D.C. Mun. Regs. tit. 26, r. 26-A3909
No public insurance adjuster shall enter into an employment contract except in conformity with these rules. There shall be a true copy of the employment contract which shall be given to the client at the time the contract is signed. The contract and copy(ies) of the contract shall (1) be printed on white or cream paper in dark or black ink; (2) have section titles captioned in bold face type which otherwise stands out significantly from the text; (3) have statements on contract which read "read both sides before signing" and "I have read the information on both sides of this contract" printed in 18 point type; (4) use layout and spacing which separates the paragraphs from each other and from the border of the paper; (5) be on one piece of paper measuring 8 1/2" X 11" to be printed on both sides and which shall state:
INFORMATION ABOUT YOUR PUBLIC INSURANCE ADJUSTER
EMPLOYMENT CONTRACT
YOUR LEGAL RIGHTS:
Cancellation: You may cancel this contract by notifying us at the address shown on the other side of this page, in writing, by certified mail, return receipt, postmarked not later than midnight three (3) business days following the day this contract is signed.
Settlement offer: We shall forward to you any written settlement offer from the insurance company.
Fee: Our services are available for a fee to be paid by you. We cannot charge or otherwise collect a fee that exceeds ten percent (10%) of the total recovery.
Copy of the contract: We must give you a true copy of this Public Insurance Adjuster Contract at the time you sign it.
LIMITATIONS OF PUBLIC INSURANCE ADJUSTERS:
We are not allowed:
--to solicit your employment if you have already hired or contracted with another public insurance adjuster.
--to have any interest whatsoever in any home improvement, restoration, construction, salvage, or appraisal business operating in the District.
--to represent both an insurer and an insured at the same time.
--to pay anything of value to any person as an inducement to refer business to us.
--to share our fee, except with another licensed Public Insurance Adjuster.
--to advise you on any question of law.
--to advance any monies to you before settlement of the loss, where such amount would be included in the final settlement.
--to make false statements about an insurance company or its representatives.
We must:
--sign this Contract.
--inform you that we do not represent any insurance company or any insurance company adjusting firm.
* NAME OF LICENSED PUBLIC INSURANCE ADJUSTER
* The name of the licensee must appear here. If you operate as a firm or on behalf of a firm, show name of firm licensee here and names of all individual licensees in designated area.
ADDRESS
TELEPHONE NUMBER
Names of individual public insurance
Adjuster licensee(s) to appear here
READ BOTH SIDES BEFORE SIGNING (18 point type)
PUBLIC INSURANCE ADJUSTER CONTRACT
To the Interested Insurance Companies and Others Whom it May Concern:
I/we retain (name of public insurance adjuster) to act as my/our public insurance adjuster(s) and to advise and assist in the adjustment and settlement of my/our (type) loss at (address) which occurred on or about (date). In consideration for these services, I/we hereby assign out of the monies due or to become due from said Insurance Companies on account of the said loss a sum equivalent to 10% percent of the total insurance recovery.
I HAVE READ THE INFORMATION ON BOTH SIDES OF THIS CONTRACT (18 point type)
(date)
Signed: (signature of insured)
(signature of insured)
(name)
(address)
(city & state)
Agreed to: (name of individual or firm licensee)
By: (signature of Public Insurance Adjuster)
This form is in compliance with Title 26, section 3909 (form of contract) of the DCMR.
This form must be signed by the licensed Public Insurance Adjuster and the Insured.
D.C. Mun. Regs. tit. 26, r. 26-A3909