Roofers Are Not Insurance Adjusters

Warning! Roofers Are Not Insurance Adjusters

warning-against-fraud-insurance-adjustersAs in last month’s blog, scam #3, roofing contractors and roofing companies that try and advocate on behalf of a home owner while posing also as a licensed Insurance Adjuster is illegal.

Who Is A Legal Public Insurance Adjuster?

Texas Dept. of Insurance (TDI), Code Chapter 4102: A “Public Insurance Adjuster” means:

1. A person who, for direct, indirect, or any other compensation, acts on behalf of an insured to negotiate or effect the settlement of an insurance claim is performing the acts of a Public Insurance Adjuster.

This can only be done by a “licensed” adjuster not a roofer advertising “Professional Adjuster onboard”.

2. A person who advertises, solicits business, or holds themselves out to the public as an Adjuster of claims for loss or damage under any policy of insurance covering real or personal property is also performing the acts of a Public Insurance Adjuster.

Additionally, insurers cannot utilize roofers as de facto Public Insurance Adjusters nor provide commissions to them in the form of direct or indirect payments or rebates that are in excess of amount owed under the policy. Otherwise saying, your insurance company cannot send out Chuck in a truck to determine your damage, they must pay the licensed Claims Adjuster to do this job.

So as to say, if a roofer hands over two business cards, first with a roofing company’s name and his name, second one with a public Insurance Adjuster company’s name and his name, this is illegal. You either have to represent the roofing company OR the home owner as the public Insurance Adjuster.

A Public Insurance Adjuster are not allowed to work under any other name nor associate with advertisement, solicitation or business contract with a roofing company.

Also, a Public Insurance Adjuster is prohibited from participating directly or indirectly in the repair or restoration of damaged property that is the subject of a claim adjusted by the license holder. This is a conflict of interest.

A professional roofing company will work with an Insurance Adjuster, but will stick with the roofing and construction end of the job.

Don’t be the prey of these types of individuals, promising to “build up” and “work in” fictitious claims just to achieve a higher settlement.

From the Texas Dept. of Insurance (TDI), Commissioner’s Bulletin:

The department takes seriously the harm unlicensed individuals and entities can cause on the marketplace when they prey on unsuspecting consumers and the industry. I urge insurers, agents, adjusters, and consumers to help call attention to and halt attempts by unlicensed persons to negotiate insurance claims, and I encourage everyone to report these practices to the department and the TDI Fraud Unit.

The Insurance Code provides for both civil and criminal penalties for violating this licensing requirement. The department will refer unlicensed persons performing the acts of a Public Insurance Adjuster to the Texas Attorney General, pursue all remedies available under the Insurance Code, and highlight these practices to the Legislature so that it may consider further steps to regulate these persons and activities.