230-20-50 R.I. Code R. § 4.4

Current through August 19, 2024

Section 230-RICR-20-50-4.4 - License Required

A. A person shall not act or hold him/her or itself out as an adjuster in this state unless the person is licensed as an adjuster by the State of Rhode Island. Application for an individual person shall be made using the Uniform Individual Application as modified and provided by the Department.

B. The Department may issue business entity licenses to residents on a discretionary basis. Application shall be made using the Uniform Business Entity Application as modified and provided by the Department. A business entity license is not required. All persons associated with a business entity performing adjuster services must hold a valid individual license. Before approving the application for a business entity license, the department shall find that:

1. The business entity is a resident of the State of Rhode Island;

2. The business entity has paid the applicable fees; and

3. The business entity has designated a licensed adjuster responsible for the business entity's compliance with the insurance laws, rules and regulations of this state.

C. An insurance adjuster doing business under any name other than the adjusters' legal name is required to notify and obtain the consent of the Department prior to using the assumed name.

D. Each adjuster license is issued on a biennial basis. An adjuster who obtains a license during the license term shall be issued a license for the time period remaining and will have to renew at the expiration of the License, regardless of the period of time he, she or it has been licensed. The Department does not prorate license fees.

E. A license as an adjuster shall not be required of the following:

1. An attorney-at-law admitted to practice in this state, when acting in his or her professional capacity as an attorney;

2. A person who negotiates or settles claims arising under a life or health insurance policy or an annuity contract;

3. An insurance producer licensed by the Department, when the insurance producer adjusts, or assists in the adjustment of claims arising only under policies of insurance or fidelity or surety bonds negotiated, solicited, or effected by him or her or by the insurance producer, whether the insurance producer is a person, partnership, or corporation, for which he or she acts;

4. A person employed for the purpose of obtaining facts surrounding a loss or furnishing technical assistance to a licensed adjuster, including but not limited to photographers, estimators, private investigators, engineers, and handwriting experts;

5. An individual who is employed to investigate suspected fraudulent insurance claims but who does not adjust losses or determine claims payments;

6. A person who solely performs executive, administrative, managerial, or clerical duties, or any combination thereof, and who does not investigate, negotiate, or settle claims with policyholders, claimants, or their legal representative;

7. A licensed health care provider or its employee who provides managed care services as long as the services do not include the determination of compensability;

8. A managed care organization or any of its employees or an employee of any organization providing managed care services so long as the services do not include the determination of compensability;

9. A person who settles only reinsurance or subrogation claims;

10. A person who investigates, negotiates, or settles life, accident and health, annuity, or disability insurance claims;

11. An individual employee, under a self-insured arrangement, who adjusts claims on behalf of their employer;

12. A person authorized to adjust workers' compensation or disability claims under the authority of a third-party administrator (TPA) license pursuant to R.I. Gen. Laws Chapter 27-2; and

13. A person who adjusts claims for portable electronic insurance offered pursuant to R.I. Gen. Laws Chapter 27-2.

F. A licensed adjuster that is unable to comply with license renewal procedures due to military service or some other extenuating circumstance (e.g., a long-term medical disability) may request a waiver of those procedures. The adjuster may also request a waiver of any examination requirement, fine, or other sanction imposed for failure to comply with renewal procedures.

230 R.I. Code R. § 230-RICR-20-50-4.4

Amended effective 6/11/2019