CLAIM Act

Summary: Claims Licensing Advancement for Interstate Matters Act or CLAIM Act - Urges the National Association of Insurance Commissioners (NAIC) to: (1) adopt a model independent claims adjuster licensing Act meeting specified criteria, and (2) adopt and administer a multi-state examination for an independent claims adjuster seeking to adjust claims in a jurisdiction other than his or her home state. Authorizes the NAIC to prescribe examinee eligibility requirements, and requires any multi-state examination to require adjusters to demonstrate essential competence with cross-jurisdictional legal and regulatory concepts. Declares that nothing in this Act shall be construed to: (1) require a state to adopt licensing requirements for independent claims adjusters if it does not have such requirements; (2) limit the right of a state to establish licensing fees or enforce its laws regarding the adjusting of insurance claims, provided that such a fee is uniform regardless of the licensee's state of residence; or (3) affect the jurisdiction and authority of a state insurance regulator to prescribe and enforce its insurance laws, rules, and regulations governing independent claims adjuster activity in its jurisdiction. Sets forth criteria for state compliance with this Act, including reciprocity.  Authorizes an independent claims adjuster meeting the requirements of this Act to ascertain, determine, negotiate, or settle a claim in a state that is not in compliance with this Act, but only if the adjuster: (1) holds a valid license in his or her home state, and (2) has passed any multi-state examination established and administered by the NAIC.  Prohibits a state from imposing additional requirements upon such an adjuster.  Authorizes an independent claims adjuster meeting the licensure and examination requirements of this Act to adjust claims for losses related to any presidentially-designated major disaster, regardless of the licensure requirements of the state where the disaster is located. 

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Claims Licensing Advancement for 
Interstate Matters Act'' or the ``CLAIM Act''.

SEC. 2. MODEL LICENSING ACT.

    To promote the policy of robust consumer protection for and more 
efficient interstate adjusting of property, casualty, disability, or 
workers' compensation claims, the Congress hereby urges the National 
Association of Insurance Commissioners to adopt a model independent 
claims adjuster licensing Act that--
            (1) contains basic standards for the integrity, personal 
        qualifications, education, training, and experience required of 
        independent claims adjusters, including continuing education 
        requirements and ethics course requirements; and
            (2) does not impose any limitation or condition upon any 
        independent claims adjuster to be licensed or otherwise 
        authorized to do business in a State because of his or her 
        status as a non-resident of that State.

SEC. 3. MULTI-STATE EXAMINATION.

    (a) Establishment.--The Congress hereby urges the NAIC to adopt and 
administer a multi-State examination for an independent claims adjuster 
seeking to adjust claims in a jurisdiction other than his or her home 
State.
    (b) Examinee Eligibility.--The NAIC may require that, as a 
condition for taking a multi-State examination administered pursuant to 
this section, the examinee shall--
            (1) be duly licensed as an independent claims adjuster by 
        his or her home State;
            (2) meet such integrity, degree, training, and experience 
        requirements as the NAIC considers necessary; and
            (3) meet any continuing education requirements as 
        established by his or her home State.
    (c) Cross-Jurisdiction Competency.--Any multi-State examination 
administered pursuant to this section shall require adjusters to 
demonstrate essential competence with cross-jurisdictional legal and 
regulatory concepts, and shall include such ethics and other testing as 
the NAIC deems necessary.

SEC. 4. STATE AUTHORITIES.

    Nothing in this Act shall be construed to--
            (1) require a State that does not have licensing 
        requirements for independent claims adjusters to adopt any such 
        requirements;
            (2) subject to section 6, limit the right of a State to 
        establish licensing fees or enforce its laws regarding the 
        adjusting of insurance claims, provided that such fee is 
        uniform regardless of the State of residence of the licensee; 
        or
            (3) affect the jurisdiction and authority of a State 
        insurance regulator to prescribe and enforce its insurance 
        laws, rules, and regulations regulating independent claims 
        adjuster activity in its jurisdiction.

SEC. 5. INTERSTATE CLAIMS ADJUSTING LICENSING REFORMS.

    (a) In General.--A State is in compliance with the requirements of 
this subsection, and section 6 shall not apply with respect to such 
State, if before the expiration of the 4-year period beginning on the 
date of the enactment of this Act the State has enacted and has in 
effect--
            (1) in the case only of a State that requires and issues 
        licenses for independent claims adjusters, laws and regulations 
        governing individuals and entities authorized to operate as 
        independent claims adjusters within the State that are 
        functionally equivalent in meaning and effect to those under 
        any model act developed pursuant to section 2; and
            (2) laws and regulations governing non-home State 
        individuals and entities operating as independent claims 
        adjusters within that State that provide for the reciprocity 
        required under subsection (c) with other States.
    (b) Uniformity Requirements.--A State that licenses independent 
claims adjusters shall be deemed to have established the uniformity 
referred to in subsection (a)(1) if it has enacted and adheres to 
criteria for the licensing and authorization of adjusters that are 
functionally equivalent in meaning and effect to those set forth in a 
model act established pursuant to section 2.
    (c) Reciprocity Requirements.--The laws and regulations of a 
certain State shall be considered to provide for the reciprocity 
required under this subsection only if such laws and regulations--
            (1) do not require licensure of independent claims 
        adjusters; or
            (2) permit any independent claims adjuster who has a 
        license in another State that is the adjuster's home State to 
        obtain authorization to engage in the business of adjusting in 
        such certain State as a non-resident to the same extent that 
        such adjuster is permitted to practice in the adjuster's home 
        State, without satisfying any additional requirements other 
        than, if required under applicable law, to submit--
                    (A) proof of being licensed in good standing in the 
                adjuster's home State; Provided, That such home State 
                has enacted laws and regulations governing individuals 
                and entities authorized to operate as independent 
                claims adjusters within such home State that are 
                functionally equivalent in meaning and effect to those 
                under any model act developed pursuant to section 2; 
                and
                    (B) payment of any requisite fee to the appropriate 
                authority of the certain State; Provided, That the 
                amount of such fee does not exceed any fee required to 
                be paid by an adjuster whose home State is such certain 
                State.
    (d) NAIC Determination.--
            (1) Determination.--A State shall be considered to be in 
        compliance with subsection (a) for purposes of this Act if the 
        NAIC determines that, before the expiration of the 4-year 
        period beginning on the date of enactment of this Act, the 
        State is in compliance with the requirements under such 
        subsection.
            (2) Continued review.--With respect to any State that the 
        NAIC has determined to be in compliance with the requirements 
        of subsection (a), the Congress hereby urges NAIC to continue 
        to review and determine such State's compliance with the 
        requirements of subsection (a) on an annual basis. If the NAIC 
        determines at any time that a State no longer is in compliance 
        with the requirements of subsection (a), section 6 shall apply 
        with respect to such State.
            (3) Judicial review.--The appropriate United States 
        District Court shall have exclusive jurisdiction over any 
        challenge arising under this section. The court shall apply the 
        standards set forth in section 706 of title 5, United States 
        Code, in reviewing any such challenge.

SEC. 6. AUTHORITY FOR INTERSTATE CLAIMS ADJUSTING.

    (a) Authority.--In the case of any State that requires and issues 
licenses for independent claims adjusters but is not in compliance with 
section 5(a), after the expiration of the 4-year period beginning on 
the date of the enactment of this Act, an independent claims adjuster 
and the adjuster's employer may ascertain, determine, negotiate, or 
settle a claim in such State, but only if the adjuster meets the 
following requirements:
            (1) The independent claims adjuster holds a valid such 
        license in his or her home State.
            (2) If the NAIC has established and administers a multi-
        State examination pursuant to section 3, the adjuster has 
        passed such examination.
    (b) Prohibition of Additional State Requirements.--An independent 
claims adjuster authorized under subsection (a) to investigate, 
evaluate, negotiate the resolution of a claim in a State that is not in 
compliance with section 5 shall not be subject to any additional 
licensure or other requirements from such State in order to adjust 
claims and otherwise act as an independent claims adjuster in such 
State.

SEC. 7. ACCELERATING CLAIMS ADJUSTING OF LOSSES CAUSED BY NATURAL OR 
              OTHER DISASTERS.

    (a) Authority to Adjust.--An independent claims adjuster meeting 
the requirements of subsection (b) may adjust claims for losses related 
to any natural or other disaster, occurring in any jurisdiction, that 
has been designated by the President as a major disaster pursuant to 
section 401 of the Robert T. Stafford Disaster Relief and Emergency 
Assistance Act (42 U.S.C. 5170) notwithstanding the licensure 
requirements of the State in which the disaster area for the major 
disaster is located and notwithstanding the requirements under section 
6 of this Act for interstate claims licensing.
    (b) Adjuster Requirements.--The requirements under this subsection 
with respect to an independent claims adjuster are as follows:
            (1) State license.--The adjuster holds a valid license as 
        an independent claims adjuster in his or her home State 
        (whether actual or designated, pursuant to section 8(a)(1)).
            (2) Multi-state examination.--If the NAIC has adopted and 
        administers a multi-State examination pursuant to section 3, 
        the adjuster has passed such an examination.

SEC. 8. DEFINITIONS.

    For purposes of this Act, the following definitions shall apply:
            (1) Home state.--
                    (A) Actual.--The term ``home State'' means, with 
                respect to an independent claims adjuster, the State in 
                which the adjuster maintains his, her, or its principal 
                place of residence or business and is licensed as an 
                independent claims adjuster.
                    (B) Designated.--If the State in which an 
                independent claims adjuster maintains his or her 
                principal place of residence or business does not issue 
                an independent claims adjuster license for the line or 
                lines of authority sought, such term means any other 
                State in which the independent claims adjuster is so 
                licensed and that is designated by such adjuster as his 
                or her home State.
            (2) Independent claims adjuster.--The term ``independent 
        claims adjuster'' means an individual, other than a public 
        adjuster, who undertakes on behalf of insurers or self-insurers 
        to investigate, evaluate, and negotiate the resolution of the 
        amount of a property, casualty, disability, or workers' 
        compensation claim, loss, or damage on behalf of an insurance 
        policy or insurer or as a third-party on behalf of a self-
        insurer. Such term includes company or staff adjusters, who are 
        individuals, other than a public adjuster, employed by property 
        casualty insurers and undertake to investigate, evaluate, and 
        negotiate the resolution of a property, casualty, disability, 
        or workers' compensation claim, loss, or damage on behalf of an 
        insurance policy or insurer.
            (3) Naic.--The term ``NAIC'' means the National Association 
        of Insurance Commissioners.
            (4) Public adjuster.--The term ``public adjuster'' means 
        any person who, for compensation or any other thing of value, 
        on behalf of the insured acts, aids, advertises, or solicits 
        business to ascertain, determine, negotiate, or settle the 
        amount of a claim, loss, or damage, solely in relation to first 
        party claims arising under contracts that insure the real or 
        personal property of the insured.
            (5) State.--The term ``State'' means the States of the 
        United States, the District of Columbia, the Commonwealth of 
        Puerto Rico, the Commonwealth of the Northern Mariana Islands, 
        Guam, the Virgin Islands, American Samoa, and any other 
        territory or possession of the United States.
            (6) State law.--The term ``State law'' includes all laws, 
        decisions, rules, regulations, or other State action of any 
        State having the effect of law; and a law of the United States 
        applicable only to the District of Columbia shall be treated as 
        a State law rather than as a law of the United States.