Public Adjuster: A professional who is licensed to help policyholders (the insured) in appraising and negotiating an insurance claim.
Florida Department of Financial Services: The state agency responsible for regulating the insurance industry in Florida, including licensing and overseeing public adjusters.
Florida Statutes Regulating Public Adjusters: Laws and regulations in Florida that govern the conduct and operation of public adjusters.
Company Adjusters: Insurance adjusters who are employed by an insurance company to assess the damage and determine the amount the company will pay for the claim.
Independent Adjusters: Insurance adjusters who work independently, not for a specific insurance company. They can be hired by insurance companies or policyholders to assess damage and determine claim value.
Insured: The individual or entity who is covered under an insurance policy.
Claimant: The person making an insurance claim.
Contract: A legally binding agreement between the public adjuster and the insured, outlining the services to be provided and the fees.
Fee Negotiation: The process of discussing and agreeing on the fees for the public adjuster’s services.
Claim Settlement: The resolution of an insurance claim, including the payment made by the insurance company to the insured.
Licensed Attorney: A person who is legally qualified to practice law, and who can also represent an insured in insurance claims in some cases.
Commission: The fee paid to a public adjuster, often a percentage of the claim settlement.
Permanent Business Address: The official business location of the public adjuster.
License Number: The unique identifier assigned to a licensed public adjuster by the Florida Department of Financial Services.
Insurance Claims: A formal request to an insurance company asking for a payment based on the terms of the insurance policy.
Public Trust: The expectation that public adjusters will act in the best interests of their clients and conduct their business ethically and honestly.
Fair and Honest Treatment: The expectation that public adjusters will deal with all parties in an insurance claim in a fair and honest manner.
Contract Terms: The specific conditions, provisions, obligations, and rights outlined in a contract between a public adjuster and an insured.
Property Insurance Claim: A formal request to an insurance company for coverage or compensation for a covered loss or policy event.
Professional Representation: The act of a public adjuster representing a policyholder in dealings with an insurance company.
Claim Payments: The money that an insurance company pays to the insured after a claim is settled.
Obstruction of Insurer: Any action by a public adjuster that prevents an insurance company from having reasonable access to the insured property.
Reasonable Access to Insured Property: The right of an insurance company to inspect the property that is the subject of an insurance claim.
Public Adjuster Near Me: A common search term used by individuals looking for local public adjuster services.
Policyholder: The individual or entity who owns an insurance policy.
Emergency Claims: Insurance claims that are filed in response to an unexpected and urgent loss, such as damage from a natural disaster.
Ethical Requirements: Standards of professional conduct that public adjusters are expected to adhere to.
Power of Attorney: A legal document that gives one person (the public adjuster, in this case) the authority to act on behalf of another person (the insured) in specific matters related to the insurance claim.
Authority to Choose the Repair Contractor: In some cases, a public adjuster may have the authority to choose the contractor who will repair the damage. This should be clearly stated in the contract between the public adjuster and the insured.
Florida Public Adjuster License: A license issued by the Florida Department of Financial Services that authorizes an individual to work as a public adjuster in the state.
Resident Insurance Adjuster: An insurance adjuster who is licensed and resides in the state where they provide their services.
Florida Public Adjuster Bond: A type of insurance that protects insureds if the public adjuster violates the terms of their license.
License Violation: Any action or conduct by a public adjuster that is contrary to the terms and conditions of their license.
Insurance Agent: A professional who sells insurance policies. Unlike public adjusters, they work on behalf of insurance companies, not policyholders.
State-Licensed Public Adjusters: Public adjusters who are licensed by a state’s department of insurance to operate within that state.
Compensation by Contractors or Attorneys: This refers to the situation where public adjusters receive payment from contractors or attorneys, which is prohibited in some jurisdictions.
Insurance Regulations: These are rules established by state and federal authorities to govern the conduct of insurance companies, agents, and adjusters.
Law Firm Lawyer: A legal professional who may work in conjunction with a public adjuster to help a policyholder with their insurance claim.
Final Settlement: The agreed-upon amount that an insurance company will pay to resolve an insurance claim.
Reopened Claim: An insurance claim that was previously closed but has been reopened due to new information or disputes about the claim amount.
Supplemental Claim: An additional insurance claim that is filed after the initial claim if the policyholder discovers more damage that was not included in the original claim.
Additional Work Compensation: Extra fees that a public adjuster may charge for additional work on complex claims, such as reopened or supplemental claims.
One-Way Attorney Fee Law: A law that allows policyholders to recover legal fees if they win a lawsuit against their insurance company. This law has been eliminated in Florida for homeowner insurance claims.
Homeowner Insurance Claims: Claims made on a homeowner’s insurance policy, often related to damage to the home from events like fires, storms, or theft.
Claim Negotiation: The process of discussing and agreeing on the amount an insurance company will pay to settle an insurance claim.
Claim Appraisal: An assessment of the damage related to an insurance claim to determine the cost of repair or replacement.
Claim Denial: When an insurance company refuses to pay a claim, often because they believe the policy does not cover the loss or the claim is fraudulent.
Claim Dispute: A disagreement between the policyholder and the insurance company over the amount to be paid on a claim.
Insurance Fraud: Any attempt to cheat an insurance process, including inflating the amount of a claim, filing claims for damage that didn’t occur, or making false statements on an insurance application.
Insurance Policy: A contract between an insurance company and a policyholder that outlines the terms of coverage, including what is covered, the cost of the policy (premium), and the amount the policyholder must pay out of pocket before the insurance company pays (deductible).
Insurance Premium: The amount of money that an individual or business pays for an insurance policy.
Insurance Deductible: The amount you pay out of pocket for damages before your insurance coverage kicks in.
Insurance Coverage: The amount of risk or liability covered for an individual or entity by way of insurance services.
Insurance Claim Process: The process an insurance company uses to determine whether it will pay a claim and, if so, how much.
Insurance Policy Limits: The maximum amount of money an insurance company will pay for a covered loss.
Actual Cash Value: The value of your property, based on the current cost to replace it minus depreciation.
Replacement Cost: The cost of replacing lost or damaged property without deducting for depreciation.
Depreciation: The decrease in home or property value due to age, wear and tear, or other factors.
Exclusions: Specific conditions or circumstances listed in your insurance policy that are not covered by the policy.
Endorsements: A policy endorsement is any amendment or addition to an existing insurance contract which changes the terms or scope of the original policy.
Underwriting: The process of evaluating the risk and exposures of potential clients.
Liability: The state of being responsible for something, especially by law.
Peril: The cause of a possible loss, such as fire, windstorm, theft, or explosion.
Indemnity: A principle of insurance which provides that when a loss occurs, the insured should be restored to the approximate financial condition occupied before the loss occurred, no better, no worse.
Subrogation: The legal right of an insurance company to seek reimbursement from the person or entity legally responsible for an accident after the insurer pays a claim.
Adjuster’s Report: A detailed report by the adjuster summarizing the facts of the loss and the damages, including the determination of coverage and the adjuster’s evaluation of the loss.
Proof of Loss: A formal statement made by the insured to the insurance company regarding a loss. The purpose of the proof of loss is to place before the insurance company sufficient information concerning the loss to enable it to determine its liability under the policy.
Loss Payee: A person or entity that is entitled to all or part of the insurance payment in the event of a covered loss to the insured property.
Insurable Interest: The interest an insurance policy owner has in the risk that is insured. The owner of an insurance policy has an insurable interest in the insured property if he or she would suffer a financial loss or certain other kinds of losses if the insured property were damaged.
Appraisal: A process used when you and your insurance company disagree about the amount of loss. Each side hires an appraiser, and the two appraisers choose an umpire. An agreement by any two of these three people is binding.
Policy Expiration Date: The date when your insurance coverage ends.
Claim Adjuster: A person who investigates and settles insurance claims.
Direct Physical Loss: Damage to or the loss of property itself.
Named Perils: Specific dangers listed in an insurance policy that are covered.
All-Risk Policy: An insurance contract that covers all risks of loss that can happen to a property, except those specifically excluded.
Umpire: In an insurance context, an umpire is an independent professional who is chosen to decide on the amount of a claim or loss when the insured and insurer cannot agree.
Loss Ratio: The ratio of losses paid out in claims plus adjustment expenses divided by the premiums earned.
Risk: The chance of loss or the person or entity that is insured.
Salvage: The value of property that is physically recovered from a loss.
Claim File: A file that is established for each separate insurance claim that occurs.
Catastrophe: A severe and often sudden disaster that causes significant damage. Insurance companies often have catastrophe response teams.
Deductible Clause: A clause in an insurance policy that specifies the amount of loss that the insured must pay before the insurance company will pay a claim.
First Party Claim: A claim that a policyholder files directly with their insurance company.
Third Party Claim: A claim that an individual or entity files against another individual’s or entity’s insurance company.
Bad Faith: When an insurance company fails to deal fairly with a policyholder, it is often referred to as acting in bad faith.
Material Misrepresentation: A significant misstatement on an application form. If a company had access to the correct information at the time of application, it would not have agreed to accept the application.
Fraud Investigation: An investigation designed to determine whether fraud has occurred. For example, an insurance company may investigate if it suspects that a policyholder has inflated the value of a claim.
Excess Insurance: Insurance that provides coverage beyond the primary policy.
Aggregate Limit: A maximum amount that an insurance policy will pay over a specified period.
Proximate Cause: The primary cause of a loss, which sets into motion a chain of events that leads to a result without the intervention of any force started and working actively from a new and independent source.
