Ethics and Responsibilities for Florida Adjusters
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About this ebook
This textbook is a study of ethical conduct for insurance adjusters in Florida, examining some of the ethical dilemmas they face and presenting the topics of deceptive trade practices and fair claims handling.
In this book you will learn the general concepts of adjuster ethics, gain an understanding of ethical decision making, compare ethical obligations and legal requirements, identify the duties resulting from the law of agency, examine guidelines and law for Florida adjusters to follow, and learn about adjuster liability.
Major subjects covered include:
* Introduction to Adjuster Ethics
* The Common Law of Agency
* Perspective on the Unauthorized Practice of Law
*Ethics for the Insurance Industry
* Complex Ethical Dilemmas that Challenge Adjusters
* Legal Vs. Ethical Requirements
* Adjuster Liability (Unethical Conduct may lead to Bad Faith Claims)
* Fair Claims Handling Guidelines and Law for FL Adjusters
* Deceptive Trade Practices in General
* Regulating Fair Claims Practices and Unfair Claim Settlement Practices
* Property and Casualty Claims Practices
* Adjusters and the Florida Insurance Code
* The Insurance Adjusters Law
* Adjuster Code of Ethics
* The Unfair Insurance Trade Practices Act
* Authority and Enforcement
* Disciplinary Guidelines for Public Adjusters
Michael Lustig
Michael Lustig is a graduate of the University of San Diego, California and a former Professor at California State University at Pomona and Immaculate Heart College (Los Angeles). He has been a California Real Estate Broker and the Owner and President of Real Estate License Services, a California real estate and insurance licence school, since 1978, offering state-approved license courses in 47 states and the District of Columbia. He is the author of 35 books on real estate and insurance topics.
Read more from Michael Lustig
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Ethics and Responsibilities for Florida Adjusters - Michael Lustig
Ethics and Responsibilities
for Florida Adjusters
Prepared by Michael Lustig
Contributing Editor: Denise Iona
Distributed by:
Cal State Exams
5059 Newport Ave. #209
San Diego, CA 92107
Phone Toll-Free 1-800-729-0207
Smashwords Edition
Copyright © 2011 - 2005 REAL ESTATE LICENSE SERVICES, INC. Copyright registered. All rights reserved. No part of this material may be reprinted, reproduced, transmitted, stored in a retrieval system, placed in a computer or on the Internet, or otherwise utilized, in any form or by any means electronic or mechanical, including photocopying or recording, now existing or hereinafter invented, nor may any part of this course be used for teaching without permission from the copyright holder. CAL-STATE EXAMS is a division of REAL ESTATE LICENSE SERVICES, INC., holder of the registered copyright.
TABLE OF CONTENTS
LESSON 1: INTRODUCTION TO ADJUSTER ETHICS
INTRODUCTION
THE COMMON LAW OF AGENCY
CREATING THE AGENCY RELATIONSHIP - AUTHORITY OF AGENT - TERMINATION OF AGENCY - AN AGENT’S OBLIGATIONS
PERSPECTIVE ON THE UNAUTHORIZED PRACTICE OF LAW
WHAT CONSTITUTES THE PRACTICE OF LAW? - LEGAL KNOWLEDGE - PROHIBITIONS
LESSON 2: ETHICS FOR THE INSURANCE INDUSTRY
OVERVIEW
THE NEW FOCUS OF BUSINESS ETHICS - ETHICS IN THE INSURANCE BUSINESS - WHO IS RESPONSIBLE?
ENCOURAGING ETHICS
AT THE CORPORATE LEVEL - MIDDLE MANAGEMENT - AGENCY LEVEL
ETHICS CAN BE TAUGHT
KNOWING RIGHT FROM WRONG - A FORUM FOR ETHICS DISCUSSIONS
ETHICS MUST TAKE HIGH PRIORITY
COMPLEX ETHICAL DILEMMAS THAT CHALLENGE ADJUSTERS
WHEN THE PRESSURE IS ON - THE ETHICS OF THE MARKETPLACE - INTERPRETATION - ETHICAL ISSUES OF INDEMNIFICATION - INSURANCE FRAUD - SELECTING INDEPENDENT EXPERTS - CONTAINING COSTS - TIMEFRAMES FOR FAIR CLAIMS SETTLEMENT - THE USE OF SURVEILLANCE - NEGOTIATING IN GOOD FAITH
LEGAL VS. ETHICAL REQUIREMENTS
THE LEGAL REQUIREMENTS - THE ETHICAL REQUIREMENTS
ETHICAL FITNESS SHOULD BEGIN AT THE TOP
LESSON 3: ADJUSTER LIABILITY
INTRODUCTION
PARTIES TO WHOM DUTIES ARE OWED
DUTIES OWED TO THE STATE - DUTIES OWED TO THE INSURER - DUTIES OWED TO INSUREDS AND CLAIMANTS
UNETHICAL CONDUCT MAY LEAD TO BAD FAITH CLAIMS
CONCLUSION
LESSON 4: FAIR CLAIMS HANDLING GUIDELINES AND LAW FOR FLORIDA ADJUSTERS
DECEPTIVE TRADE PRACTICES IN GENERAL
REGULATING FAIR CLAIMS PRACTICES
UNFAIR CLAIM SETTLEMENT PRACTICES
PROPERTY AND CASUALTY CLAIMS PRACTICES
ACKNOWLEDGING COMMUNICATIONS AND IMPLEMENTING STANDARDS FOR THE PROMPT INVESTIGATION OF CLAIMS - COMMUNICATIONS TO OR BY AN AGENT - PROVIDING NECESSARY CLAIM FORMS
CLAIM SETTLEMENT PRACTICES RELATING TO MOTOR VEHICLE INSURANCE
CLAIM SETTLEMENT PRACTICES RELATING TO PROPERTY INSURANCE
CLAIM SETTLEMENT PRACTICES RELATING TO HEALTH MAINTENANCE ORGANIZATIONS
LESSON 5: ADJUSTERS AND THE FLORIDA INSURANCE CODE
INSURANCE REGULATION IN FLORIDA
THE INSURANCE ADJUSTERS LAW
PUBLIC ADJUSTER - INDEPENDENT ADJUSTER - COMPANY EMPLOYEE ADJUSTER - NONRESIDENT COMPANY EMPLOYEE ADJUSTER - CATASTROPHE OR EMERGENCY ADJUSTER - PRIMARY ADJUSTER - OFFICE AND RECORDS - EXCLUSIVE EMPLOYMENT
ADJUSTER CODE OF ETHICS
ETHICAL REQUIREMENTS - SPECIAL CONSIDERATIONS FOR PUBLIC ADJUSTERS
THE UNFAIR INSURANCE TRADE PRACTICES ACT
MISREPRESENTATIONS AND FALSE ADVERTISING OF INSURANCE POLICIES - FALSE INFORMATION AND ADVERTISING GENERALLY - DEFAMATION - BOYCOTT, COERCION, OR INTIMIDATION - FALSE STATEMENTS AND ENTRIES - STOCK OPERATIONS AND ADVISORY BOARD CONTRACTS - UNFAIR DISCRIMINATION - UNLAWFUL REBATES - UNFAIR CLAIM SETTLEMENT PRACTICES - COMPLIANT HANDLING PROCEDURES - MISREPRESENTATION IN INSURANCE APPLICATIONS - TWISTING - ADVERTISING GIFTS PERMITTED - FREE INSURANCE PROHIBITED - ILLEGAL DEALINGS IN PREMIUMS - INSURANCE COST SPECIFIED IN PRICE PACKAGE
- CERTAIN INSURANCE TRANSACTIONS THROUGH CREDIT CARD FACILITIES - INTERLOCKING OWNERSHIP AND MANAGEMENT - PROHIBITED ARRANGEMENTS AS TO FUNERALS - CERTAIN LIFE INSURANCE RELATIONS WITH FUNERAL DIRECTORS PROHIBITED - FALSE CLAIMS; OBTAINING OR RETAINING MONEY DISHONESTLY - PROPOSAL REQUIRED - SOLICITING OR ACCEPTING NEW OR RENEWAL INSURANCE RISKS BY INSOLVENT OR IMPAIRED INSURER - REFUSAL TO INSURE - POWERS OF ATTORNEY - SLIDING - CHURNING - DECEPTIVE USE OF NAME
AUTHORITY AND ENFORCEMENT
HEARING - CEASE AND DESIST ORDERS - ADMINISTRATIVE FINES - CIVIL LIABILITY
DISCIPLINARY GUIDELINES FOR PUBLIC ADJUSTERS
CHAPTER QUIZZES
LESSON 1 – INTRODUCTION TO ADJUSTER ETHICS
LESSON 2 – ETHICS FOR THE INSURANCE INDUSTRY
LESSON 3 – ADJUSTER LIABILITY
LESSON 4 – FAIR CLAIMS HANDLING GUIDELINES AND LAW FOR FLORIDA ADJUSTERS
LESSON 5 – ADJUSTERS AND THE FLORIDA INSURANCE CODE
LESSON 1: INTRODUCTION TO ADJUSTER ETHICS
INTRODUCTION
This lesson is intended as a general introduction to the study of adjuster ethics and responsibility. It includes openings to some of the subject areas covered in more detail later in the course.
In this chapter, students will be introduced to the common law of agency, the body of law applicable to consensual relationships in which one person consents to act on behalf of another person and subject to that person's control. The law of agency requires certain standards of behavior within the framework of the principal/agent relationship because agency doctrine governs the consequences, for both the principal and agent, of the agent's interactions with third parties. Insurance adjusters,