H. B. 4401
(By Delegates Perry, Ashley, Hall and Hartman)
[Introduced February 2, 2012; referred to the
Committee on Banking and Insurance then Finance.]
A BILL to amend and reenact §33-12B-1, §33-12B-5 and §33-12B-9 of the Code of West Virginia, 1931, as amended; and to amend said code by adding thereto a new section, designated §33-12B-4a, all relating to insurance; licensure of adjusters; definitions, including a definition of “automated claims adjudication system”; and exemptions for certain individuals from adjuster licensure in this state and licensing of residents of Canada in this state.
Be it enacted by the Legislature of West Virginia:
That §33-12B-1, §33-12B-5 and §33-12B-9 of the Code of West Virginia, 1931, as amended, be amended and reenacted; and that said code be amended by adding thereto a new section, designated §33-12B-4a, all to read as follows:
ARTICLE 12B. ADJUSTERS.
(a) An "adjuster" is any individual who, for compensation, fee or commission, investigates and settles claims arising under property, casualty or surety insurance contracts, on behalf solely of either the insurer or insured. A licensed attorney who is qualified to practice law in this state is deemed not to be an adjuster for the purposes of this article.
(b) “Automated claims adjudication system” means a preprogrammed computer system designed for the collection, data entry, calculation and final resolution of portable electronics insurance claims which:
(1) May only be utilized by a licensed adjuster, licensed producer or supervised individuals operating pursuant to section four-a of this article;
(2) Must comply with all claims payments requirements of the insurance code; and
(3) Must be certified as compliant with this section by a licensed adjuster that is an officer of the entity which employs the individuals operating pursuant to section four-a of this article.
(b) (c) "Company adjuster" means an adjuster representing the interests of the insurer, including an independent contractor and a salaried employee of the insurer.
(c) (d) “Home state” means the District of Columbia or any state or territory of the United States in which an adjuster maintains his or her principal place of residence or business and in which he or she is licensed to act as a resident adjuster. If a person’s principal place of residence or business does not license adjusters for the type of adjuster license sought in this state, he or she shall designate as his or her home state any state in which he or she has such a license.
(d) (e) "Public adjuster" means an independent contractor representing solely the financial interests of the insured named in the policy.
(e) (f) “Crop adjuster” means a person who adjusts crop insurance claims under the federal crop insurance program administered by the United States Department of Agriculture.
§33-12B-4a. Exemptions from license.
Individuals who collect claim information from, or furnish claim information to, insureds or claimants and who conduct data entry including entering data into an automated claims adjudication system are exempted from licensure under this article: Provided, That no more than twenty-five such persons are under the supervision of one licensed adjuster or licensed producer.
§33-12B-5. Qualifications for adjuster's license; examinations; exemptions.
(a) For the protection of the people of West Virginia, the commissioner shall not issue, renew or permit to exist any adjuster's license, except to an individual who:
(1) Is eighteen years of age or more.
(2) Is a resident of West Virginia, except for nonresident adjusters as provided in section nine of this article.
(3) Satisfies the commissioner that he or she is trustworthy and competent.
(b)(1) The commissioner may, at his or her discretion, test the competency of an applicant for a license under this section by examination. However, in order to qualify for a crop adjuster license, an applicant must pass a written examination that tests the knowledge of the individual concerning the insurance laws of this state and the duties and responsibilities of a multiperil crop adjuster. In lieu of such an examination, the commissioner may accept certification that the individual has passed a proficiency examination approved by the federal Risk Management Agency.
(2) If such an examination is required, each examinee shall pay a $25 examination fee for each examination to the commissioner, which fees shall be used for the purposes set forth in section thirteen, article three of this chapter. The commissioner may, at his or her discretion, designate an independent testing service to prepare and administer such examination subject to direction and approval by the commissioner, and examination fees charged by such service shall be paid by the applicant.
(c) The requirements of this section do not apply to licenses issued to emergency adjusters.
(d) A resident of Canada may not be licensed pursuant to this article, nor designate this state as his or her home state, unless that person has successfully passed the adjuster examination and has complied with the other applicable portions of this section, except that the applicant is not required to comply with the provisions of subdivision(a) (2) of this section.
§33-12B-9. Licensing of nonresident adjusters.
(a) A nonresident applicant for an adjuster license who holds a similar license in his or her home state may be licensed as a nonresident adjuster in this state if the applicant’s home state has established, by law or regulation, like requirements for the licensing of a resident of this state as a nonresident adjuster.
(b) As a condition of continuing a nonresident adjuster license, the licensee must maintain a license in his or her home state.
(c) If a nonresident adjuster desires to become a resident adjuster he or she must apply to become one within ninety days of establishing legal residency in this state.
(d) If a nonresident adjuster has his or her license suspended, terminated or revoked by his or her home state, the adjuster must immediately notify the commissioner of that action.
(e) A resident of Canada may not be licensed as a nonresident adjuster under this section unless that person has obtained a resident or home state adjuster license in another state.
NOTE: The purpose of this bill is to create an exemption from licensure as an adjuster or certain individuals who conduct data entry into an automated claims adjudication system for portable electronics insurance claims.
Strike-throughs indicate language that would be stricken from the present law, and underscoring indicates new language that would be added.
§33-12B-4a is new; therefore, it has been completely underscored.