Title 31A, Title 31A: Insurance Code

31A-26-202. Application for license. (1) The application for a license as an independent adjuster or public adjuster shall be: made to the commissioner on forms and in a manner the commissioner requires; and except as provided in Subsection, accompanied by the applicable fee, whi…

31A-26-203. Adjuster's license required. (1) The commissioner shall issue a license to act as an independent adjuster or public adjuster to a person who, as to the license classification applied for under Section: 31A-26-204 satisfies the character requirements under Section; 31A…

31A-26-204. License classifications. A resident or nonresident license issued under this chapter shall be issued under the classifications described under Subsections,, and. A classification describes the matters to be considered under a prerequisite education or examination requ…

31A-26-205. Character requirements. Each applicant for a license under this chapter shall show to the commissioner that: (1) the applicant has the good faith intent to engage in the type of business the license or licenses applied for would permit; (2) if a natural person, the ap…

31A-26-206. Continuing education requirements. (1) Pursuant to this section, the commissioner shall by rule prescribe continuing education requirements for each class of license under Section. 31A-26-204 (2) The commissioner shall impose continuing education requirements in accor…

31A-26-207. Examination requirements. (1) The commissioner may require applicants for a particular class of license under Sectionto pass an examination as a requirement to receiving a license. The examination shall reasonably relate to the specific license class for which it is p…

31A-26-208. Nonresident jurisdictional agreement. (1) If a nonresident license applicant has a valid license from the nonresident license applicant's home state or designated home state and the conditions of Subsectionare met, the commissioner shall: (1)(b) waive any license requ…

31A-26-209. Form and contents of license. (1) Licenses issued under this chapter shall be in the form the commissioner prescribes and shall set forth: the name, address, and the one or more telephone numbers of the licensee; the license classifications under Section; 31A-26-204 t…

31A-26-210. Reports from organizations licensed as adjusters. (1) An organization licensed as an adjuster under Sectionshall designate an individual who has an individual adjuster license to act on the organization's behalf in order for the licensee to do business for the organiz…

31A-26-211. Claims liaison. Authorized insurers with employees engaged in insurance adjusting may be required by the commissioner to designate one or more natural persons to whom the commissioner or the commissioner's staff may direct inquiries concerning the insurer's claims adj…

31A-26-212. Emergency license. In the event of a catastrophe or emergency which arises out of a disaster, act of God, riot, civil commotion, conflagration, or other similar occurrence, the commissioner shall, upon application, issue emergency licenses to persons who are not licen…

31A-26-213. Revoking, suspending, surrendering, lapsing, limiting, or otherwise terminating a license -- Forfeiture -- Rulemaking for renewal or reinstatement. (1) A license type issued under this chapter remains in force until: revoked or suspended under Subsection; (5) surrende…

31A-26-214. Probation -- Grounds for revocation. (1) The commissioner may place a licensee on probation for a period not to exceed 24 months as follows: after an adjudicative proceeding under, for any circumstances that would justify a suspension under Section; or Title 63G, Chap…

31A-26-214.5. License lapse and voluntary surrender. (1) A license issued under this chapter shall lapse if the licensee fails to: pay when due a fee under Section; 31A-3-103 complete continuing education requirements under Sectionbefore submitting the license renewal application…

31A-26-215. Temporary license -- Appointment of trustee for terminated licensee's business. (1) The commissioner may issue a temporary insurance adjuster license: to a person listed in Subsection: (1)(b) if the commissioner considers that the temporary license is necessary: for t…

31A-26-216. Portable electronics adjusting. (1) As used in this section, "automated claims adjudication system" means a preprogrammed computer system designed for the collection, data entry, calculation, and final resolution of a portable electronics insurance claim that: may onl…

31A-26-301. Timely payment of claims. (1) Unless otherwise provided by law, an insurer shall timely pay every valid insurance claim made by an insured. By rule the commissioner may prescribe: the kinds of notice and proof of loss that will establish validity; the manner in which …

31A-26-301.5. Health care claims practices. (1) Except as provided in Section, an insured retains ultimate responsibility for paying for health care services the insured receives. 31A-8-407 If a health care service is covered by one or more individual or group health insurance po…

31A-26-301.6. Health care claims practices. (1) As used in this section: "Health care provider" means a person licensed to provide health care under: Title 26B, Chapter 2, Part 2, Health Care Facility Licensing and Inspection; or Title 58, Occupations and Professions. "Insurer" m…

31A-26-301.7. Dental claim transparency and practices. (1) As used in this section: "Bundling" means the practice of combining distinct dental procedures into one procedure for billing purposes. "Dental plan" means the same as that term is defined in Section. 31A-22-646 "Downcodi…

31A-26-301.8. Non-covered dental services and claims documentation. (1) Terms defined in Sectionapply to this section. 31A-26-301.7 (2) An insurer may not require a dental provider to submit the dental provider's full fee-for-service charges on a claim form as a condition of paym…

31A-26-302. Settlement of claims in credit life and accident and health insurance. (1) The creditor shall promptly report all claims to the insurer or its designated claim representative. The insurer shall maintain adequate claims files. All claims shall be settled as soon as pos…

31A-26-303. Unfair claim settlement practices. (1) No insurer or person representing an insurer may engage in any unfair claim settlement practice under Subsections,, and. (2) (3) (4) (2) Each of the following acts is an unfair claim settlement practice: knowingly misrepresenting…

31A-26-304. Prohibition of conflicting roles. A person licensed concurrently as both an independent and a public adjuster may not represent both the insurer and the insured in the same transaction.

31A-26-305. Request for accepted check. If an insurance policy claimant entitled to receive money in settlement of a claim makes a timely request to the insurer for payment by accepted check, the insurer shall make payment to the claimant with a check accepted by the drawee under…

31A-26-306. Place of business -- Records. (1) An insurance adjuster licensed under this chapter shall register and maintain with the commissioner: the address and telephone number of the licensee's principal place of business; a valid business email address at which the commissio…

31A-26-307. Claim reports to commissioner. On the commissioner's request, any insurer or licensed adjuster connected with a loss or claim shall report to the commissioner all facts relative to the loss or claim arising under any insurance contract covering a subject of insurance …

31A-26-308. Settlement of liability insurance claim not admission of liability. No settlement or partial settlement of a claim against any insured under a liability insurance policy is an admission, by either the insured or the insurer, of the liability of the insured on any clai…

31A-26-309. Adjuster's duty to report illegal insurance. Sectionapplies to the adjuster's duty to report illegal insurance.

31A-26-310. Compensation of insurer's or insured's claims adjuster. (1) Except as provided in Subsection, an insurer or an insured may not pay a person who is representing the insurer or insured in connection with an insurance claim adjustment on any basis that is dependent, in w…

31A-26-311. Rescission of contracts with public adjusters. (1) Except as provided in Subsection, an insured or claimant under an insurance policy who contracts with a public adjuster to assist in the settlement of a claim may rescind that contract by delivering written notice of …

31A-26-312. Prohibited conduct. (1) An independent adjuster or public adjuster may not: participate directly or indirectly in the reconstruction, repair, or restoration of damaged property that is the subject of a claim adjusted by the independent adjuster or public adjuster; eng…

31A-26-313. Health care collection actions -- Notification required. (1) As used in this section: "Collection action" means any action taken to recover funds that are past due or accounts that are in default: for health care services; and that directly results in an adverse repor…

31A-26-401. Required contracts. (1) A public adjuster may not, directly or indirectly, act within this state as a public adjuster without having first entered into a contract, in writing, on a form a public adjuster files with the department in accordance with Section, that the p…

31A-26-402. Compensation. (1) Except as provided by Subsection, a public adjuster may receive compensation for service a public adjuster provides under this chapter consisting of: (4) an hourly fee; a flat rate; a percentage of the total amount an insurer pays to resolve a claim;…

31A-26-403.1. Assignment of property insurance policy rights and benefits. (1) A property insurance policy may prohibit the assignment of a right or benefit under the property insurance policy to a property repair contractor, roofing company, disaster clean up company, appraiser,…

31A-26-404. Funds that a public adjuster holds. A public adjuster that receives, accepts, or holds funds on behalf of an insured shall deposit the funds into a trust account within a federally insured depository institution that: (1) has a branch in this state, if the public adju…

31A-26-405. Public adjuster standards of conduct. A public adjuster may not: (1) solicit or attempt to solicit an insured during the progress of a loss-producing occurrence; (2) advertise or infer damage unless an inspection of the property has been completed; (3) offer to pay an…

31A-26-406. Record retention requirements. (1) A public adjuster shall keep at the public adjuster's address that the public adjuster registers with the commissioner a record of each investigation, adjustment, or transaction the public adjuster undertakes or completes under the p…

31A-26-407. Rulemaking. The commissioner may make rules, in accordance with: (1) addressing the forms required by this part; (2) providing for notice requirements in contracts; and (3) establishing the scope of a contract a public adjuster enters into with an insured that the pub…