1.This Act may be cited as the
Claims Licensing Advancement for
Interstate Matters Act
or the CLAIM Act
.
2.Accelerating
claims adjusting of losses caused by natural or other disasters
(a)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)The requirements
under this subsection with respect to an independent claims adjuster are as
follows:
(1)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)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.
3.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.
4.
(a)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)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
competencyAny 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.
5.Interstate claims
adjusting licensing reforms
(a)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)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)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)
(1)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)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)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.
6.Authority for
interstate claims adjusting
(a)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 requirementsAn 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.
7.For purposes of this Act, the following
definitions shall apply:
(1)
(A)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)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 adjusterThe 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)The
term NAIC means the National Association of Insurance
Commissioners.
(4)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)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)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.