Summary of Insurance Claim Adjuster Standard of Conduct Statute

In 2021, the Louisiana Legislature enacted LA R.S. 22:1674.1 entitled “Standards of conduct; acknowledgement required” governing all insurance claim adjusters. Below you will find a bullet point summary, copy of the Legislative Act, and the full text of the insurance adjuster standard of conduct statute. This information gives policyholders like you a good idea of their rights when it comes to working with the insurance company’s claims adjusters. 

Bullet Point Summary of Insurance Claim Adjuster Statute

Under Part A of the statute, the following standards of conduct apply:

  • Insurance adjusters cannot have a financial interest in any part of the claim. Only salaries and fees paid by the insurance carrier are allowed. (A.1.)
  • Insurance adjusters cannot acquire an interest in the salvage of property related to the insurance policy. (A.2.)
  • Insurance adjusters cannot recommend or solicit work for an attorney or contractor concerning the insurance claim. (A.3.)
  • Insurance adjusters cannot accept or request payment from a contractor working on the insurance claim. (A.4.)
  • Insurance adjusters must treat claimants fairly, not giver favored treatment to any claimant, and must adjust the insurance claim in strict compliance with the insurance policy.  (A.5-A7.)
  • Insurance adjusters must make unbiased and truthful reports of the facts of the insurance claim, do a thorough investigation, and be diligent in receiving a proper resolution of the claim. (A.9 and A11.)
  • Insurance adjusters must report misconduct by any licensed insurance representative to the Department of Insurance. (A.12.)
  • Insurance adjusters must use appropriate care when dealing with elderly insurance claimants. (A.13.)
  • Insurance adjusters cannot negotiate with third party claimants represented by an attorney without the attorney’s permission.  (A.14.)
  • Insurance adjusters may interview any witness without the consent of the opposing counsel or party. The adjuster must “scrupulously” avoid using any suggestions meant to induce the witness to deviate from or suppress the truth. Copies of the witness’s statement must be provided upon request. (A.15.)
  • Insurance adjusters cannot tell claimants to refrain from consulting with an attorney, misrepresent pertinent policy provisions, or misrepresent state laws. (A.16, A17, and A21.)
  • Insurance adjusters can only adjust claims when knowledgeable of the terms of the insurance policy, knowledgeable of the conditions of coverage, and they have the sufficient expertise needed to adjust the insurance claim.  (A.18.)

The above standards of conduct for insurance claims adjusters are implemented and enforced as follows:

  • Upon license issuance and renewal, claims adjusters must read the standards. (Part B.)
  • Violations of Part A are grounds for administrative action against the insurance claim adjuster. The adjuster who violates these standards will be deemed to have committed an unfair trade practice under LA R.S. 22:1964. Penalties under LA R.S. 22:1969 may be imposed by the insurance commissioner. (Part C.)
  • The statute does not create any cause of action not otherwise provided by law. (Part D.)

Legislative Act and Text of the Insurance Claim Adjuster Statute

A copy of Act 402 is available here. The text of LA R.S. 22:1674.1 is copied below. This new statute is available in the Louisiana Property Insurance Claim Statutory Handbook 2022 which I recently published through Gulf Coast Legal Publishing.

§1674.1. Standards of conduct; acknowledgment required

A. The following standards of conduct shall be binding on all claims adjusters:

(1) An adjuster shall not have a direct or indirect financial interest in any aspect of the claim, other than the salary, fee, or other consideration established with the insurer.

(2) An adjuster shall not acquire any interest in salvage of property subject to the contract with the insurer.

(3) An adjuster shall not solicit employment for, recommend, or otherwise solicit engagement, directly or indirectly, for any attorney at law, contractor, or subcontractor, in connection with any loss or damage for which the adjuster is employed or concerned.

(4) An adjuster shall not solicit or accept any compensation, directly or indirectly, from, by, or on behalf of any contractor or subcontractor engaged by or on behalf of any insured by which such adjuster has been, is, or will be employed or compensated, directly or indirectly.

(5) An adjuster shall treat all claimants fairly.

(6) An adjuster shall not provide favored treatment to any claimant.

(7) An adjuster shall adjust all claims strictly in accordance with the insurance contract.

(8) An adjuster shall not approach investigations, adjustments, and settlements in a manner prejudicial to the insured.

(9) An adjuster shall make truthful and unbiased reports of the facts after completing a thorough investigation.

(10) An adjuster shall handle every adjustment and settlement with honesty and integrity, without any remuneration to himself except that to which he is legally entitled.

(11) An adjuster, upon undertaking the handling of a claim, shall act with dispatch and due diligence in achieving a proper disposition of the claim.

(12) An adjuster shall promptly report to the department any conduct by any licensed insurance representative of this state which violates any provision of this Title or department rule.

(13) An adjuster shall exercise appropriate care when dealing with elderly claimants.

(14) An adjuster shall not negotiate or effect settlement directly or indirectly with any third-party claimant represented by an attorney, if the adjuster has knowledge of such representation, except with the consent of the attorney. For purposes of this Paragraph, the term “third-party claimant” does not include the insured or the insured’s resident relatives.

(15) An adjuster may interview any witness, or prospective witness, without the consent of opposing counsel or party. In doing so, however, the adjuster shall scrupulously avoid any suggestion calculated to induce a witness to suppress or deviate from the truth, or in any degree affect the witness’s appearance or testimony during deposition or at the trial. If any witness making or giving a signed or recorded statement so requests, the witness shall be given a copy of the statement.

(16) An adjuster shall not advise a claimant to refrain from seeking legal advice, nor advise against the retention of counsel to protect the claimant’s interest.

(17) An adjuster shall not knowingly make any oral or written misrepresentation or statement in regards to applicable policy provisions, contract conditions, or pertinent state laws.

(18) An adjuster shall not undertake the adjustment of any claim for which the adjuster is not currently competent and knowledgeable as to the terms and conditions of the insurance coverage, or which otherwise exceeds the adjuster’s current expertise.

(19) An adjuster shall not permit an unlicensed employee or representative of the adjuster to conduct business for which a license is required pursuant to the provisions of this Part.

(20) No adjuster, while so licensed by the department, may represent or act as a public adjuster.

(21) No adjuster shall materially misrepresent to an insured or other interested party the terms and coverage of an insurance contract with intent and for the purpose of effecting settlement of a claim for loss or damage or benefit under such contract on less favorable terms than those provided in and contemplated by the insurance contract.

B. Upon license issuance and license renewal, claims adjusters shall read and acknowledge the claims adjuster standards of conduct provided in this Section, in a manner prescribed by the commissioner.

C. Violation of any provision of Subsection A of this Section shall be grounds for administrative action against the licensee. In addition to administrative action, a claims adjuster who violates the provisions in Subsection A of this Section shall be deemed to have committed an unfair trade practice pursuant to R.S. 22:1964, and the penalties contained in R.S. 22:1969 may be enforced by the commissioner.

D. This Section does not create any civil action or create any cause of action not otherwise provided by law.

(Added by Acts 2021, No. 402,s. 1, eff. 8/1/2021.)