adjusting: means directing or conducting the investigation, negotiation, or settlement of a claim under an insurance policy, on behalf of an insurer, policyholder, or a claimant under an insurance policy. See Utah Code 31A-26-102
Administrator: means the same as that term is defined in Subsection (182). See Utah Code 31A-1-301
Company adjuster: means a person employed by an insurer who negotiates or settles claims on behalf of the insurer or an affiliated insurer. See Utah Code 31A-26-102
Employee: means :
(a)
an individual employed by an employer; or
(b)
an individual who meets the requirements of Subsection (53)(b). See Utah Code 31A-1-301
Group insurance policy: means a policy covering a group of persons that is issued:
(i)
to a policyholder on behalf of the group; and
(ii)
for the benefit of a member of the group who is selected under a procedure defined in:
a risk distributing arrangement providing for compensation or replacement for damages or loss through the provision of a service or a benefit in kind;
(ii)
a contract of guaranty or suretyship entered into by the guarantor or surety as a business and not as merely incidental to a business transaction; and
(iii)
a plan in which the risk does not rest upon the person who makes an arrangement, but with a class of persons who have agreed to share the risk. See Utah Code 31A-1-301
Insurance adjuster: means a person who directs or conducts the investigation, negotiation, or settlement of a claim under an insurance policy other than life insurance or an annuity, on behalf of an insurer, policyholder, or a claimant under an insurance policy. See Utah Code 31A-1-301
Insured: means a person to whom or for whose benefit an insurer makes a promise in an insurance policy and includes:
Policyholder: means a person who controls a policy, binder, or oral contract by ownership, premium payment, or otherwise. See Utah Code 31A-1-301
producer: means a person licensed or required to be licensed under the laws of this state to sell, solicit, or negotiate insurance. See Utah Code 31A-1-301
Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
(a)
a person may not perform, offer to perform, or solicit the opportunity to perform an act of insuranceadjusting without a valid license under Section 31A-26-203; and
(b)
a person may not use the insurance adjusting services of another if the person knows or should know that the one providing these services does not have a license as required by law.
(2)
The following are exempt from the license requirement of Subsection (1), when acting in the indicated capacity:
(a)
an individual engaged in insurance adjusting as a regular salaried employee of, and not an independent contractor for, an insurer;
(b)
an arbitrator or an umpire selected by the claimant and insurer to decide, alone or with others, whether a claim should be paid and how much should be paid;
(c)
an attorney at law acting in an attorney-client relationship;
(d)
an insurance producer, but only as to:
(i)
a class of insurance for which the insurance producer is licensed under Section 31A-23a-106; and
(ii)
a claim adjusted on the request of an insurer for which the insurance producer is a producer;
(e)
a regular salaried employee of, and not an independent contractor for, a policyholder or claimant under an insurance policy;
(f)
an employee of a licensed insurance adjuster who provides only administrative or clerical assistance;
(g)
an individual who does not do insurance adjusting under Section 31A-26-102, but who is specially employed to obtain facts about a loss for or furnish technical assistance to a licensed adjuster or a company adjuster, including:
(i)
a photographer;
(ii)
an estimator;
(iii)
an appraiser;
(iv)
a marine surveyor;
(v)
a private detective;
(vi)
an engineer; and
(vii)
a handwriting expert;
(h)
a holder of a group insurance policy, with respect to administrative activities in connection with that insurance policy, who receives no compensation for the policyholder’s services beyond the actual expenses estimated on a reasonable basis;
(i)
an individual engaged in insurance adjusting as a regular salaried employee of, and not an independent contractor for, an administrator licensed under Chapter 25, Third Party Administrators; or
(j)
a person who gives advice or assistance without compensation or expectation of compensation, direct or indirect.
(3)
A claim settlement between an insurer and an insured or a claimant under an insurance policy may not be considered invalid as a result of a violation of this section.
