Connecticut Administrative Code › Title 38a - Insurance Department › 788 - Public Adjusters › Section 38a-788-6 - Form of contract

Current through July 10, 2024
No public adjuster shall enter into an employment contract
				except in conformity with this regulation. There shall be a true copy of the
				employment contract which shall be given to the client at the time the contract
				is signed. The contract and all copies of the contract shall (1) be printed on
				white or cream paper in dark or black ink; (2) have section titles captioned in
				bold face type which otherwise stands out significantly from the text; (3) have
				statements on the contract which read "read both sides before signing" and "I
				have read the information on both sides of this contract" printed in 18 point
				bookman type; (4) use lay out and spacing which separates the paragraphs from
				each other and from the border of the paper; and (5) be on one piece of paper
				measuring 8½" x 11" to be printed on both sides and which shall
				state:
(1) On side one:
INFORMATION ABOUT YOUR
PUBLIC ADJUSTER EMPLOYMENT
						  CONTRACT
YOUR LEGAL RIGHTS:
Cancellation
: You may cancel this contract by
				notifying us at the address shown on the other side of this page, in writing,
				by certified mail, return receipt requested, or, if agreed upon by you and us,
				by electronic means with proof of a delivery receipt posted or delivered not
				later than midnight of the fourth calendar day following the day this contract
				is signed. If the contract is signed on a Friday, Saturday or Sunday, you will
				have until midnight on the following Thursday to send the notice of
				cancellation to us as described above.
Settlement offer
: We shall forward to you any
				written settlement offer from the insurance company.
Fee
: Our services are available for a fee to be
				paid by you. We cannot charge you a fee greater than ten percent
				(10
%
) of the actual or final settlement of the loss covered by
				this contract nor can we rebate any part of the fee specified in this
				Employment Contract.
Copy of the contract
: We must give you a true copy
				of this Employment Contract at the time you sign it.
LIMITATIONS OF PUBLIC ADJUSTERS:
We are not allowed:
-to solicit your employment between 8:00 p.m. and 8:00
				a.m.
-to solicit your employment if you have already hired or
				contracted with another public adjuster.
-to have any interest whatsoever in any construction, salvage,
				or appraisal business.
-to represent both an insurer and an insured at the same
				time.
-to pay anything of value to any person as an inducement to
				refer business to us.
-to share our fee, except with another licensed Public
				Adjuster.
-to advise you on any question of law.
-to advance any monies to you before settlement of the loss,
				where such amount would be included in the final settlement.
-to make false statements about an insurance company or its
				representatives.
We must:
-sign this Contract.
-inform you that we do not represent any insurance company or
				any insurance company adjusting firm.
(2) On side two:
*NAME OF LICENSED PUBLIC ADJUSTER
ADDRESS
TELEPHONE NUMBER
________________________________
Names of individual public
Adjuster licensee(s) to appear
here
READ BOTH SIDES BEFORE SIGNING
(18
						  point bookman type)
PUBLIC ADJUSTER EMPLOYMENT
						  CONTRACT
To the Interested Insurance Companies and Others Whom
						  it May Concern: I/we retain
						  _____________________________________________________ to act
(name of public adjuster)
as my/our public adjuster(s) and to advise and assist
						  in the adjustment and settlement of my/our
						  ________________________________________________ loss at
(type)
___________________________________________ which
						  occurred on or
(address)
about ___________________. In consideration for these
						  services, I/we hereby
(date)
assign out of the monies due or to become due from said
						  Insurance Companies on account of the said loss a sum equivalent to ________ %
						  percent of the amount of the loss when adjusted with the Insurance Companies or
						  otherwise recovered.
________________________
Signed:
____________________________
(date)
(signature of insured)
____________________________
(signature of insured)
____________________________
(name)
____________________________
(address)
____________________________
(city & state)
Agreed to:
____________________________
(name of individual or firm licensee)
By:
____________________________
(signature of public adjuster)
This form is in compliance with Section 38a-788-6 of the
				Regulations of Connecticut State Agencies. This form must be signed by the
				licensed Public Adjuster and by the Insured.
_____________________________________________________________________________________
*The name of the licensee must appear here. If you operate as a
				firm or on behalf of a firm, show name of firm licensee here and names of all
				individual licensees in designated area.