California Code of Regulations › Title 10 - Investment › Chapter 5 - Insurance Commissioner › Subchapter 7.5.1 - Insurance Adjuster Training for Evaluating Earthquake Damage › Section 2695.42 - Training Standards

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Every insurer shall provide training regarding the handling
				  of earthquake claims to insurance adjusters who evaluate earthquake claims for
				  or on behalf of the insurer. The insurer may provide the training directly or
				  have the training provided by another entity. The insurer shall ensure that the
				  course of instruction meets all requirements set forth in this Section
				  2695.42. An adjuster trained and
				  accredited by one insurer shall be deemed accredited in order to adjust claims
				  for a different insurer unless such insurer includes additional requirements.
				  The content of the training required by this section shall include the
				  following topics:
(a) The California
				Fair Claims Settlement Practices Regulations, California Code of Regulations,
				Title 10, Chapter 5, Subchapter 7.5, Section
				2695.1 -
				2696.14, inclusive. Demonstration
				of compliance with the annual training and certification requirements of
				10 CCR
				2695.6 shall satisfy an insurance adjuster's
				training requirements prescribed by this subsection.
(b) Determination of Scope of Loss: Adjusters
				shall be trained how to conduct a thorough examination of the property to be
				inspected including but not limited to: attics, crawlspaces, roofs, chimneys,
				foundations, and structural areas. The adjuster shall be trained how to make a
				complete listing of all recent earthquake damage. Training pursuant to this
				subsection shall include building code upgrade issues and procedures to be
				followed if additional hidden earthquake damage is found after repair of
				earthquake damage has begun.
(c)
				Loss Estimation Techniques: Adjusters shall be trained how to create or obtain
				an accurate estimate of all covered earthquake damage. The adjuster shall be
				trained regarding the appropriate level of detail to be contained in the
				estimate and the documentation necessary to support the estimate. Adjusters
				shall be trained to reevaluate the estimate if the actual costs of repair
				differ from the costs listed on the original estimate.
(d) Determination of Necessity for Engineer
				or Expert: Adjusters shall be trained how to evaluate visible damage and
				indicia of hidden damage to determine when to consult with an engineer or other
				expert.
(e) California Department
				of Insurance Earthquake Mediation Program: Adjusters shall receive training
				regarding the Earthquake Claims Mediation Program of the California Department
				of Insurance set forth at California Insurance Code Section
				10089.70
				and California Code of Regulations, Title 10, Chapter 5, Subchapter 7.6,
				Sections 2696.1 through
				2696.10, inclusive.
(f) Assessment of Damage to Concrete Surfaces
				and Foundations: Adjusters shall be trained on the basic techniques used to
				determine the difference between preexisting cracks in the concrete of
				structures and new cracks caused by an earthquake. Complete training pursuant
				to this subsection shall include methodology for determining when repair or
				replacement of the concrete is appropriate and proper methods for concrete
				repair including, but not limited to injected epoxy methods.
(g) Subsequently Discovered Earthquake
				Damage: Adjusters shall be trained on the basic requirements of current law
				regarding the obligation of the insurer to investigate any earthquake damage
				that is discovered or reported and when it may be appropriate to seek legal
				counsel to assist in making this determination.
(h) Programs Designed to Assist Earthquake
				Victims: Adjusters shall be trained regarding the existence of United States
				Small Business Administration and Federal Emergency Management Agency or other
				similar programs intended to assist earthquake victims. Training pursuant to
				this subsection shall include an overview of these programs and deadlines, and
				how these programs and deadlines interact with the underlying earthquake
				insurance claim.
1. New section
				  filed 3-25-2004; operative 3-25-2004 pursuant to Government Code section
				  11343.4
				  (Register 2004, No. 13).
Note: Authority cited: Section
					 10089.3,
					 California Insurance Code. Reference: Sections
					 790.03(h),
					 10089.3 and
					 10089.70,
					 California Insurance Code; and Sections
					 2695.1-2695.14 and
					 2696.1-2696.10, Title 10,
					 California Code of Regulations.