THEHONOURABLE DIANNE FEISTEIN,
331HART SENATE OFFICE BUILDING,
USSenator Dianne Feistein,
Myname is (surname). I am writing to you as a constituent under your45thcongressional district. My concerns are based on the SB-488Independent Insurance Adjusters: Public Insurance Adjusters billwhich was introduced in February 26th,2015 by Senator Marty Block. I visited one of your offices at SanDiego on the afternoon of 10thMarch 2015 in need of knowing what you think about the bill.Fortunately, I was told that you fully support the bill and that youin your opinion it will be a break-through in the insurance industryas a whole. You have my vote because of this and in my opinion thebill will fill many gaps in the insurance sector and below are my twocents on my take to support the bill.
Thelaw on the face of it seeks to be inclusive especially inrequirements of operating as an insurance adjuster.The current Actprovides that an insurance adjuster is exclusive of a privateinvestigator who engages in the insurance adjustment business. It ismy opinion that this is quite limiting and the bill seeks to correctthis. First and fore most, renaming the Act from Public InsuranceAdjuster to Independent Insurance adjuster would bring out thenecessity that is precisely the aim of the bill.
Ifully support this bill because among others, it expands thecategories of people exempt from the Act to include even individualswho are employed to investigate suspected fraudulent claims and aperson who solely performs executive, managerial and administrativeduties or both. However, the individual must not negotiate or settleclaims with policy holders or claimants. This, I say, is good news topeople like my sister who was recently found in a fix, she was fined$500 because she was found guilty of a misdemeanor.
Shehad unknowingly negotiated a health claimwithout involving theemployer who had been licensed to perform insurance operations thesame was used in settlement of the claim. My sister did not have theknowledge of what was neededfor the application process to be legallycomplete. Since she was not a company employee adjuster, she wasfound guilty of a misdemeanor of holding herself out to the public asan adjuster. Further to this, there have been many complaints of thefact that there are some individuals who having been representingthemselves as insurance adjusters to the public. This is unethicaland it shows lack of professionalism in the industry
Inthe light of the aforesaid, this bill provides that even theemployees should be trained and allowed to gain experience beforethey can handle any insurance duties and responsibilities. This way,the insurance industry will be handled with competency (Lewis, 2015).In this bill the Independent Insurance adjuster will also be liableif any requirements are not complied with. In the case of ContinentalInsurance Company v. Bayless and Roberts, Inc, itwas decided that the adjusters must be held liable for the crimetort. In the event that an adjuster does not investigate a claim tohis best and fails to hold the best interests of the client whilenegotiating, then it is only prudent that he’s found liable ofnegligence.
Thebill caters mostly for the policy holders’ interests and beingindependent, then that will make the policy holders get bettersettlements. This way, if the bill is supported then we the people ofCalifornia will be catered for in our claims and settlements. Forexample at my neighborhood last month, a parent to my friend wasforced on a cheap settlement by the attorney because he was savingthe insurance company a lot of money (William et al, pp 4-22) Thisclearly shows that the insurance industry is full of greedy andselfish individuals who would do anything, as far as oppress theclaimants, in order to fulfill their personal interests.
Inthe light of this, a report released by the Coalition AgainstInsurance Fraud provided that fraud amounts to 5-10% of the insuranceclaims and that fraud steals approximately $80 billion a year throughinsurance. In Automobile Insurance, Carlifornia and some other stateslike Florida were said to be the hotspots of fraud which started asearly as in the application process. The bill will revise this by thetight requirements during the entire process and as early as fromapplication bearing in mind that insurance fraud can be committed byany party actively involved in the insurance transactions.
Thebill is also helpful and mindful of those persons who find themselvesin disasters and catastrophic situations. The insurance companiestake longer to compensate claimant who find themselves in need whendisaster strikes. With the implementation of this bill such matterwill be addressed because of the provision that non licensedinsurance adjuster may take over the situation. However, theunlicensed adjuster must satisfy the commissioner as required. Thiswill definitely speed up the settlement of the affected persons.
ContinentalInsurance Company v. Bayless and Roberts, Inc.,608 P.2d 281 (Alas. 1980).
JacksonLewis, NinthCircuit Finds That Insurance Claims Adjusters Are ExemptAdministrative Employees Under California Law– See,http://www.natlawreview.com/article/ninth-circuit-finds-insurance-claims-adjusters-are-exempt-administrative-employees-u#July2015
WilliamF. Merlin Jr., Mary Kestenbaum&Gunn Merlin, ClaimsAdjustment Rules: What Insurance Companies Recognize, Lawyers Need ToLearn And Judges Must Recognize, July2002
CoalitionAgainst Insurance Fraud, Bythe Numbers:Fraud statistics see http://www.insurancefraud.org/statistics.htm#.VimYyZeucy4