Claims Licensing Advancement for Interstate Matters Act or CLAIM Act - Authorizes an independent claims adjuster meeting specified requirements to adjust claims for losses related to any disaster occurring in any jurisdiction designated by the President as a major disaster pursuant to the Robert T. Stafford Disaster Relief and Emergency Assistance Act, regardless of state licensure requirements governing the major disaster area.
Requires an adjuster to: (1) hold a valid license in his or her home state, and (2) have passed any multi-state examination established and administered by the National Association of Insurance Commissioners (NAIC).
Urges NAIC to: (1) adopt a certain model independent claims adjuster licensing Act, and (2) develop and administer a multi-state examination for an independent claims adjuster seeking to adjust claims in a jurisdiction other than his or her home state.
Sets forth criteria for state compliance with this Act, including reciprocity.
Authorizes any independent claims adjuster meeting the requirements of this Act to ascertain, determine, negotiate, or settle a claim in a state that is not in compliance with this Act. Prohibits such a state from imposing additional requirements upon such an adjuster.
[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6415 Introduced in House (IH)]
112th CONGRESS
2d Session
H. R. 6415
To facilitate prompt and efficient adjusting of insurance claims in the
case of natural and other disasters and losses, to encourage licensing
of insurance claims adjusters, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 14, 2012
Mr. Fincher introduced the following bill; which was referred to the
Committee on Financial Services
_______________________________________________________________________
A BILL
To facilitate prompt and efficient adjusting of insurance claims in the
case of natural and other disasters and losses, to encourage licensing
of insurance claims adjusters, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Claims Licensing Advancement for
Interstate Matters Act'' or the ``CLAIM Act''.
SEC. 2. ACCELERATING CLAIMS ADJUSTING OF LOSSES CAUSED BY NATURAL OR
OTHER DISASTERS.
(a) Authority To Adjust.--An independent claims adjuster meeting
the requirements of subsection (b) may adjust claims for losses related
to any natural or other disaster, occurring in any jurisdiction, that
has been designated by the President as a major disaster pursuant to
section 401 of the Robert T. Stafford Disaster Relief and Emergency
Assistance Act (42 U.S.C. 5170) notwithstanding the licensure
requirements of the State in which the disaster area for the major
disaster is located and notwithstanding the requirements under section
6 of this Act for interstate claims licensing.
(b) Adjuster Requirememts.--The requirements under this subsection
with respect to an independent claims adjuster are as follows:
(1) State license.--The adjuster holds a valid license as
an independent claims adjuster in his or her home State
(whether actual or designated, pursuant to section 7(1)).
(2) Multi-state examination.--If the National Association
of Insurance Commissioners has established and administers a
multi-State examination pursuant to section 4, the adjuster has
passed such an examination, as certified by the NAIC.
SEC. 3. MODEL LICENSING ACT.
To promote the policy of robust consumer protection for and more
efficient interstate adjusting of property, casualty, disability, or
workers' compensation claims, the Congress hereby urges the NAIC to
adopt a model independent claims adjuster licensing Act that--
(1) contains basic standards for the integrity, personal
qualifications, education, training, and experience required of
independent claims adjusters, including continuing education
requirements and ethics course requirements; and
(2) does not impose any limitation or condition upon any
independent claims adjuster to be licensed or otherwise
authorized to do business in a State because of his or her
status as a non-resident of that State.
SEC. 4. MULTI-STATE EXAMINATION.
(a) Establishment.--The Congress hereby urges the NAIC to develop
and administer a multi-State examination for an independent claims
adjuster seeking to adjust claims in a jurisdiction other than his or
her home State.
(b) Examinee Eligibility.--The NAIC may require that, as a
condition for taking a multi-State examination administered pursuant to
this section, the examinee shall--
(1) be duly licensed as an independent claims adjuster by
his or her home State;
(2) meet such integrity, degree, training, and experience
requirements as the NAIC considers necessary; and,
(3) meet any continuing education requirements as
established by his or her home State.
(c) Cross-Jurisdiction Competency.--Any multi-State examination
administered pursuant to this section shall require adjusters to
demonstrate essential competence with cross-jurisdictional legal and
regulatory concepts, and shall include such ethics and other testing as
the NAIC deems necessary.
SEC. 5. INTERSTATE CLAIMS ADJUSTING LICENSING REFORMS.
(a) In General.--A State is in compliance with the requirements of
this subsection, and section 6 shall not apply with respect to such
State, if before the expiration of the 3-year period beginning on the
date of the enactment of this Act the State has enacted and has in
effect--
(1) in the case only of a State that requires and issues
licenses for independent claims adjusters, laws and regulations
governing individuals and entities authorized to operate as
independent claims adjusters within the State that are
functionally equivalent in meaning and effect to those under
any model act developed pursuant to section 3; and
(2) laws and regulations governing non-home State
individuals and entities operating as independent claims
adjusters within that State that provide for the reciprocity
required under subsection (c) with other States.
(b) Uniformity Requirements.--A State that licenses independent
claims adjusters shall be deemed to have established the uniformity
referred to in subsection (a)(1) if it has enacted and adheres to
criteria for the licensing and authorization of adjusters that are
functionally equivalent in meaning and effect to those set forth in a
model act established pursuant to section 3.
(c) Reciprocity Requirements.--The laws and regulations of a
certain State shall be considered to provide for the reciprocity
required under this subsection only if such laws and regulations--
(1) permit any independent claims adjuster who has a
license in another State that is the adjuster's home State to
obtain authorization to engage in the business of adjusting in
such certain State as a non-resident to the same extent that
such adjuster is permitted to practice in the adjuster's home
State, without satisfying any additional requirements other
than, if required under applicable law, to submit--
(A) proof of being licensed in good standing in the
adjuster's home State; Provided, That such home State
has enacted laws and regulations governing individuals
and entities authorized to operate as independent
claims adjusters within such home State that are
functionally equivalent in meaning and effect to those
under any model act developed pursuant to section 3;
and,
(B) payment of any requisite fee to the appropriate
authority of the certain State; Provided, That the
amount of such fee does not exceed any fee required to
be paid by an adjuster whose home State is such certain
State; or
(2) do not require licensure of independent claims
adjusters.
(d) NAIC Determination.--
(1) Determination.--A State shall be considered to be in
compliance with subsection (a) for purposes of this Act if the
NAIC determines that, before the expiration of the 3-year
period beginning on the date of enactment of this Act, the
State is in compliance with the requirements under such
subsection.
(2) Continued review.--With respect to any State that the
NAIC has determined to be in compliance with the requirements
of subsection (a), the Congress hereby urges NAIC to continue
to review and determine such State's compliance with the
requirements of subsection (a) on an annual basis. If the NAIC
determines at any time that a State no longer is in compliance
with the requirements of subsection (a), section 6 shall apply
with respect to such State.
(3) Judicial review.--The appropriate United States
District Court shall have exclusive jurisdiction over any
challenge arising under this section. The court shall apply the
standards set forth in section 706 of title 5, United States
Code, in reviewing any such challenge.
SEC. 6. AUTHORITY FOR INTERSTATE CLAIMS ADJUSTING.
(a) Authority.--In the case of any State that requires and issues
licenses for independent claims adjusters but is not in compliance with
section 5(a), after the expiration of the 3-year period beginning on
the date of the enactment of this Act, an independent claims adjuster
may ascertain, determine, negotiate, or settle a claim in such State,
but only if the adjuster meets the following requirements:
(1) The independent claims adjuster holds a valid such
license in his or her home State.
(2) If the NAIC has established and administers a multi-
State examination pursuant to section 4, the adjuster has
passed such examination.
(b) Prohibition of Additional State Requirements.--An independent
claims adjuster authorized under subsection (a) to ascertain,
determine, negotiate, or settle a claim in a State that is not in
compliance with section 5 shall not be subject to any additional
licensure or other requirements from such State in order to adjust
claims and otherwise act as an independent claims adjuster in such
State.
SEC. 7. DEFINITIONS.
For purposes of this Act, the following definitions shall apply:
(1) Home state.--
(A) Actual.--The term ``home State'' means, with
respect to an independent claims adjuster, the State in
which the adjuster maintains his, her, or its principal
place of residence or business and is licensed as an
independent claims adjuster.
(B) Designated.--If the State in which an
independent claims adjuster maintains his or her
principal place of residence or business does not issue
an independent claims adjuster license for the line or
lines of authority sought, such term means any other
State in which the independent claims adjuster is so
licensed and that is designated by such adjuster as his
or her home State.
(2) Independent claims adjuster.--The term ``independent
claims adjuster'' means an individual or entity, other than a
public adjuster, who undertakes to ascertain, determine,
negotiate, or settle the amount of a property, casualty,
disability, or workers' compensation claim, loss, or damage on
behalf of an insurance policy or insurer or as a third-party on
behalf of a self-insurer.
(3) NAIC.--The term ``NAIC'' means the National Association
of Insurance Commissioners.
(4) Public adjuster.--The term ``public adjuster'' means
any person who, for compensation or any other thing of value,
acts, aids, advertises, or solicits business to ascertain,
determine, negotiate, or settle the amount of a claim, loss, or
damage, solely in relation to first party claims arising under
contracts that insure the real or personal property of the
insured.
(5) State.--The term ``State'' means the States of the
United States, the District of Columbia, the Commonwealth of
Puerto Rico, the Commonwealth of the Northern Mariana Islands,
Guam, the Virgin Islands, American Samoa, and any other
territory or possession of the United States.
(6) State law.--The term ``State law'' includes all laws,
decisions, rules, regulations, or other State action of any
State having the effect of law; and a law of the United States
applicable only to the District of Columbia shall be treated as
a State law rather than as a law of the United States.
<all>
Introduced in House
Introduced in House
Sponsor introductory remarks on measure. (CR E1543-1544)
Referred to the House Committee on Financial Services.
Referred to the Subcommittee on Insurance, Housing and Community Opportunity.
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