INSURANCE COMMISSIONER TAKES ACTION TO PROTECT WISCONSIN CONSUMERS ISSUING A FINAL DECISION AGAINST CONTRACTOR ACTING AS PUBLIC ADJUSTER

The following information was released by the Wisconsin Office of the Commissioner of Insurance:

The Office of the Commissioner of Insurance (OCI) has announced that Commissioner Nathan Houdek issued a final decision to impose civil forfeitures of $6,000 after finding that a contractor was acting as a public adjuster under Wisconsin law, which subjected him to the standards of Wis. Stat. ch. 629, and that he violated those standards by engaging in prohibited conduct and fraudulent practices.

The contractor's business model, which combined home repair services with "claim assistance" through assignments of benefits which violated state law. Wis. Stat. 629.10(3) prohibits a person acting as a public adjuster from having a financial interest in the subject of a claim beyond the compensation set out in the adjuster's contract.

"This decision makes clear that if you are acting as a public adjuster in Wisconsin, you must follow the rules that apply to public adjusters," said Commissioner Houdek. "Consumers deserve to know that anyone negotiating an insurance claim on their behalf is free from financial conflicts and is truthful in their dealings with insurers and regulators."

Guidance for Public Adjusters

Public adjuster standards apply based on conduct: Anyone negotiating an insurance claim on behalf of a policyholder is acting as a public adjuster, regardless of their job title, and are subject to all of the laws found in Wis. Stat. ch. 629.

Avoid conflicts of interest: A public adjuster may not have any financial interest in the claim beyond the agreed compensation in the contract, nor may they refer the consumer to anyone in whom they have a direct or indirect financial interest or receive anything of value from. See Wis. Stat. 629.10

Allow the consumer to choose their contractor: A public adjuster cannot require the consumer to work with a specific contractor. See Wis. Stat. 629.09

Work with an approved Public Adjuster Contract: A public adjuster contract must be approved and on file with the Office of the Commissioner of Insurance and conform with the requirements listed in Wis. Stat. 629.04.

Be truthful: False or misleading statements made to consumers, insurers, or regulators can result in penalties.

Be knowledgeable: Review and abide by all of the laws and regulations applicable to Public Adjusters under Wis. Stat. ch. 629.

Guidance for Consumers

Review contracts carefully: Be cautious of agreements that assign your insurance benefits to a contractor or third party. Public Adjusters are prohibited from requesting or accepting an assignment of insurance policy proceeds from an insured.

Choose your contractor independently: A Public Adjuster cannot require you to work with a specific contractor or require you to allow them to choose the contractor that you work with.

Understand representation: Only a public adjuster who complies with Wisconsin law may negotiate with your insurer on your behalf.