RÉSUMÉ DIGEST
ACT 174 (SB 266) 2016 Regular Session Long
Prior law required any business entity seeking to be engaged in business as an independent
insurance claims adjusting company to provide a listing of all executive officers and directors
of the applicant and of all executive officers and directors of entities owning and any
individuals owning, directly or indirectly, 10% or more of the outstanding voting securities
of the applicant. Provided that in order to make a determination of eligibility, the
commissioner of insurance may require submission of addresses, social security numbers,
criminal and administrative histories, fingerprints, background checks, and biographical
statements of each executive officer and director.
New law retains these provisions but changes "owning" to "controlling" and defines "control"
as provided in the Insurance Holding Company System Regulatory Law of the Insurance
Code.
Prior law provided for reciprocity for licensed claims adjusters for those from states that
require licensure. New law provides that a nonresident who is not eligible for licensure under
reciprocity provisions in the Insurance Code may designate Louisiana as his home state
provided the person successfully passes the adjuster examination and complies with all the
requirements for a Louisiana resident adjuster.
Prior law provided that an individual who applies for a claims adjuster license in La. who
was previously licensed as a claims adjuster in another state based on a claims adjuster
examination shall not be required to complete an examination. Provided that this exemption
is available only if the person is currently licensed in that state or if the application is
received within 12 months of the cancellation of the applicant's previous claims adjuster
license and if the prior state issues a certification that, at the time of cancellation, the
applicant was in good standing in that state, or the state's producer database records or
records maintained by the National Association of Insurance Commissioners (NAIC), its
affiliates, or subsidiaries, indicate that the adjuster is or was licensed in good standing.
New law deletes these provisions.
Prior law provided that an individual licensed as a claims adjuster in another state based on
a claims adjuster examination who moves to this state shall make application within 90 days
of establishing legal residence to become a resident claims adjuster licensee. Provided that
no examination is required of that individual to obtain a claims adjuster license.
New law limits this exemption from examination requirements to a person who is currently
licensed in another state or if the application is received within 90 days of the cancellation
of the applicant's previous claims adjuster license and if the prior state issues a certification
that, at the time of cancellation, the applicant was in good standing in that state or the state's
producer database records or records maintained by the National Association of Insurance
Commissioners (NAIC), its affiliates, or subsidiaries, indicate that the adjuster is or was
licensed in good standing.
Prior law provided that an individual who applies for a claims adjuster license in La. who
was previously licensed as a claims adjuster in La. shall not be required to complete an
examination. This exemption is available only if the application is received within 12 months
of the cancellation of the applicant's previous claims adjuster license in La. and if, at the time
of cancellation, the applicant was in good standing in La., and had passed the required
examination. New law increases the 12 month time frame to 24 months.
New law authorizes the commissioner to waive the workers' compensation examination
requirement for an individual who has three years of verifiable experience adjusting workers'
compensation claims within the preceding five years, provided the application is received on
or before August 1, 2017.
New law provides that a claims adjuster may receive qualification for a license in one or
more of the following lines of authority:
(1)Property and casualty. (2)Workers' compensation.
(3)Crop.
(4)Any limited line for which the commissioner issues a limited license.
New law provides that a claims adjuster doing business under any name other than the claims
adjuster's legal name is required to notify the commissioner of insurance prior to using the
assumed name. Prior to the use of or changes to any trade name or names, the claims adjuster
is required to provide written notification to the commissioner. Requires that a certified copy
of the registration from the secretary of state shall accompany the application for a trade
name and provides that the use by any claims adjuster of a nonapproved trade name subjects
the person to a fine not exceeding $250. Provides that if the adjuster continues to use a
nonapproved trade name for ten or more days after being notified to cease using the
nonapproved trade name, then the adjuster is subject to an additional fine not to exceed
$5,000.
Prior law provided that a claims adjuster whose license has lapsed may, within 12 months
from the expiration date of the renewal, reinstate the license upon approval of the
commissioner. Provided that a penalty in the amount of double the unpaid renewal fee shall
be required for the reinstatement of the claims adjuster license. Provided that reinstatement
shall be effective on the date the commissioner of insurance approves the request for
reinstatement.
New law removes these provisions and provides that a licensed claims adjuster who allows
his license to lapse may, within two years from the expiration date of the license, reinstate
the same license upon proof of fulfilling all continuing education requirements through the
date of reinstatement and upon payment of all fees due. Provides that if the license has been
lapsed for more than two years, the applicant shall fulfill the requirements for issuance of a
new license.
Prior law provided that the commissioner may place on probation, suspend, revoke, or refuse
to issue, renew, or reinstate a claims adjuster's license or may levy a fine not to exceed $500
for each violation up to $10,000 aggregate for all violations in a calendar year, unless a fine
is established by separate provision in the Insurance Code authorizing a greater penalty, or
any combination of actions, for any one or more of the following causes:
(1)Providing incorrect, misleading, incomplete, or materially false information in the
license application.
(2)Violating any state insurance law or regulation or a subpoena or order of the
commissioner of insurance or of another state's insurance commissioner.
(3)Obtaining or attempting to obtain a license through misrepresentation or fraud.
(4) Improperly withholding, misappropriating, or converting any money or property
received in the course of conducting insurance business.
(5) Intentionally misrepresenting the terms of an actual or proposed insurance contract
or application for insurance.
(6) Conviction of a felony related to the adjustment of insurance claims.
(7) Admitting to or committing fraud or unfair trade practices.
(8) Using fraudulent, coercive, or dishonest practices.
(9) Demonstrating incompetence, untrustworthiness, or financial irresponsibility while
conducting business.
(10) Denial, suspension, or revocation of an insurance license, or its equivalent, in any
other state, province, district, or territory. (11) Forging a name on an application for insurance or any document related to an
insurance transaction.
(12) Cheating, including improperly using notes or any other reference material, to
complete an examination for an insurance license.
(13) Knowingly accepting insurance business from an individual who is not licensed but
who is required to be licensed by the commissioner of insurance.
(14) Failure to comply with an administrative or court order imposing a child support
obligation.
(15) Failure to pay state income tax or comply with any administrative or court order
directing payment of state income tax.
(16) Violating R.S. 22:1674(F).
(17) Failure to complete assignment of adjustment of a claim in a thorough and timely
manner, including submission of the adjustment of a claim to the party which made
that assignment.
New law retains prior law and adds the following reasons:
(1) Providing incorrect, misleading, incomplete, or materially false information in the
license renewal application.
(2) Violating the insurance laws or regulations of the United States or any other
jurisdiction.
(3) Intentionally misrepresenting the terms of an actual or proposed insurance binder,
rider, or plan, including all forms or documents that are attached, or will be attached,
to an actual or proposed insurance contract, binder, rider, plan, or application for
insurance.
(4) Conviction of or a nolo contendere plea to any felony, participation in a pretrial
diversion program pursuant to a felony charge, suspension or deferral of sentence and
probation pursuant to Article 893 of the Code of Criminal Procedure or similar law
of another state, or conviction of any misdemeanor involving moral turpitude, or
public corruption, or the adjustment of insurance claims.
(5) The refusal to submit physical evidence of identity or the conviction of a felony, in
accordance with R.S. 22:1922(B) and (C).
(6) Employing or allowing to associate with his business, in any manner, any person
engaged in the business of insurance who has been convicted of a felony under the
laws of this or any other state, the United States, or any other jurisdiction. "Business
of insurance" means the writing of insurance or the reinsuring of risks by an
insurance producer or insurer, including all acts necessary or incidental to such
writing or reinsuring, and the activities of persons who act as, or are, officers,
directors, agents, or employees of producers or insurers, or who are other persons
authorized to act on behalf of such persons.
(7) The conviction of a felony involving dishonesty or breach of trust pursuant to 18
U.S.C. §1033 and §1034, without written consent from the commissioner of
insurance pursuant to 18 U.S.C. §1033, or any successor statute regulating crimes by
or affecting persons engaged in the business of insurance whose activities affect
interstate commerce.
The above provisions are effective August 1, 2016.
Prior law provided an exemption from licensure for workers' compensation adjusters.
New law repeals that exemption effective August 1, 2017. (Amends R.S. 22:1664(C)(2), 1665(D) and (E), 1669, 1671(A), (D), (E), (F), and (G), and
1672 (A); adds R.S. 22:1665 (F) and 1671(H); repeals R.S. 22:1662(13))