association of Public Insurance Adjusters (NAPIA) publishes a code of conduct that sets out the ethical standards that all public insurance adjusters must follow. It prescribes: The following rules of professional conduct and ethics apply to all members of NAPIA: Members must act in a spirit of fairness and justice towards their customers, insurance companies and the general public. Members must refrain from making incorrect requests. No incorrect presentation of any kind may be made to an insured or the insurance companies. The commission prices must be fair and equitable and strict in accordance with the prevailing custom in the locality and must, if there are laws or regulations for insurance departments, fully comply with such laws or regulations. Members must behave in a way that gives them respect and trust. They must work in harmony with each other, with their customers and the representatives of the insurance companies in order to promote a cordial and harmonious relationship with all branches of the insurance business and with the general public. The members must be equipped with knowledge and experience for the work they perform. They must not jeopardize the interest of the public adaptation profession or risk injustice to the insured or to the insurance companies by trying to deal with losses or claims for which they are not qualified and for which they cannot find competent technical assistance. Members may not engage in unauthorized law. Members may not acquire any interest in recovered property or participate in any way, directly or indirectly, in the reconstruction, repair or restoration of damaged property, except with the insured's knowledge, consent and permission. The members must be cooperative and help each other in all possible ways. Members may not distribute or use any form of agreement, advertising or printed matter that is detrimental to the public adaptation profession, or that does not comply with the rules and regulations of the insurance department of the state in which such member is professionally engaged, or that may expose public adaptation and public adjusters for criticism or disrespect. An example of a general insurance adjuster and the lawyer who did not follow NAPIA's requirements. Both represented the same client, involving a claim stemming from the Northridge earthquake in California, 1

994. The earthquake caused billions of dollars in damage across southern California. It attracted lawyers and public organizers who sought large fines like vultures flying over a dead antelope. As a result of the disaster, the insurers' investigation was limited due to the extent of losses caused by the earthquake and the need to meet their needs quickly. Many unnecessary and false complaints were filed. Insurance fraud was rampant and insurers paid rather than fighting because there were insufficient staff available to deal with fraud and government agencies threatened insurers with large fines if they did not pay quickly. © 2020 – Barry Zalma Barry Zalma, Esq., CFE, now limits his practice to working as an insurance consultant specializing in insurance coverage, insurance claims handling, infidelity and insurance fraud almost equally for insurers and policyholders. He also acts as an arbitrator or mediator for insurance-related disputes. He practiced law in California for more than 44 years as an insurance coverage and claims lawyer and more than 52 years in the insurance industry. He is available at http://www.zalma.com and zalma@zalma.com.


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