Texas Insurance Regulation
Texas Licensing Requirements Criminal Penalty
A person commits an offense if the person acts as an adjuster without a license or if an adjuster handles claims covering a line of insurance other than the line for which the adjuster is specifically licensed. These offenses are considered misdemeanors punishable by: -A fine of not more than $500 -Confinement in the county jail for not more than six months -Both the fine and the confinement (4101.203)
Texas Licensing Requirements Definitions- Ajuster
A person who: Investigates or adjusts losses on behalf of an insurer as an independent contractor or as an employee of: -An adjustment bureau -An association -A general property and casualty agent or personal lines property and casualty agent -An independent contractor -An insurer - A managing general agent Supervises the handling of claims Investigates, adjusts, supervises the handling of, or settles workers' compensation claims, for an insurer or a third-party administrator, including claims for services that aware provided through a certified workers compensation health care network.
Continuing Education Automatic Fines
All automatic fines must be paid by check or money order made payable to the Texas Department of Insurance within 30 calendar days after the date of issuance of the automatic fine, unless the fined party disputes the assessment of the automatic fine and files a written request for contested case hearing within the 30 day period. If the assessment of the fine is disputed, the Department may, in its discretion, assert other matters and claims against the fined party at such hearing and also seek any disciplinary action available under the Insurance Code including additional fine amounts in excess of the automatic fine amount. The Department adopts the following automatic fine: -Failure by a licensee to obtain the required number of continuing education hours- $50 per credit hour not completed -Failure of an education provider to issue a properly completed certificate of completion within 30 days following completion of course- $100 per certificate -Providing a course to students prior to course certification- $200 -Providing a course to students after course certification has expired- $200 per student - Providing an assigned course to students prior to approval of the assignment- $200 per student, per instance, - Providing an assigned course to students after the assignment has expired- $200 per student, per instance (19.1001- .1018)
Continuing Education Requirements- Part 1
All licensees must complete 24 hours of continuing education within each reporting period, except that limited lines licensees, those selling life insurance not exceeding $15,000 and county mutual agents must complete 10 hours of continuing education during each reporting period. Licensees must complete at least two hours of the continuing education requirement in the subject of ethics. Licensees may satisfy the remainder of the continuing education requirement by completing certified courses applicable to any license type. Licensees holding more than one license are not be required to complete more than 24 hours of continuing education courses. if a licensee does not complete the required hours of CE before the expiration date of the license, the licensee will have 90 days to complete the deficient number of hours and pay a fine of $50 dollars per deficient hour. If these two conditions are not met within 90 days of the license expiring, the license will be inactivated, and the licensee will have to apply to a new license. A new license will not be granted until the deficient CE hours are completed, and the fine is paid.
Texas Licensing Requirements Adjuster Application
An applicant for an adjuster license must submit to the Department the appropriate required application form. The application requests information that the Department reasonably requires, including information about the applicant's: -Identity -Personal history -Experience -Business record When the application for a license is submitted, it must be accompanied by the required fee (4101.052).
Continuing Education Notification to Department of Certain Information
An individual license holder in Texas must notify the Department on a monthly basis of: -A change of the license holder's mailing address -A felony conviction of the license holder -An administrative action taken against the license holder by a financial or insurance regulator of this state, another state or the US. A corporation or partnership licensed by the Texas Department must file under oath, on the form prescribed by the Commissioner, biographical information for: -Each executive officer, director, or unlicensed partner who administers the entity's operations int this state; - Each shareholder who is in control of the corporation or partner who has the right or ability to control the partnership. -If the corporation or partnership is owned, in whole or in part, by another entity, each individual who is in control of the parent entity. A corporation or partnership must notify the Department not later than the 30th day after the date of: -A felony conviction of a licensed person working in the entity or an individual associated with the entity who is required to file biographical information with the Department -An administrative action taken against the licensee in another jurisdiction -The addition or removal of an officer, director, partner, member, or manager (4001.252)
Texas Licensing Requirements General Exemptions- Part 2
An individual who is employed to investigate suspected fraudulent insurance claims but who does not adjust losses or determine claims payments A licensed public insurance adjuster An individual who -Collects claim information from, or furnishes claim information to, an insured or claimant and enters data into an automated claims adjudication system - Is employed by a licensed independent adjsuter or its affiliate where no more than 25 individual collecting or furnishing claims information or entering data into an automated claims adjudication system, are supervised by a single licensed independent adjuster or a single licensed agent An individual employed by an insurer or an affiliate of the insurer who adjusts a loss that does not exceed $500. Additionally, if this individual authorizes a payment on a first-party claim for a loss where the coverage limit is $500 or less, they are not required to hold an adjuster license. A nonresident adjuster is not required to hold a Texas adjuster license to -Adjust only a ingle loss in this state -Adjust losses arising out of a catastrophe -Act as a temporary substitute for a licensed adjuster Claims arising under workers' compensation insurance policies, including claims relating to services provided through a certified workers compensation health care network, do not constitute claims arising under life, accident, or health insurance policies. A licensed agent acting as a supervisor is not required to be licensed as an adjuster (4101.002)
Texas Licensing Requirements Adjusters as Roofing Contractors
An insurance adjuster licensed in Texas may not adjust a loss related to roofing damage on behalf of an insurer, if the adjuster is a roofing contractor or otherwise provides roofing services or roofing products for compensation, or is a controlling person in a roofing-related business. A roofing contractor may not act as an adjuster or advertise to adjust claims on any property for which the contractor is providing or may provide roofing services, regardless of whether the contractor holds a Texas adjuster license. A roofing contractor may not act as a public adjuster or advertise to adjust claims on any property for which the contractor is providing or may provide roofing, services, regardless of whether the contractor holds a Texas public adjuster license. The Commissioner is charged with the authority to adopt rules and regulations necessary to implement and enforce these codes (4101.251, 4102.163)
Commissioner of Insurance Withdrawal of Deposit
An insurer that makes a deposit with the Comptroller may withdraw all or part of the deposit if: -The insurer first deposits with the Comptroller other securities proposed to be withdrawn -The Commissioner must approve the withdrawal and substitution. An insurer, without making a substitute deposit may not withdraw all or part of the deposit made for the protection of the insurer's policyholders or creditors in a particular state, country, or province that requires the deposit unless: The insurer must file with the Commissioner sufficient evidence that the insurer has withdrawn from business and does not have any unsecured liabilities outstanding or potential policyholder liabilities or obligations in the other state, country, or province. The Commissioner must approve the withdrawal before it can be made (481.006) When two or more insurers that have two or more deposits made for identical purposes, merge, consolidate, or enter into a total reinsurance contract by which the ceding insurer is dissolved, and the ceding insurer's assets and liabilities are acquired or assumed by the surviving insurer, the new, surviving, or reinsuring insurer may withdraw all of the deposits, except for the deposit of the greatest amount and value. The new, surviving, or reinsuring insurer must demonstrate that the deposits are duplicated and that the insurer is the owner of the deposits (481.007) An insurer that has made a deposit, is entitled to a return of the deposit if the insurer applies for the return of the deposit and demonstrates to the Commissioner that the deposit is no longer required (481.008). When a certified copy of the Commissioner's order issuing the release of the deposit is received by the Comptroller, the deposit must be released, transferred, and delivered to the owner (481.009).
Continuing Education Exemptions- Part 1
Any exemption or extension for continuing education grated to a licensee, will apply to all license types held by the licensee. The Department may audit a licensee to confirm the continued existence of circumstances supporting the exemption or extension. Agents holding the license of legal reserve life insurance agents and general lines- life, accident and health insurance agents; managing general agents; local recording agents, solicitors, general lines- property and casualty agents, and insurance service representatives who have been continuously licensed for at least 20 years or more as of December 31, 2002, are exempt from continuing education requirements. Agents must register and confirm that they qualify for this exemption by submitting a written request to the Department indicating that they have met the longevity requirement. "Continuously licensed" means that the licensee has held a Department-issued licensed for the entire period of time without any lapse in excess of 90 days in which the licensee was not licensed or failed to renew a license. Nonresident licensees who are in compliance with their resident state's continuing education requirements will be exempt from continuing education in Texas. Licensees will qualify for this exemption based on the state of resident claimed in the licensee's initial application or by sending written notification to the Department or its designee stating that the licensee is a resident of another state with a certificate of good standing, or by sending any other document acceptable to the Department, showing that the licensee has a resident license in good standing that state.
Commissioner of Insurance Deposit with Comptroller
At times, Texas domestic insurers are required by another state, country, or province (jurisdiction) to make a deposit with an officer of this state, to gain admission into the other jurisdiction to conduct insurance business. In this case, the insurer can make a voluntary deposit of cash or securities with the Texas Comptroller in an amount that is sufficient to satisfy the conditions of the other jurisdiction. In this situation, the Commissioner is required to approve any securities that are deposited as being of the type and character that the insurer is authorized to invest by law. (481.001; 481.002) The comptroller will hold the deposit made by an insurer exclusively for the protection of all policyholders or creditors of the insurer, whether they are located in Texas or in the jurisdiction that required the deposit (481.003). The proper officer of an insurer making a deposit may, at a reasonable time, and according to the rules of the Comptroller and Commissioner: -Examine the deposit -Detach coupons from the securities -Collect interest on the deposit (481.004) For purposes of state, county or municipal taxation, the situs (the place of taxation) of deposited securities is the municipality and county in which the principal business office of the insurer making the deposit is fixed by the insurer's charter (481.005)
Texas Licensing Requirements Fees
Before issuing or renewing an adjuster license, the Department will collect a nonrefundable license application fee. An applicant for a renewal license must remit the fee before the expiration of the license being renewed. If the applicant's license has been expired for not more than 90 days, the applicant will also have to pay, in addition to the regular license fee, a second fee equal to one-half of the original application fee. Before administering the state licensing examination, the Department will set and collect a nonrefundable examination fee. All fees collected will be deposited to the credit of the Texas Department of Insurance operating account (4101.057)
Commissioner of Insurance Computation of Reserve for Insurer with No Basis Prescribed by Law
Every insurer engaged in the insurance business in Texas is subject to set aside the prescribed reserves in an amount set by law for the type of insurance policies sold within the state. If state law does not set the reserve amount for a particular type of insurance, the Department will compute the reinsurance reserve on the basis prescribed by law an insurer writing fire insurance. An insurance company writing fire insurance in Texas are required to maintain reinsurance or unearned premium reserves on all policies in force (491.051).
Texas Licensing Requirements Adjuster License Required
Except in the situations explained above, no one may act as, or represent themselves as an adjuster in Texas unless the person holds an adjuster license (4101.051)
Texas Licensing Requirements Emergency Adjuster License
If a catastrophe or an emergency arises out of a disaster, act of God, riot, civil commotion, conflagration, or other similar occurrence, the Commissioner will, on application, issue an emergency license to a person if the application is certified to the Commissioner not later than the fifth day after the date on which the person beings work as an adjuster by: - A person who holds an adjuster license - An insurer that maintains an office int his state and holds a certificate of authority to engage in the business of insurance in this state. The person or insurer that certifies an application for an emergency adjuster, will be be responsible for the loss and the claims practices of the emergency license holder whom the person or insurer certifies. The Commissioner may, after notice and hearing, revoke an emergency license if grounds for revocation exist. An emergency license is effective for a period not to exceed 90 days. The Commissioner may extend the term of the emergency license for additional period of 90 days. The Commissioner will establish a fee for an emergency license and the licensee must pay the fee to the Department not later than the 30th day after the date on which the Department issues the license. The Commissioner may issue the emergency license to an applicant who meets the requirements, regardless of whether the applicant is a resident of Texas or is a license adjuster in another state (4101.101).
Commissioner of Insurance Records of Complaints
If a written complaint is filed with the Department, the Department, at least quarterly and until final disposition of the complaint, will notify each party to the complaint of the status unless the notice would jeopardize an undercover investigation. The Department will keep an information file about each complaint filed with the Department that concerns an activity regulated by the Department or the Commissioner (521.003-.004)
Commissioner of Insurance Other Remedies for Violations
In addition to any other remedy available for a violation of the insurance code, another Texas insurance law, a rule of the Commissioner or Department may: -Deny an application for an original license -Suspend, revoke, or deny renewal of a license -Place on probation a person whose license has been suspended -Assess an administrative penalty -Reprimand a license holder -Require a license holder to qualify or re-qualify for the license (4005.102).
Commissioner of Insurance Duties of Department
In addition to the other duties required of the Texas Department of Insurance, the Department will: -Regulate the business of insurance in this state; -Administer the workers compensation system of this state according to the regulations provided by the Texas Labor Code -Ensure that this Code and other laws regarding insurance and insurance companies are executed -Protect and ensure the fair treatment of consumers -Ensure fair competition in the insurance industry in order to foster a competitive market (31.001-.002)
Commissioner of Insurance Inquires
In this section, "authorization" means a permit, certificate of registration, or other authorization issued or existing under the insurance code. The Department may address a reasonable inquiry to any insurance company or an agent or other holder of an authorization relating to: - The person's business condition - Any matter connected with the person's transactions that the Department considers necessary for the property discharge of the Department's duties. A person receiving an inquiry from the Commissioner must respond to the inquiry in writing not later than the 15th day after the date the inquiry is received. A response made that is privileged or confidential by law remains so until it is introduced into evidence at an administrative hearing or in a court (38.001).
Continuing Education Licensee Record Maintenance
Licensees and adjuster applicants must provide evidence of completion of courses to the Department or its designee upon request. Each licensee must maintain evidence of each course completed for a period of four years from the date of completion of the course for the purpose of investigation or audit. Licensees must continue to maintain evidence of compliance during any period in which the licensee has been notified by the Department or its designee that the records and/or the licensee's compliance is the subject of an investigation or audit. Types of course completion evidence of compliance may include: -A certificate of completion from a provider -A college transcript -A passing grade report from a national designation program -A certificate or report of completed continuing education hours issued by a professional licensing authority or a provider of a course certified by a professional licensing authority -A letter from the program sponsor's representative stating the number of hours the licensee taught. The Department will consider the filling of a properly completed renewal application with the Department as a licensee's certification that all required continuing education hours for the reporting period have been completed, absent a timely written request or notice for extension or exemption. The Department's renewal of any license does not relieve a licensee from compliance with the continuing education requirements for any reporting period and failure to obtain required continuing education hours without obtaining a prior exemption or extension will subject the licensee to administrative action. It is the license's responsibility to comply with this section and maintain evidence that the licensee has completed the required continuing education hours. A licensee should immediately report to the Department or its designee any discrepancy the licensee discovers between a course taken by a licensee and the credit hours certified to the licensee by the provider.
Continuing Education Exemptions- Part 3
Licensees called to active military service in a combat theater may apply to the Department for an exemption from or an extension of time for meeting the continuing education requirements or extending their license renewal. The licensee must request the exemption or extension prior to the end of the reporting period for which it applies and must include: - A copy of the order to active duty status, service in a combat theater, or other positive documentation of military service that will prevent the licensee from compliance -A clear request for either an extension or exemption, or both; -The expected duration of the assignment; and -Any other information the licensee believes may assist the Department or that the Department requests on a case by case basis.
Continuing Education Exemptions- Part 2
Licensees who met the criteria of illness, medical disability or circumstances beyond the control fo the licensee may apply for an extension of time to complete their continuing education requirement or a waiver, in whole or in part, of the continuing education requirement. Business reasons do not constitute circumstances beyond the control of the licensee. The Department will establish the duration of the extension when it is granted. If the circumstances supporting the extension continue beyond the granted extension period, the licensee may reapply for an extension. The licensee must request the extension prior to the end of the reporting period for which it applies and must include at least the following information: -Statement of the exact nature of the illness, medical disability or other extenuating circumstances beyond the control of the licensee that have prevented or will prevent the licensee from completing the required hours within the two-year reporting period. -Evidence in the form of medical reports from attending physician(s) and insurance claims regarding the illness or medical disability of the licensee or evidence through insurance claims and/or other documentation as determined regarding circumstances beyond the control of the licensee. -Assessment of the condition of the licensee whether it is temporary, permanent or unknown. -Statement as to whether the licensee will or will not be able to perform activities including any acts of an agent or adjuster -Estimated date when the licensee will be able to perform any activities including any acts of an agent or adjuster in accordance with the medical reports or other documents pertaining to circumstances beyond the control of the licensee. -Any other information that may be requested by the Department.
Texas Licensing Requirements Definitions- Business entity
Means a corporation, association, partnership, limited liability company, limited liability partnership, or other legal entity.
Commissioner of Insurance Computation of Reinsurance Reserves for Certain Insurers
On December 31 of each year the Department computes the reinsurance reserve for all unexpired risks of all domestic insurers or foreign/alien insurers doing business in Texas. However, this does not apply to the following types of insurance: -Life insurance -Fire insurance -Marine insurance -Inland Marine insurance -Lightning insurance -Tornado insurance (491.052)
Commissioner of Insurance Imposition of Sanction- Part 1
The Commissioner also has the authority to impose other sanctions in addition to the authority to enforce a sanction, penalty, fine, forfeiture, denial, suspension, or revocation otherwise authorized by law (81.003). After notice and opportunity for a hearing, the Commissioner may cancel or revoke an authorization (license, certificate) if the holder of the authorization is found to be in violation of, or to failed to comply with , the insurance code or a rule of the Commissioner. (82.051). In addition to the cancellation or revocation of an authorization, the Commissioner may: Suspend the authorization for a specified time not to exceed one year Order the holder of the authorization to cease and desist from -The activity that violates the insurance code or a rule of the Commissioner -The failure to comply with the insurance code or a rule of the Commissioner a. Direct the holder of the authorization to pay an administrative penalty b. Direct the holder of the authorization to make restitution c. Take any combination of those actions (82.052).
Commissioner of Insurance Duty to Examine Carriers- Part 2
The Commissioner has the authority to use a final or preliminary examination report, an examiner's or company's work papers or other documents, or any other information discovered or developed during an examination in connection with a legal or regulatory action that the Commissioner, in the Commissioner's sole discretion, considers appropriate. In conducting an examination, the Department will use audits and work papers that the carrier makes available to the Department and that are prepared by an accountant or accounting firm meeting the qualifications of state law. The Department may conduct a separate audit of the carrier if necessary. The carrier must provide the Department with: -The work papers of an accountant or accounting fir or the carrier - A record of the communications between the accountant or accounting firm and the carrier that relate to an audit. Information obtained during an examination is confidential and may not be disclosed to the public except when introduced as evidence in a hearing. A carrier is subject to disciplinary action if the carrier or the carrier's agent fails or refuses to comply with: -This section or a rule adopted under this subchapter or -A request by the Department or an appointed examiner to b e examined or to provide information request as part of an examination (401.062).
Commissioner of Insurance Chief Executive
The Commissioner is the Department's chief executive and administrative officer. The Commissioner will administer and enforce this Code, other insurance laws of this state, and other laws granting jurisdiction or applicable to the Department or the Commissioner. The Commissioner has the powers and duties vested in the Department by: -The Insurance Code and other insurance laws of this state -The Labor Code and other workers compensation insurance laws of this state (31.021)
Commissioner of Insurance Rules
The Commissioner may adopt rules necessary to implement the insurance laws of the state and to meet the minimum requirements of federal law, including regulations (4001.005).
Commissioner of Insurance Imposition of Sanction- Part 2
The Commissioner may direct the holder of an authorization to make complete restitution to each Texas resident, each Texas insured, and each entity operating in this state that is harmed by a violation of, or failure to comply with, the insurance code or a rule of the Commissioner. The form and amount as well as the period of time in which the licensee must make restitution is determined by the Commissioner (82.053) If it is found after hearing that a holder of an authorization holder has failed to comply with an order issued, the Commissioner will cancel each authorization held by the hold (82.054) The Commissioner may informally dispose of a matter by consent order, agreed settlement, stipulation, or default. An information disposition may include a provision under which the holder of the authorization agrees to a sanction with the express reservation that: - The holder does not admit a violation of the insurance code or Commissioner's rule -The existence of a violation is in dispute (82.055) The Commissioner must give notice of an action taken against an authorization holder to Insurance Commissioner or similar officer of each state (82.056)
Commissioner of Insurance Sanctions
The Commissioner may impose sanctions (penalties) on any individual, entity, agent of an entity, or corporation, association partnership or any other artificial person who is engaged in the business of insurance. The Commissioner's authority to sanction applies to each form of "authorization" granted by the Commissioner including: -A domestic or foreign, stock or mutual, life, health, or accident insurance company -A domestic or foreign, stock or mutual, fire or casualty insurance company -A Mexican casualty company -A domestic or foreign Lloyd's plan insurer -A domestic or foreign reciprocal or interinsurance exchange -A domestic or foreign fraternal benefit society -A domestic or foreign title insurance company -A stipulated premium insurance company -A nonprofit legal service corporation -A health maintenance organization -A statewide mutual assessment company -A local mutual aid association -A local mutual burial association - A nonprofit hospital, medical, or dental service corporation - A country mutual insurance company -A farm mutual insurance company (82.001; 82.002)
Texas Licensing Requirements Reinstatement or Reissuance of License
The Commissioner may not reinstate or reissue the license of a license holder or former license holder whose license has been suspended, revoked, or refused renewal until the Commissioner determines that the cause for a suspension, revocation, or refusal of a license issued no longer exists (4101.202).
Commissioner of Insurance Revocation or Modification of Certificate Authority
The Commissioner may revoke or modify a certificate of authority if a condition or requirement for granting the certificate is no longer satisfied. The Commissioner must notify an insurance carrier in writing of the Commissioner's intent to revoke or modify the carrier's certificate of authority. The Commissioner must provide the notice not later than the 10th day before the date the revocation or modification is to occur. The Commissioner must specifically state in the notice the reason for the action (86.001-.002).
Commissioner of Insurance Definitions Commissioner
The Commissioner of Insurance
Commissioner of Insurance Electronic Transfers
The Commissioner will adopt rules for the electronic transfer of any fee, guarantee fund, or other money owed to or held for the benefit of this state that the Department has the responsibility to administer under this Code or another insurance law of this state. The Commissioner will require the electronic transfer of any amount held or owed that exceeds $500,000. (201.004)
Commissioner of Insurance Impairment of Insurer
The Commissioner will order an insurer to remedy an impairment of the insurer's surplus, aggregate surplus, or aggregate of guaranty fund and surplus, as applicable, by brining the surplus to an acceptable level specified by the Commissioner, or to cease engaging in business in this state, if the Commissioner determine that: The surplus required of a stock insurance company engaged in the kind of insurance business described by the company's certificate of authority: -Is impaired by more than 50% -Is less than the minimum level of surplus required by risk-based capital and surplus rules adopted by the Commissioner The required aggregate of guaranty fund and surplus of a Lloyd's plan, or the required aggregate surplus of a reciprocal or inter-insurance exchange or of a mutual company, other than a life insurance company, engaged in the kind of insurance business described by the insurer's certificate of authority: -Is impaired by more than 25% -Is less than the minimum level of surplus required by risk-based capital and surplus rules adopted by the Commissioner. After issuing an order described by this section, the Commissioner will immediately institute any proceeding necessary to determine what further actions the Commissioner will take in relation to the matter (404.051-053)
Commissioner of Insurance Duty to Examine Carriers- Part 1
The Department or an examiner appointed by the Department must visit at the carrier's principal office: -Each carrier that is organized under the laws of this state -Each other carrier that is authorized to engage in business in this state. The Department or an examiner appointed by the Department may visit the carrier for the purpose of investigating the carrier's affairs and condition. The Department or an examiner appointed by the Department will examine the carrier's financial condition and ability to meet the carrier's liabilities and compliance with the laws os this state that affect the conduct of the carrier's business. The Department or an examiner appointed by the Department may conduct the visit and examination of a carrier alone with representatives of the insurance supervising Departments of other states. The Department will visit and examine a carrier as frequently as the Department considers necessary. At a minimum, the Department must examine a carrier not less frequently than once every five years. The Commissioner will adopt rules governing the frequency of examinations of carriers that have been organized or incorporated for less than 5 years. Unless the Department requests that an examination cover a longer period, the examination and ending on December 31 of the year preceding the year in which the examination is being conducted. The Department or the examiner appointed by the Department: -Has free access, and may require the carrier or the carrier's agent to provide free access, to all books and papers of the carrier or the carrier's agents that relate to the carrier's business and affairs. -Has the authority to summon and examine under oath, if necessary, an officer, agent, or employee of the carrier or any other person in relation to the carrier's affairs and condition.
Continuing Education Failure to Comply
The Department or its designee may at any time investigate or audit a licensee's continuing education records. The Commissioner may, after notice and opportunity for hearing, discipline a licensee if the Commissioner determine that the license holder: -Is in violation of, or has filed to comply with, the continuing education requirements -Has provided submitted, or filed any document which in whole or in part is false or deceptive for the purpose of providing evidence of complying with the continuing education requirement or in responding to any inquiry from the Department concerning compliance. -Has falsified records or participated in activity which allows circumvention of the continuing education requirements: -Has received or used unauthorized materials or assistance or provided to another student unauthorized materials or assistance before or during an examination or interactive inquiry period -Has failed to pay within 90 days an automatic fine without properly requesting a hearing
Texas Licensing Requirements General Exemptions- Part 1
The adjuster licensing requirements do not apply to: An attorney who: -Adjusts insurance losses periodically and incidentally to the practice of law -Does not represent that the attorney is an adjuster A salaried employee of an insurer who is not regularly engaged in the adjustment, investigation, or supervision of insurance claims; A person employed only to furnish technical assistance to a licensed adjuster, including: -an attorney -an engineer -an estimator -a handwriting expert -a photographer -a private detective An agent or general agent or general agent of an authorized insurer who processes an undisputed or uncontested loss for the insurer under a policy issued by the agent or general agent A person who performs clerical duties and does not negotiate with parties to disputed or contested claims A person who handles claims arising under life, accident, and health insurance policies; A person: -who is employed principally as a right-of- way agent and/or claims agent -Whose primary responsibility is the acquisition of easements, leases, permits, or other real property rights -Who handles only claims arising out of operations under those easements, leases, permits, or other contracts or contractual obligations
Texas Licensing Requirements Types of Adjuster's Licenses
The following types of adjuster's licenses are approved for issuance: -All lines adjuster -Property, casualty, and surety adjuster -Workers' compensation adjuster The following are exempted from the requirement of an adjuster's license examination or reexamination administered by the Department or the Department's authorized testing service: -Those persons holding CPCU designation -Those persons who have received the Associate in Claims (AIC) designation -Those persons who have a certificate of completion showing that within the past 12 months the applicant has completed a certified adjuster pre-licensing education program and passed the state examination -Those persons who have an adjuster's license that has been expired for a period of more than 90 days but less than one year. Each adjuster license must be renewed every two years on the licensee's birthday unless suspended or revoked by the Commissioner. An applicant for renewal fee and completed application for renewal Adjusters may only renew a license that has not expired or has not been expired for more than 90 days; otherwise, the adjuster must apply to the Department for a new license. If an adjuster's license has been expired for one year or more , the adjuster applicant must submit to reexamination. The reexamination must be completed within the 12 months preceding the application unless the adjuster applicant can show that the applicant is exempt from the reexamination. Any person wishing to take the examination for an insurance adjuster's license must submit an examination fee with the application in advance of taking the examination. The fee will not be refunded to any applicant who may for any reason fail to take such examination or to any applicant who may fail to pass the examination (28 TAC 19.601-.602).
Texas Licensing Requirements Examination Required
To be eligible for an adjuster license, an applicant must personally take and pass a written examination of the applicant's qualifications and competency. The Commissioner approves the examinations, whether they are given by an individual company where the pre-licensing course was taken or given by Pearson VUE. To be approved, the examination must be of sufficient scope to reasonably test the applicant's knowledge relative to the kinds of insurance that may be dealt with under the license and and of: -the duties of a licensed adjuster -the laws of this state that apply to a licensed adjuster The Commissioner may require a reasonable waiting period before an applicant who fails to pass an examination is eligible to be retested on a similar examination (4101.054)
Continuing Education Requirements- Part 2
To ensure that there is no delay in renewing a license, license holders are encouraged to complete CE hours at least 30 days before the license expires to allow time for the CE provider to report the successful completion of the courses to the Department. Licensees may not count any education course credit they receive before the date the permanent license is issued by the Department as complying with applicable continuing education requirements. Licensees must complete all continuing education hours during the reporting period. A licensee may not carry forward excess hours completed in one reporting period to a subsequent reporting period and a licensee may not complete hours in any subsequent period to correct a shortage of hours in a previous reporting period. Licensees holding a license subject to continuing education which is prorated by the Department to coincide with the renewal of another license and those licensees that are resident licensees of other states or jurisdictions but become residents of Texas between renewals of the Texas license must complete continuing education on a prorated schedule. The total credit hours required will be determined at the rate of one hour for each whole month between the issue or last renewal date of the license or the date of Texas residency to the next actual renewal date of the license up to the maximum number of hours required for the licensee during the reporting period. A licensee will not be required to complete continuing education for a reporting period on a prorated basis if the dates between which the prorated schedule would begin and end are less than six complete months. Licensees completing prorated schedules must complete at last two of the required hours in the subject of ethics. Licensees must complete at least 50% of their required continuing education hours in certified classroom or classroom equivalent courses, regardless of any other license type held by the licensee.
Texas Licensing Requirements License Qualifications
To qualify for a license under this chapter, an applicant must present evidence satisfactory to the Department that the applicant: -Is at least 18 years of age - Resides in Texas or a state or country that permits a resident of Texas to act as an adjuster in that state or country. -Has complied with all federal laws relating to employment or the transaction of business in the United States, if he or she does not reside in the US. -Is trustworthy. - Has had experience, special education, or training of sufficient duration and extent regarding the handling of loss claims under insurance contracts to make the applicant competent to fulfill the responsibilities of an adjuster. -Has passed the state licensing examination or presented evidence that the applicant has been exempted. The Commissioner will issue a license to an applicant who meets the above qualifications (4101.053).
Texas Licensing Requirements License Expiration and Renewal
To renew a license, an adjuster must complete the required continuing education courses taken by the licensee must be approved and certified by the Department. (4101.059) The expiration and renewal of an adjuster license is on the license holder's birthday, every two years (4101.61)
Texas Licensing Requirements Definitions- insurer
includes someone who is self-insured for the purpose of this discussion (4101.001)
Texas Licensing Requirements Definitions- Automated claims adjudication system
means a computer program designed for the collection, data entry, calculation, and final resolution of portable consumer electronic insurance claims that a licensed independent adjuster, a licensed agent, an officer of a business entity licensed under the Texas insurance code, or a supervised individual.
Texas Licensing Requirements Definitions- Person
means an individual or business entity
Commissioner of Insurance Definitions Department
means the Texas Department of Insurance
Texas Licensing Requirements Definitions- Home state
with respect to an adjuster, means; -The state in which the adjuster maintains the adjuster's principal place of residence or business and is licensed to act as a resident adjuster -If the state of the adjuster's principal place of residence or business does not license adjusters for the line of authority sought, a state in which the adjuster is licensed and in good standing and that is designated by the adjuster as the adjuster's home state.
