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Property Law
Dealing with Possible Fraudulent Public Adjusters
By Karen Karabinos
Public adjusters, those individuals who are hired by insureds to assist them with preparing their insurance claim, can provide valuable assistance to an insured. Increasingly, however, some public adjusters are proving to be a hindrance to effectively and efficiently resolving an insured’s claim. Even some are attempting to defraud the insured and the insurance company. This article will address some of the recent tactics by public adjusters and what strategies an insurance company might consider in response.
Tactic #1: “You Cannot Directly Contact My Insured”
The public adjuster often tries to bar the insurance carrier from directly contacting the insured. The prohibition may come in the form of the public adjuster advising the carrier that the adjuster may not contact the insured directly. We have learned that in some contracts executed between the insured and the public adjuster, the insured is specifically prohibited from contacting the carrier directly.
Karen Karabinos
While the contract the insured executed with the public adjuster may authorize the public adjuster to communicate directly with the insurance company on his/ her behalf, carriers should not allow a public adjuster to prevent direct contact with its insured. The insurance policy is a binding contract between the carrier and its insured that sets forth duties owed by each in connection with a claim. Due to that contract, an insurer carrier should continue to directly contact the insured as needed, but in deference to the fact that the insured has hired a public adjuster, carriers should copy the public adjuster on any and all communications. If the insured contacts the carrier directly, or vice versa, an email or letter to the public adjuster should be sent confirming any phone calls in which the public adjuster was not involved.
Some states have enacted legislature specifically prohibiting a public adjuster from entering into a contract with the insured that prohibits the insured from initiating or maintaining direct communications with the insurance company. For example, in May 2022, the Georgia Legislature enacted House Bill 254, now O.C.G.A. §§ 33-23-43, 33-23-43.2 and 33-23-43.3 addressing public adjuster’s authority in the state of Georgia. One provision provides that a public adjuster contract may not contain a term that “[r]estricts an insured’s right to initiate and maintain direct communications with his or her attorney, the insurer, the insurer’s adjuster, the insurer’s attorney, or any other person regarding settlement of the insured’s claim.” §§ 33-23-43.2(c)(1). Therefore, it is important to obtain a copy of the contract between the insured and the public adjuster to ensure that the provisions do not violate any statutory restrictions.
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FDCC ANNUAL FIVES 2023