Claims Licensing Advancement for Interstate Matters Act or CLAIM Act - Urges the National Association of Insurance Commissioners (NAIC) to: (1) adopt a model independent claims adjuster licensing Act meeting specified criteria, and (2) adopt 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.
Authorizes the NAIC to prescribe examinee eligibility requirements, and requires any multi-state examination to require adjusters to demonstrate essential competence with cross-jurisdictional legal and regulatory concepts.
Declares that nothing in this Act shall be construed to: (1) require a state to adopt licensing requirements for independent claims adjusters if it does not have such requirements; (2) limit the right of a state to establish licensing fees or enforce its laws regarding the adjusting of insurance claims, provided that such a fee is uniform regardless of the licensee's state of residence; or (3) affect the jurisdiction and authority of a state insurance regulator to prescribe and enforce its insurance laws, rules, and regulations governing independent claims adjuster activity in its jurisdiction.
Sets forth criteria for state compliance with this Act, including reciprocity.
Authorizes an 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, but only if the adjuster: (1) holds a valid license in his or her home state, and (2) has passed any multi-state examination established and administered by the NAIC.
Prohibits a state from imposing additional requirements upon such an adjuster.
Authorizes an independent claims adjuster meeting the licensure and examination requirements of this Act to adjust claims for losses related to any presidentially-designated major disaster, regardless of the licensure requirements of the state where the disaster is located.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2156 Introduced in House (IH)]
113th CONGRESS
1st Session
H. R. 2156
To encourage uniformity and reciprocity among States that license
insurance claims adjusters and to facilitate prompt and efficient
adjusting of insurance claims in the case of natural and other
disasters and losses, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 23, 2013
Mr. Fincher (for himself, Mrs. Blackburn, and Mr. Tiberi) introduced
the following bill; which was referred to the Committee on Financial
Services
_______________________________________________________________________
A BILL
To encourage uniformity and reciprocity among States that license
insurance claims adjusters and to facilitate prompt and efficient
adjusting of insurance claims in the case of natural and other
disasters and losses, 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. 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 National
Association of Insurance Commissioners 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. 3. MULTI-STATE EXAMINATION.
(a) Establishment.--The Congress hereby urges the NAIC to adopt 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. 4. STATE AUTHORITIES.
Nothing in this Act shall be construed to--
(1) require a State that does not have licensing
requirements for independent claims adjusters to adopt any such
requirements;
(2) subject to section 6, limit the right of a State to
establish licensing fees or enforce its laws regarding the
adjusting of insurance claims, provided that such fee is
uniform regardless of the State of residence of the licensee;
or
(3) affect the jurisdiction and authority of a State
insurance regulator to prescribe and enforce its insurance
laws, rules, and regulations regulating independent claims
adjuster activity in its jurisdiction.
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 4-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 2; 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 2.
(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) do not require licensure of independent claims
adjusters; or
(2) 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 2;
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.
(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 4-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 4-year period beginning on
the date of the enactment of this Act, an independent claims adjuster
and the adjuster's employer 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 3, the adjuster has
passed such examination.
(b) Prohibition of Additional State Requirements.--An independent
claims adjuster authorized under subsection (a) to investigate,
evaluate, negotiate the resolution of 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. 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 Requirements.--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 8(a)(1)).
(2) Multi-state examination.--If the NAIC has adopted and
administers a multi-State examination pursuant to section 3,
the adjuster has passed such an examination.
SEC. 8. 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, other than a public
adjuster, who undertakes on behalf of insurers or self-insurers
to investigate, evaluate, and negotiate the resolution of 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. Such term includes company or staff adjusters, who are
individuals, other than a public adjuster, employed by property
casualty insurers and undertake to investigate, evaluate, and
negotiate the resolution of a property, casualty, disability,
or workers' compensation claim, loss, or damage on behalf of an
insurance policy or 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,
on behalf of the insured 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 E758-759)
Referred to the House Committee on Financial Services.
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