Florida Insurance Commissioner David Altmaier

Florida Attorney General Candidate Sean Shaw and I collaborated and drafted language that made people making the values, numbers, scopes of loss or directly or indirectly, helping determine an insurance claim amount, have an attorney license or a public adjuster license. We wanted to better protect consumers and help stop allegations of or actual insurance fraud from occurring.

There were alleged “third party administrators” soliciting for work from public adjusters who were not public adjusters. It appeared to Sean Shaw and myself that the Office of Insurance Regulation and the public would want to have the people actually doing the work to determine the values for a claim to be accountable to a regulatory body. We thought it would reduce scammers who wrongfully inflated the value of insurance claims. We also wanted to hold public adjusters accountable for their submissions and from abusing their license and hiding behind an excuse that they were not intentionally submitting fraudulent claims or otherwise harming Florida consumers.

The officers of the Florida Association of Public Insurance Adjusters (FAPIA) also wanted to protect the public and their reputations. They wanted only people who have licenses to help prepare insurance claims.

Sean and I drafted this portion of the statute that came into effect on January 1, 2018, to help prevent people who lack a public adjuster license aiding an insured or public adjuster in preparing an insurance claim, and make doing so a crime. Here is a link to the House Bill which was passed and the part I helped draft:

(19) Except as otherwise provided in this chapter, no person, except an attorney at law or a public adjuster, may for money, commission, or any other thing of value, directly or indirectly:
(a) Prepare, complete, or file an insurance claim for an insured or a third- party claimant;
(b) Act on behalf of or aid an insured or a third-party claimant in negotiating for or effecting the settlement of a claim for loss or damage covered by an insurance contract;
(c) Advertise for employment as a public adjuster; or
(d) Solicit, investigate, or adjust a claim on behalf of a public adjuster, an insured, or a third-party claimant.

In my speeches starting in 2017, I have been teaching, telling, and warning people to get a Florida public adjuster license if they wanted to do or assist with insurance adjustment work for policyholders or public adjusters. Otherwise, they could wait until after a big storm occurs and face a long delay in getting one issued.

Some people who have criminal records or lack the character requirements to obtain such a license cannot get a license. Sean and I wanted to prevent those people from working on insurance claims in Florida through an indirect means. I know people like this and some I call friends—but “love the sinner and hate the sin.” There are consequences for wrongful conduct.

If you are working on Florida insurance claims and do not have a license, I think you could go to jail. If you are one of these people, I am not your attorney, and you should obtain a second opinion from somebody who is an attorney. The purpose of the bill was to prevent third-parties without a license from working and assisting on preparing the claim. How can I say otherwise, since I helped draft this? I would tell you to stop.

Another attorney may provide you another opinion and tell you that what you do is legal. But, I know what I intended in my suggestions to wording of the bill. If another attorney wants to get sued if he is wrong and have you risk arrest and going to jail or being fined, so be it.

David Altmaier is Florida’s Insurance Commissioner. While we initially had different views about the statistics regarding closed claims following Hurricane Irma, he is a very bright and dedicated public servant. His insurance background was as an insurance agent, and I am certain that his focus is on protecting insurance consumers. Public adjusters should expect that his office will conduct market conduct studies of their files. I certainly expect that his capable insurance investigators are in the Florida Panhandle looking for signs of illegal activity and will get the support of local prosecutors. Their job is to enforce regulations and the law.

Since I have had my phone blowing up with people I know that are not licensed upset about me publicly stating what I am writing about above, I expect some may not heed my warning. Please do not break the law. If you are good at assisting policyholders, simply go get a public adjusters license.

  • Good Start

    I was president of FAPIA when this bill was passed and was involved in the drafting of the bill. I can say unequivocally that Chip’s interpretation accurately reflects the intent of the bill. FAPIA and DFS were and are still concerned with the numerous “loss consultants”, “estimators” “appraisers” or other unlicensed individuals out there soliciting policyholders to assist them with their claims. I agree with Chip’s statement that if you are one of those unlicensed people you had better get a PA license or risk the legal consequences of not doing so – Don Phillips

    • rogerpoe

      So Good Start, and Chip – Licensed Reconstruction Contractors and other Reconstruction Experts that are prepared to help rebuild insured clients properties after Hurricanes Irma and Michael, are acting illegally by providing insured clients with reconstruction costs estimates?

      • I would like to see Chip’s answer, but I don’t think that is what he is saying. Contractors (and others) can write estimates, but contractors (and others) can’t assist in the settlement of insurance claims, and contractors (and others) can’t write the estimate in exchange for money or a percentage of the claim.

  • rogerpoe

    Chip – Nationwide, for many decades, disaster recovery contractors naturally also have as clients..insured clients. They are Not concerned about establishing loss claims values. Are you saying that simply because a client has an insurance contract, contractors are breaking the law somehow by doing business with them by way of writing reconstruction costs estimates, and all that that inherently means by way of intrinsic reconstruction business dynamics demands?

    • Good Start

      Roger: Contractors run afoul of the statute if they prepare an estimate for money. It is fine for a contractor to give a policyholder or anyone else an estimate to repair damage. They just can’t accept money or anything else of value for preparing the estimate – Don Phillips

      • that is the way I read it as well. if the contractor just writes the estimate, they should be fine.

      • rogerpoe

        Good Start – You stated – “Contractors run afoul of the statute if they prepare an estimate for money.” ?? Are you suggesting that construction business owners/storm damage experts should only provide aggregate disaster scope assessments, and disaster recovery reconstruction costs estimates,..for free..to Insureds?

      • Chris Pce

        Don, will contents experts require licensing too since they assess value and are paid for their services/estimates?

  • Edward Fako

    I remember an article last year written by Steve Badger that proclaimed a similar analogy.

    Does this intend to prevent a licensed Contractor from preparing an Estimate or derive a Contract Value, even if their Estimator works In house?

    What is the statutory intent on that?

  • shirley heflin

    Dear Chip:

    It’s disheartening to see these articles about who can do what with this license and who can’t do this without one (i.e., law license and/or Public Adjuster license). While all this ink is being wasted on existing laws, people need help with their insurance claims in Panama City, FL, Mexico City, FL, etc. It’s also disheartening to see Public Adjusters tell people they provide free “estimate reviews” (saw on Facebook). They advise that they don’t handle cases less than $20,000.00 as it isn’t worth their time. In other words, the little person is cast aside like molded bread. This is infuriating. This is despicable because it all boils down to money which makes the world (and greedy people) go round and round and round and round………….

    • I don’t do this, but I’m not seeing the harm in offering to review estimates (not policy reviews, as those should be done by agents or attorneys, right Chip?). It’s a way to get in the door, knowing most (if not all) carrier estimates are going to be inadequate. Like I said, I don’t do it, but I don’t see the harm either. As far as minimums, that has always been. Some PAs don’t want to handle claims under 6 figures. Some say $50K. I guess some are now saying $20K, especially when capped at 10%, even on supplements. If they want to lose that business, and the potential referrals and good will, that is up to them. I take all legit claims of any size. All. Valid claims under $1K are handled without charge. 14 years, and still in business somehow.

    • Edward Fako

      Shirley,

      One of the most outspoken Florida PA’s contuously comments that he will not even consider any claims less than $100,000

      Where and who can the 95% of claimants go who don’t meet his standards?

    • rogerpoe

      Good points Shirley. My concern is that fair and free market enterprise principles that create niche market opportunities and livelihoods after disasters, are illicitly and unethically quashed because others have political connections to do so.

  • James Purcell

    There seem to be a lot of unanswered questions on the effect of this new legislation.

    The statute exempts people performing duties under another professional license. In FL, infrared thermographers, leak detection companies, home theater contractors, antiques appraisers and various other specialty trades are not required to be licensed. Are they then breaking the law by ‘investigating’ a claim if they are paid for their work? As the statute is worded, isn’t EagleView breaking the law by providing aerial measurements and photos used by a PA to estimate and adjust a claim?

    It also appears anyone serving as appraiser for a homeowner must also be licensed as a PA, since their work would fall under the definition of public adjusting. Since appraisers for insureds are now required to be licensed public adjusters:

    – Does the insured’s appraiser now have to give the insured a 3-day right of rescission?

    – Is the insured’s appraiser’s fees capped at 10/20% of additional recovery, if any?

    – If a PA is also involved with the loss, does the 10/20% fee cap apply to the combined fees of the PA and appraiser, or separately?

    – Since a PA cannot receive payment until additional monies are recovered, does this mean the insured’s appraiser cannot charge a retainer or advance towards fees and costs?

    – Are both the PA and appraiser required to provide copies of their estimates to the insured? Can they provide the same estimate or must they be different?

    These are just a handful of questions I have, which leads me to believe the bill, while well-intentioned, needs some tweaking to accomplish its intentions.

    • Chris Pce

      Great comment, James. Not to mention desk estimate writers, that take field scope notes from PA’s & contractors and compile the estimate based on those notes. Are they breaking the law now, too??

      EDIT: This also just occurred to me, if a PA does use a desk or field writer, are THEY now criminally liable for utilizing the service of a non-licensed estimator?? There are many inconsistencies with this legislation that would effectively cast a huge net on industry professionals and technically make many criminals. I feel the wording needs to be much more specific.

  • William Cook

    Chip and Sean
    It is very much appreciated by this adjuster for addressing the associated problems that your
    combined skills and efforts have served to correct. I list below some of the issues that have come to my and other associates attention to seek further clarification.

    1. Can this statute be interpreted to require that an appraiser for insurers or insureds acting in the capacity of an appointed appraiser by an insurer must hold a license as an adjuster?
    2. Must an agreed on umpire by appraisers hold an adjuster license.?
    3. Am I correct to assume that a licensed CPA evaluating or processing a business income loss for insurers or an insured may not be required to be licensed.?
    3. Does this statute impact a licensed contractor, mold assessor, handyman, roofer or bodyshop foreman, without benefit of a signed contract for doing the insured repairs, submit their findings to insurers without being subject to punishment?
    4. Does a company such as Enservio, retained by insurers for compiling compiling contents inventory and values, be immune from adjuster licensing requirements?
    5. Can a damage consultant hired by an attorney firm representing an insured or insurers be immune from adjuster licensing requirements?
    6. What is the process for documenting and filing a complaint should one of the above parties are suspected of violating the spirit of the statute?
    7. If there is a dual authority for a violation of the statutes such as may be by a licensed contractor, which authority, DBPR or DFS will prosecute the violation?
    In the past, neither authority would agree that they were the correct entity to take the violator to the wood shed.

    With your’s or Sean’s permission I would like to share your response with the 400 plus members of my forum group to be used as a guideline when encountering possible violations of the statues.
    As ever
    Thanks for all that you do for our industry.

    William S. Cook

  • Kyle Larson

    It seems to me you only run afoul here if you were to submit an estimate to an insurer without being an atty or PA. and clearly an insured could write their own estimate. If a PA, Atty, or Homeowner asks me, and pays me, to write an estimate, that they then submit to an insurer, how is that not legal?

  • Get your facts straight

    626.854 FL Statute
    (15) A licensed contractor under part I of chapter 489, or a subcontractor, may not adjust a claim on behalf of an insured unless licensed and compliant as a public adjuster under this chapter. However, the contractor may discuss or explain a bid for construction or repair of covered property with the residential property owner who has suffered loss or damage covered by a property insurance policy, or the insurer of such property, if the contractor is doing so for the usual and customary fees applicable to the work to be performed as stated in the contract between the contractor and the insured.