N.M. Admin. Code § 13.4.8.14

Current through Register Vol. 35, No. 17, September 10, 2024

Section 13.4.8.14 - CONDUCT OF ADJUSTERS

A.Standards of conduct. All adjusters shall adhere to the following standards of conduct:

(1) An adjuster shall not permit an unlicensed employee or representative of the adjuster to conduct business for which a license is required pursuant to the Insurance Code.

(2) An adjuster shall be honest and fair in all communications with the insured, the insurer and the public.

(3) An adjuster shall give prompt, knowledgeable service and courteous, fair and objective treatment at all times.

(4) An adjuster shall not give legal advice, and shall not deal directly with any policyholder or claimant who is represented by legal counsel without the consent of the legal counsel involved.

(5) An adjuster shall comply with all local, state and federal privacy and information security laws, if applicable.

(6) An adjuster shall not pay a commission, service fee or other valuable consideration to a person for investigating or settling claims in this state if that person is required to be licensed pursuant to the Insurance Code and is not so licensed.

(7) An adjuster shall not undertake the adjustment of any claim if the adjuster is not competent and knowledgeable as to the terms and conditions of the insurance coverage or which otherwise exceeds the adjuster's experience. An adjuster shall obtain competent technical assistance, when necessary to help handle claims and losses outside the adjuster's area of expertise.

(8) An adjuster shall disclose to an insured if the adjuster has any interest or will be compensated by any construction firm, salvage firm, building appraisal firm, motor vehicle repair shop or any other business entity that performs any work in conjunction with damages caused by the insured loss.

B.Conduct prohibited.

(1) An adjuster shall not represent an insured on a claim or charge a fee to an insured while representing the insurance carrier against which the claim is made.

(2) An adjuster shall not advance money to any potential client or insured.

(3) An adjuster shall not adjust a loss related to physical damage of a property on which the adjuster also acts as or is employed as any type of contractor or otherwise provides building repairs or products of any type for compensation, or is a controlling person in a business relating to such contracting, regardless of whether the contractor is a licensed adjuster.

(4) An adjuster shall avoid any direct or indirect financial interest of a claim adjusted by the adjuster other than the salary, fee, commission or other consideration established in a written contract, unless, in the case of a public adjuster, full written disclosure has been made to the insured.

(5) An adjuster shall avoid conflicts of interest, including acquiring any interest in salvaged property or participating in any way, directly or indirectly, in the reconstruction, repair, or restoration of damaged property that is the subject of a claim adjusted, unless, in the case of a public adjuster, full written disclosure has been made to the insured and written permission has been obtained from the insured.

(6) In those instances in which an adjuster who is also a contractor is performing either as an adjuster or as a contractor on behalf of an insured, the adjuster shall provide the insured with a disclaimer, on a form promulgated by the superintendent and signed by the adjuster, indicating in which of these two capacities the adjuster is serving the insured and affirming that the adjuster is not serving the insured in the other capacity. The adjuster shall retain copies of such signed disclaimers and make them available to the superintendent upon the superintendent's request.

N.M. Admin. Code § 13.4.8.14

Adopted by New Mexico Register, Volume XXX, Issue 11, June 11, 2019, eff. 7/1/2019