FL Adjuster Claim Professional Exam Study Guide

The Department of Financial Services licenses agents, adjusters, and agencies to regulate insurance transactions between insurers and consumers.

Persons Required to be Licensed

Those who solicit, sell, or negotiate insurance products in Florida must be licensed.

All-Lines Adjuster [626.8548]

An all-lines adjuster represents an insurer to investigate claims or losses and determine settlement amounts for all insurance lines except life insurance and annuities.

Licensing of All-Lines Adjusters [626.8734]

• Must be at least 18 years old.
• Must pass the state license examination for an all-lines adjuster.
• Exam exemption if licensed in a reciprocal state.

Temporary Licenses [626.872]

• Issued for one year if employed by a licensed adjuster or authorized insurer.
• Applicant must be 18+, trustworthy, and pay the license fee.
• Cannot negotiate settlements over $20,000.

Agency Licensure [626.015, .112, .172]

• Agencies must be licensed or registered.
• Application includes owners’ names, addresses, agency details, and fingerprints.
• Pre-2003 agencies owned by licensed agents may register without fingerprints.
• Unlicensed agencies face up to $10,000 fine; unregistered agencies up to $5,000.

Agent in Charge & Branch Locations [626.172, .747]

• Each agency branch must have a full-time licensed agent.
• Agent must be present for insurance activities at branch locations.

All claims and applications must state: "Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a false, incomplete, or misleading statement is guilty of a third-degree felony."

Penalty: Up to $5,000 fine.

The Department or Office of Insurance Regulation may investigate an applicant’s qualifications, residence, business location, character, experience, background, and fitness. Applicants must submit fingerprints for criminal background checks.

• Applicants must pass the state exam for a producer’s license.
• Maximum five attempts in a 12-month period.
• Fee charged per exam.

Certified Public Accountants (CPAs) are exempt from licensing if they only advise on insurance needs or coverage without receiving commissions or referral fees.

Continuing Education [626.2815]

• 24 hours every two years, including 4 hours in law and ethics.
• Life/health and property/casualty adjusters: half of hours in each type.
• 6+ years licensed: 20 hours in intermediate/advanced courses.
• 25+ years or CLU/CPCU/BS in insurance: 5 hours every two years.
• Non-compliance prevents appointment renewal or new appointments.

Change of Address [626.551]

• Notify Department within 30 days of changes in name, address, phone, or email.
• Penalties: $250 first offense, $500+ or suspension for subsequent offenses.
• License terminated if adjuster moves out of Florida.

Appointments [626.311, .381, .876]

• Insurer appoints adjusters; appointment requires Department approval and fees.
• Independent adjusters limited to one employer.
• Appointments renewed every 24 months during agent’s birth month.
• Expired appointments: No insurance activity for 48 months unless reappointed.

Reportable Criminal Actions [626.451]

• Insurer reports adjuster’s felony guilty plea within 15 days.
• Adjuster reports felony guilty plea within 30 days.

Suspension, Termination, Revocation [626.611, .621]

• Failing to maintain qualifications.
• Misrepresentation or fraud in licensing.
• Failing exams or violating insurance code.
• Misrepresenting policy terms or engaging in fraudulent practices.
• Felony convictions or crimes involving moral turpitude.

Prohibited Activities

• Rebating [626.572, .9541]: Cannot offer rebates or value to induce insurance purchase unless specified in the contract.
• Commission Sharing [626.794, .838]: Unlicensed persons cannot receive commissions.
• Representing Unauthorized Insurer [626.902]: Third-degree felony.
• Unregistered Securities: License suspension/revocation for selling unregistered securities.
• Prohibited Fees [44-354]: Cannot charge fees not specified in the contract.

Adjusters must keep claim and loss records for at least five years after adjustment completion.

• Acknowledge claim within 7 days.
• Begin investigation within 7 business days of proof of loss.
• Pay or deny claim within 60 days, or pay interest if delayed.

Admitted and Non-Admitted Insurers

Admitted: Licensed with a certificate of authority in the state.

Non-Admitted: Not certified; transact through surplus lines brokers.

Surplus Lines [626.915]

Non-admitted insurers approved by OIR for coverage unavailable from admitted insurers. Handled by surplus lines brokers; premiums may be high, no FIGA protection.

Reciprocal Insurers

Unincorporated group insuring each other via indemnity contracts.

Residual Markets

Coverage for those rejected by voluntary insurers, e.g., workers’ compensation or property insurance.