CLAIM Act

To encourage uniformity and reciprocity among States that license insurance claims adjusters and to facilitate prompt and efficient adjusting of insurance claims in the case of natural and other disasters and losses, and for other purposes. 1. Short title This Act may be cited as the Claims Licensing Advancement for Interstate Matters Act CLAIM Act 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. 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. 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. 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 (B) payment of any requisite fee to the appropriate authority of the certain State; Provided (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 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. 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 (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. 8. Definitions For purposes of this Act, the following definitions shall apply: (1) Home State (A) Actual The term home State (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 (3) Naic The term NAIC (4) Public adjuster The term public adjuster (5) State The term State (6) State law The term State law

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.