W. Va. Code R. § 114-25-2

Current through Register Vol. XLI, No. 45, November 8, 2024

Section 114-25-2 - Definitions

2.1. "Adjuster" means any individual who investigates, negotiates or settles insurance claims. As used in this rule, the term "adjuster" includes public adjusters, company adjusters, and independent adjusters, unless specified otherwise.

2.2. "Code" means the W. Va. Code.

2.3. "Commissioner" means the West Virginia Insurance Commissioner.

2.4. "Company adjuster" means an adjuster who is a staff employee of an insurance company, who is paid by the insurance company, and who investigates, negotiates, or settles claims.

2.5. "Emergency adjuster" means a person who is authorized by the Commissioner to perform adjusting activities in West Virginia during an insurance emergency.

2.6. "Home state" means the District of Columbia or any state or territory of the United States in which an adjuster maintains his or her principal place of residence or business and in which he or she is licensed to act as a resident adjuster: Provided, That if a person's principal place of residence or business does not license adjusters for the type of adjuster license sought in this state, he or she shall designate as his or her home state any state in which he or she has such a license.

2.7. "Independent adjuster" means an individual, a business entity, an independent contractor, or an employee of a contractor, who contracts for compensation with insurers or self-insurers; is one whom the insurer's or self-insurer's tax treatment of the individual is consistent with that of an independent contractor, rather than as an employee, as defined in the Internal Revenue Code; and investigates, negotiates, or settles property, casualty, or workers' compensation claims for insurers or self-insurers.

2.8. "Insurance emergency" means a temporary situation declared by the Commissioner pursuant to W. Va. Code §§ 33-2-10a and/or 33-12B-11a when he or she finds that there is an inadequate number of licensed adjusters to meet the demands of the public.

2.9. "Licensed adjuster" means a person with a valid West Virginia resident or non-resident adjuster license or an emergency license.

2.10. "Public adjuster" means:

2.10.a. Any person who, for compensation or any other thing of value and solely in relation to first party claims arising under insurance contracts that insure the real or personal property of the insured, acts on behalf of the insured in negotiating for, or effecting the settlement of a claim for loss or damage covered by an insurance contract.

2.10.b. A person who advertises for employment as a public adjuster of insurance claims or solicits business or represents himself or herself to the public as a public adjuster of first party insurance claims for losses or damages arising out of policies of insurance that insure real or personal property.

2.10.c. A person who directly or indirectly solicits business, investigates or adjusts losses, or advises an insured about first party claims for losses or damages arising out of policies of insurance that insure real or personal property for another person engaged in the business of adjusting losses or damages covered by an insurance policy on behalf of the insured.

W. Va. Code R. § 114-25-2