CLAIM Act

I 116TH CONGRESS 1ST SESSION H. R. 4037 To promote uniformity and reciprocity among States that license insurance claims adjusters and to facilitate prompt and efficient adjusting of insur- ance claims, and for other purposes. IN THE HOUSE OF REPRESENTATIVES JULY 25, 2019 Mr. KUSTOFF of Tennessee (for himself and Mr. FOSTER) introduced the fol- lowing bill; which was referred to the Committee on Financial Services, and in addition to the Committee on Agriculture, for a period to be sub- sequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To promote uniformity and reciprocity among States that license insurance claims adjusters and to facilitate prompt and efficient adjusting of insurance claims, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Claims Licensing Ad- 4 vancement for Interstate Matters Act’’ or the ‘‘CLAIM 5 Act’’. 6 VerDate Sep 11 2014 21:07 Aug 15, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H4037.IH H4037 pamtmann on DSKBFK8HB2PROD with BILLS 2 •HR 4037 IH SEC. 2. STATE FLEXIBILITY IN MULTISTATE ADJUSTER LI- 1 CENSING REFORMS. 2 (a) IN GENERAL.—Section 4, or in the case of crop 3 adjusting section 6, shall take effect upon the expiration 4 of the 4-year period beginning on the date of the enact- 5 ment of this Act unless, before the expiration of such pe- 6 riod, those States that license independent claims adjust- 7 ers have enacted— 8 (1) uniform laws and regulations governing the 9 licensure of individuals and entities authorized to 10 adjust insurance claims within the State; and 11 (2) reciprocity laws and regulations governing 12 the licensure of nonresident individuals and entities 13 authorized to adjust insurance claims within those 14 States. 15 (b) UNIFORMITY REQUIRED.—States shall be deemed 16 to have established the uniformity necessary to comply 17 with subsection (a)(1) if the States— 18 (1) establish uniform criteria regarding the in- 19 tegrity, personal qualifications, education, training, 20 and experience of licensed independent claims ad- 21 justers for— 22 (A) property and casualty insurance; 23 (B) workers compensation insurance; 24 (C) crop insurance (to the extent that a 25 State licenses crop insurance adjusters; and 26 VerDate Sep 11 2014 21:07 Aug 15, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H4037.IH H4037 pamtmann on DSKBFK8HB2PROD with BILLS 3 •HR 4037 IH (D) such other lines as a State may choose 1 to regulate; 2 (2) establish uniform continuing education re- 3 quirements for licensed independent claims adjusters 4 for each line of insurance under paragraph (1) that 5 a State chooses to regulate; 6 (3) establish uniform ethics course require- 7 ments for licensed independent claims adjusters in 8 conjunction with the continuing education require- 9 ments under paragraph (2); 10 (4) do not impose any requirement upon any 11 independent claims adjuster to be licensed or other- 12 wise qualified to do business as a nonresident that 13 has the effect of limiting or conditioning that inde- 14 pendent claims adjuster’s activities because of its 15 residence or place of operations; and 16 (5) utilize a uniform license application. 17 (c) RECIPROCITY REQUIRED.—States shall be 18 deemed to have established the reciprocity required to 19 comply with subsection (a)(2) if the following conditions 20 are met: 21 (1) ADMINISTRATIVE LICENSING PROCE- 22 DURES.—Each State that licenses independent 23 claims adjusters permits an independent claims ad- 24 juster that has a license for adjusting insurance 25 VerDate Sep 11 2014 21:07 Aug 15, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H4037.IH H4037 pamtmann on DSKBFK8HB2PROD with BILLS 4 •HR 4037 IH claims in their home State to receive a license to ad- 1 just insurance claims in those other States as a non- 2 resident to the same extent that such independent 3 claims adjuster is permitted to adjust insurance 4 claims in their home State without satisfying any 5 additional requirements other than submitting— 6 (A) a request for licensure utilizing the 7 uniform license application; 8 (B) a copy of, or evidence of, a valid li- 9 cense held by the adjuster in their home State 10 (unless such information is available in the Na- 11 tional Insurance Producer Registry Producer 12 Database); and 13 (C) the payment of any requisite fee to the 14 appropriate authority. 15 (2) CONTINUING EDUCATION REQUIRE- 16 MENTS.—Each State that licenses an independent 17 claims adjuster accepts an insurance claims adjust- 18 er’s satisfaction of their home State’s continuing 19 education requirements for licensed insurance claims 20 adjusters to satisfy the State’s own continuing edu- 21 cation requirements. 22 (3) NO LIMITING NONRESIDENT REQUIRE- 23 MENTS.—A State does not impose any requirement 24 upon any independent claims adjuster to be licensed 25 VerDate Sep 11 2014 21:07 Aug 15, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H4037.IH H4037 pamtmann on DSKBFK8HB2PROD with BILLS 5 •HR 4037 IH or otherwise qualified to do business as a non- 1 resident that has the effect of limiting or condi- 2 tioning that independent claims adjuster’s activities 3 because of its residence or place of operations. 4 (4) RECIPROCAL RECIPROCITY.—Each of the 5 States that satisfies paragraphs (1), (2), and (3) 6 grants reciprocity to residents of all of the other 7 States that satisfy such paragraphs. 8 (d) COMPLIANCE.— 9 (1) DETERMINATION.—A State shall be consid- 10 ered to be in compliance with subsection (a) for pur- 11 poses of this Act if the State, before the expiration 12 of the 4-year period beginning on the date of the en- 13 actment of this Act, publishes a finding that it is in 14 compliance with the provision. Any such publication 15 shall be made following notice by the State of its in- 16 tention to publish the finding, and the State’s ac- 17 ceptance of comments on the proposed finding. After 18 notice required by this paragraph, a State agency 19 shall give interested persons an opportunity to par- 20 ticipate through submission of written data, views, 21 or arguments. After consideration of the relevant 22 matter presented, the agency shall incorporate in the 23 finding adopted a concise general statement of the 24 VerDate Sep 11 2014 21:07 Aug 15, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H4037.IH H4037 pamtmann on DSKBFK8HB2PROD with BILLS 6 •HR 4037 IH basis and purpose and shall respond to the com- 1 ments it received in detail. 2 (2) JUDICIAL REVIEW.—The appropriate 3 United States District Court shall have exclusive ju- 4 risdiction over any challenge arising under this sec- 5 tion. The court shall apply the standards set forth 6 in section 706 of title 5, United States Code, in re- 7 viewing any such challenge. 8 SEC. 3. STATE AUTHORITIES. 9 Nothing in this Act shall be construed to— 10 (1) require a State that does not have licensing 11 requirements for independent claims adjusters to 12 adopt any such requirements; 13 (2) subject to section 2, limit the right of a 14 State to establish licensing fees or enforce its laws 15 regarding the adjusting of insurance claims, pro- 16 vided that such State fee is uniform regardless of 17 the State of residence of the licensee in that State; 18 or 19 (3) affect the jurisdiction and authority of a 20 State insurance regulator to prescribe and enforce 21 its insurance laws, rules, and regulations regulating 22 independent claims adjuster activity in its jurisdic- 23 tion. 24 VerDate Sep 11 2014 21:07 Aug 15, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H4037.IH H4037 pamtmann on DSKBFK8HB2PROD with BILLS 7 •HR 4037 IH SEC. 4. AUTHORITY FOR INTERSTATE CLAIMS ADJUSTING. 1 In the case of any State that requires and issues li- 2 censes for independent claims adjusters (other than crop 3 adjusters) but is not in compliance with section 2, after 4 the expiration of the 4-year period beginning on the date 5 of the enactment of this Act, an independent claims ad- 6 juster may apply to the National Association of Registered 7 Agents and Brokers for Membership for the purpose of 8 licensure in each such State not in compliance with section 9 2, provided that such independent claims adjuster pays the 10 requisite fees, including licensing fees. For purposes of 11 this provision, upon such date an independent claims ad- 12 juster shall be determined to be a person that negotiates 13 policies of insurance and offers advice, counsel, opinions 14 or services related to insurance, as such terms are used 15 in section 334(5) of Public Law 106–102, as amended by 16 section 202(a) of Public Law 114–1 (15 U.S.C. 6764(5); 17 129 Stat. 27). 18 SEC. 5. WAIVER OF LICENSE RENEWAL IN CERTAIN CIR- 19 CUMSTANCES. 20 If a natural person, while licensed or applying to be 21 licensed to adjust claims pursuant to any State statute 22 enters the military service of the United States and is in 23 that service at a time prescribed for the filing of a renewal 24 application or payment of a licensing fee, the filing of that 25 application and the payment of the fee shall be waived, 26 VerDate Sep 11 2014 21:07 Aug 15, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H4037.IH H4037 pamtmann on DSKBFK8HB2PROD with BILLS 8 •HR 4037 IH and the license held by that licensee at the time of his 1 or her entry into military service shall remain in force dur- 2 ing the period of that military service and until the end 3 of the license year in which he or she is released from 4 that service, but not for less than six months after that 5 release. During that period, that person may secure a li- 6 cense of the type held by him or her on his or her entry 7 into military service upon the filing of an application and 8 paying the fee therefor without the necessity of taking an 9 examination or paying a penalty. 10 SEC. 6. CROP ADJUSTING. 11 In the case of any State that requires and issues li- 12 censes for independent crop insurance adjusters but is not 13 in compliance with section 2, after the expiration of the 14 4-year period beginning on the date of the enactment of 15 this Act, an independent claims adjuster may adjust 16 claims in such State for crop insurance provided that the 17 crop adjuster has met the certification requirements of the 18 Federal Crop Insurance Corporation in his or her home 19 State or designated home State, as established by the Fed- 20 eral Crop Insurance Act (7 U.S.C. 1501 et seq.) and pro- 21 vided that such crop adjuster pays the requisite fees, in- 22 cluding State licensing fee. 23 VerDate Sep 11 2014 21:07 Aug 15, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H4037.IH H4037 pamtmann on DSKBFK8HB2PROD with BILLS 9 •HR 4037 IH SEC. 7. DEFINITIONS. 1 For purposes of this Act, the following definitions 2 shall apply: 3 (1) HOME STATE.— 4 (A) ACTUAL.—The term ‘‘home State’’ 5 means, with respect to an independent claims 6 adjuster, the State in which the adjuster main- 7 tains his, her, or its principal place of residence 8 or business and is licensed upon having passed 9 an exam as an independent claims adjuster. 10 (B) DESIGNATED.—If the State in which 11 an independent claims adjuster maintains his or 12 her principal place of residence or business does 13 not issue an independent claims adjuster license 14 or require an examination as a condition for 15 such licensure for the line or lines of authority 16 sought, such term means any other State in 17 which the independent claims adjuster is so li- 18 censed upon having passed an exam and that is 19 designated by such adjuster as his or her home 20 State. 21 (2) INDEPENDENT CLAIMS ADJUSTER.—The 22 term ‘‘independent claims adjuster’’ means an indi- 23 vidual, other than a public adjuster, who undertakes 24 on behalf of insurers or self-insurers to investigate, 25 evaluate, and negotiate the resolution of the amount 26 VerDate Sep 11 2014 21:07 Aug 15, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H4037.IH H4037 pamtmann on DSKBFK8HB2PROD with BILLS 10 •HR 4037 IH of a property, casualty, liability, disability, or work- 1 ers’ compensation claim, loss, or damage on behalf 2 of an insurance policy or insurer or as a third party 3 on behalf of a self-insurer. Such term includes com- 4 pany or staff adjusters, who are individuals, other 5 than a public adjuster, employed by property cas- 6 ualty insurers and undertake to investigate, evalu- 7 ate, and negotiate the resolution of a property, cas- 8 ualty, liability, disability, crop loss, or workers’ com- 9 pensation claim, loss, or damage on behalf of an in- 10 surance policy or insurer or as a third party on be- 11 half of a self-insurer. 12 (3) PUBLIC ADJUSTER.—The term ‘‘public ad- 13 juster’’ means any person who, for compensation or 14 any other thing of value, on behalf of the insured 15 acts, aids, advertises, or solicits business to ascer- 16 tain, determine, negotiate, or settle the amount of a 17 claim, loss, or damage, solely in relation to first 18 party claims arising under contracts that insure the 19 real or personal property of the insured. 20 (4) STATE.—The term ‘‘State’’ means the 21 States of the United States, the District of Colum- 22 bia, the Commonwealth of Puerto Rico, the Com- 23 monwealth of the Northern Mariana Islands, Guam, 24 VerDate Sep 11 2014 21:07 Aug 15, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H4037.IH H4037 pamtmann on DSKBFK8HB2PROD with BILLS 11 •HR 4037 IH the Virgin Islands, American Samoa, and any other 1 territory or possession of the United States. 2 (5) STATE LAW.—The term ‘‘State law’’ in- 3 cludes all laws, decisions, rules, regulations, or other 4 State action of any State having the effect of law; 5 and a law of the United States applicable only to the 6 District of Columbia shall be treated as a State law 7 rather than as a law of the United States. 8 Æ VerDate Sep 11 2014 21:07 Aug 15, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6301 E:\BILLS\H4037.IH H4037 pamtmann on DSKBFK8HB2PROD with BILLS