Acts and Regulations

2009-52 - Adjusters

Full text
Current to 1 January 2024
NEW BRUNSWICK
REGULATION 2009-52
under the
Insurance Act
(O.C. 2009-181)
Filed May 11, 2009
Under section 358 of the Insurance Act, the Lieutenant-Governor in Council makes the following Regulation:
Citation
1This Regulation may be cited as the Adjusters Regulation - Insurance Act.
Definitions
2The following definitions apply in this Regulation.
“Act” means the Insurance Act.(Loi)
“adjuster’s licence” means a level 1, level 2, level 3 or level 4 licence issued under this Regulation.(licence d’expert en sinistres)
Adjusters
3(1)A person acts as an adjuster when he or she offers, promises or attempts to act as an adjuster or claims that he or she is authorized to act in that capacity.
3(2)The following persons shall be deemed not to be acting as adjusters:
(a) a liquidator or trustee in bankruptcy in the performance of his or her duties;
(b) a testamentary executor, director, trustee or fiduciary in the performance of his or her duties;
(c) an engineer, architect, appraiser, assessor or other expert whose services are required by a party for the purpose of obtaining the opinion or testimony of the expert; and
(d) an adjuster dealing exclusively with ocean marine losses.
ADJUSTERS’ LICENCES
Classification of licences
4(1)Licences authorizing persons to act as adjusters are classified as follows:
(a) level 1 - probationary adjuster’s licence;
(b) level 2 - assistant adjuster’s licence;
(c) level 3 - adjuster’s licence; and
(d) level 4 - general adjuster’s licence.
4(2)A level 3 licensee shall specialize in at least one of the following types of adjusting for which he or she has successfully completed the program set out in subsection 20(1):
(a) property damage;
(b) automobile physical damage;
(c) automobile accident benefits; or
(d) bodily injury.
Scope of licences
5(1)Subject to sections 11 and 16, a level 1 or level 2 licensee is authorized to act as an adjuster with respect to any claim with respect to which his or her supervisor is authorized by licence to act.
5(2)A level 3 licensee specializing in property damage claims is authorized to act as an adjuster with respect to first or third party claims arising out of damage to or loss of property of any kind which is or is alleged to be covered by a policy of insurance or security having as its primary purpose the insuring of property, unless the claims arise under a policy of automobile insurance or ocean marine insurance.
5(3)A level 3 licensee specializing in automobile physical damage claims is authorized to act as an adjuster with respect to first or third party claims arising out of damage to property resulting from the ownership, possession or use of any kind of self-propelled vehicle which is or is alleged to be covered by a policy of automobile insurance.
5(4)A level 3 licensee specializing in automobile accident benefit claims is authorized to act as an adjuster with respect to accident benefit claims arising under a policy of automobile insurance.
5(5)A level 3 licensee specializing in bodily injury claims is authorized to act as an adjuster with respect to third party claims arising out of any bodily injury or death.
5(6)A level 4 licensee is authorized to act as an adjuster with respect to any claim that may be adjusted by a level 3 licensee specializing in any of the types of adjusting referred to in subsection 4(2).
Application for licence, fees
6An application for an adjuster’s licence shall be submitted to the Superintendent with those documents that the Superintendent requires and the following fees:
(a) for a level 1 licence, $10;
(b) for a level 2 licence, $10;
(c) for a level 3 licence, $15 for each type of adjusting in which the applicant specializes; or
(d) for a level 4 licence, $35.
Expiration
7(1)A level 1 licence expires on the anniversary date of the issue of the licence.
7(2)A level 2 licence expires on the anniversary date of the issue or of the renewal of the licence.
7(3)A level 3 or a level 4 licence expires on June 30, following the issue or the renewal of the licence.
Renewal
8(1)A level 2, a level 3 or a level 4 licence may be renewed if the licensee pays the fee prescribed in section 6 and meets the requirements of the Act and this Regulation.
8(2)A level 2 licence may be renewed only twice.
Information on licence
9(1)An adjuster’s licence shall contain the following information:
(a) the name of the licensee;
(b) the expiry date of the licence;
(c) the classification of the licence;
(d) in the case of a level 3 licence, the types of adjusting in which the licensee specializes; and
(e) if the licensee is employed, the name of the licensee’s employer.
9(2)A licensee shall immediately advise the Superintendent of any changes to his or her information and shall return his or her adjuster’s licence to the Superintendent.
9(3)If the changes to an adjuster’s licence involve a change of classification of the licence, a change in the type of adjusting in which the licensee specializes or a change of employer, the licensee shall submit a new adjuster’s licence application and pay the fee prescribed in section 6.
9(4)For all other changes to an adjuster’s licence, the Superintendent shall amend the licence accordingly and return it to the licensee.
Ceasing to act as adjuster
10(1)A licensee who ceases to act as an adjuster shall immediately inform the Superintendent in writing of the reasons he or she has ceased to act as an adjuster.
10(2)A licensee who ceases to act as an adjuster, or whose licence is revoked or not renewed, shall return his or her licence to the Superintendent.
LEVEL 1 - PROBATIONARY ADJUSTER’S LICENCE
Supervisor’s role
11(1)A level 1 licensee shall be supervised by a level 3 licensee having a minimum of 12 months of experience at that level or by a level 4 licensee, and the supervisor shall be responsible for the instruction and conduct of the level 1 licensee.
11(2)A level 1 licensee shall not adjust an insurance claim in his or her own right.
11(3)A level 1 licensee shall not enter into correspondence, submit reports or prepare memoranda respecting the adjustment of an insurance claim assigned to his or her supervisor unless authorized by his or her supervisor.
11(4)A level 1 licensee shall have all claim reports and settlement offers countersigned by his or her supervisor.
11(5)On the request of the Superintendent, the supervisor of a level 1 licensee shall provide the Superintendent information with respect to the level 1 licensee.
Obligation to move to level 2
12A level 1 licensee shall obtain a level 2 licence within 12 months after being issued a level 1 licence.
Extension of time
13(1)If, for reasons beyond his or her control, a level 1 licensee is unable to obtain a level 2 licence within the time provided in section 12, he or she may apply to the Superintendent, in writing and before the expiration of the time provided, for an extension of time.
13(2)The Superintendent may extend the time provided in section 12 for the period of time the licensee is unable to obtain the level 2 licence, up to a maximum of one year, and the expiration date under section 7 is extended for an equivalent period of time.
13(3)An extension of time to obtain a level 2 licence may be granted only once.
Reinstatement
14(1)A person who ceases to hold a level 1 licence may apply for reinstatement of his or her licence, if he or she is eligible, no earlier than one year after the date on which he or she ceased to hold the licence.
14(2)A person whose level 1 licence is reinstated shall not be credited with work experience acquired before the reinstatement, although any courses successfully completed under subsection 15(1) shall be recognized, subject to any conditions that may be imposed by the Superintendent under the Act.
14(3)If a person’s level 1 licence is reinstated and he or she again ceases to hold the licence, the person is not eligible for a further adjuster’s licence.
2016, c.36, s.8
LEVEL 2 - ASSISTANT ADJUSTER’S LICENCE
Conditions for issuing a licence
15(1)Either before a level 1 licence is issued or within 12 months after the licence is issued, unless an extension of time is given under section 13, an applicant for a level 2 licence shall have successfully completed one of the following programs offered by the Insurance Institute of Canada:
(a) course number C11 Principles and Practices of Insurance; or
(b) course numbers C81 General Insurance Essentials - Part 1 and C82 General Insurance Essentials - Part 2.
15(2)Within 12 months after a level 1 licence is issued, the applicant for a level 2 licence shall have acquired 12 months of work experience as an adjuster.
15(3)The Superintendent may waive any part of the work experience requirement for an applicant for a level 2 licence if the Superintendent is satisfied that the applicant has sufficient experience or training in the insurance industry.
Supervisor’s role
16(1)A level 2 licensee shall be supervised by the holder of a level 3 licence who has a minimum of 12 months of experience at that level or by the holder of a level 4 licence, and the supervisor shall be responsible for the instruction and conduct of the level 2 licensee.
16(2)A level 2 licensee shall not adjust an insurance claim in his or her own right.
16(3)A level 2 licensee shall not enter into correspondence, submit reports or prepare memoranda respecting the adjustment of an insurance claim assigned to his or her supervisor unless authorized by his or her supervisor.
16(4)The supervisor of a level 2 licensee shall, upon the request of the Superintendent, provide the Superintendent information with respect to the level 2 licensee.
Obligation to move to level 3
17A level 2 licensee shall obtain a level 3 licence within 36 months after being issued a level 2 licence.
Extension of time
18(1)If, for reasons beyond his or her control, a level 2 licensee is unable to obtain a level 3 licence within the time provided under section 17, he or she may apply to the Superintendent, in writing and before the expiration of the time provided, for an extension of time.
18(2)The Superintendent may extend the time provided in section 17 for the period of time the licensee is unable to obtain the level 3 licence, up to a maximum of one year, and the expiration date in section 7 is extended for an equivalent period of time.
18(3)An extension of time to obtain a level 3 licence may be granted only once.
Reinstatement
19(1)A person who ceases to hold a level 2 licence may apply for reinstatement of his or her licence, if he or she is eligible, no earlier than one year after the date on which he or she ceased to hold the licence.
19(2)Despite subsection (1), a person who does not hold a level 2 licence for a period of 2 years or more shall only be eligible to apply for a level 1 licence.
19(3)A person whose level 2 licence is reinstated shall not have work experience acquired before the reinstatement credited towards the obtainment of a level 3 licence, although any courses successfully completed under subsections 15(1) and 20(1) shall be recognized, subject to any conditions that may be imposed by the Superintendent under the Act.
19(4)A person who is issued a level 1 licence under this section shall not be credited with work experience acquired before the issuance, although any courses successfully completed under subsections 15(1) and 20(1) shall be recognized, subject to any conditions that may be imposed by the Superintendent under the Act.
19(5)A person reinstated with a level 2 licence who ceases to hold that licence is not eligible for a further adjuster’s licence.
19(6)A person issued a level 1 licence under this section who ceases to hold that licence, or who is subsequently issued a level 2 licence and ceases to hold that licence, is not eligible for a further adjuster’s licence.
2016, c.36, s.8
LEVEL 3 - ADJUSTER’S LICENCE AND
LEVEL 4 - GENERAL ADJUSTER’S LICENCE
Level 3 licence - conditions for issuing
20(1)Either before a level 2 licence is issued or within 36 months after the licence is issued, unless an extension of time is given under section 18, the applicant for a level 3 licence shall have successfully completed one of the following programs offered by the Insurance Institute of Canada:
(a) for a specialization in property damage:
(i) course number C11 Principles and Practice of Insurance or course numbers C81 General Insurance Essentials - Part 1 and C82 General Insurance Essentials - Part 2;
(ii) course number C12 Insurance on Property;
(iii) course number C13 Insurance Against Liability - Part 1;
(iv) course number C110 Essentials of Loss Adjusting or C17 Claims 1; and
(v) course number C111 Advanced Loss Adjusting or course numbers C33 Insurance on Property - Part 2 and C46 Claims 2;
(b) for a specialization in automobile physical damage:
(i) course number C11 Principles and Practice of Insurance or course numbers C81 General Insurance Essentials - Part 1 and C82 General Insurance Essentials - Part 2;
(ii) course number C13 Insurance Against Liability - Part 1;
(iii) course number C14 Automobile Insurance - Part 1;
(iv) course number C110 Essentials of Loss Adjusting or C17 Claims 1; and
(v) course number C111 Advanced Loss Adjusting or C46 Claims 2;
(c) for a specialization in automobile accident benefits:
(i) course number C11 Principles and Practice of Insurance or course numbers C81 General Insurance Essentials - Part 1 and C82 General Insurance Essentials - Part 2;
(ii) course number C14 Automobile Insurance - Part 1;
(iii) course number C32 Bodily Injury Claims;
(iv) course number C110 Essentials of Loss Adjusting or C17 Claims 1; and
(v) course number C111 Advanced Loss Adjusting or C46 Claims 2; or
(d) for a specialization in bodily injury:
(i) course number C11 Principles and Practice of Insurance or course numbers C81 General Insurance Essentials - Part 1 and C82 General Insurance Essentials - Part 2;
(ii) course number C13 Insurance Against Liability - Part 1;
(iii) course number C14 Automobile Insurance - Part 1;
(iv) course number C32 Bodily Injury Claims;
(v) course number C110 Essentials of Loss Adjusting or C17 Claims 1; and
(vi) course number C111 Advanced Loss Adjusting or C46 Claims 2.
20(2)Within 36 months after a level 2 licence is issued, the licensee shall acquire 24 months of work experience in claims adjusting, but any experience acquired before the level 2 licence was issued shall not count for the purpose of this subsection.
Level 3 licence - foreign adjuster
21(1)Despite section 20, a level 3 licence may be issued to an applicant who meets the following conditions:
(a) the applicant is an adjuster in good standing in another province or territory of Canada or a state of the United States of America;
(b) the applicant has acquired 36 months of work experience as an adjuster in a province or territory of Canada or state of the United States of America; and
(c) the applicant has successfully completed at least one of the programs set out in subsection 20(1), or the applicant establishes to the satisfaction of the Superintendent that he or she has equivalent training or work experience.
21(2)If the applicant is an adjuster in good standing in another province or territory of Canada or a state of the United States of America who does not otherwise meet the conditions for issuing a level 3 licence, the Superintendent may issue the applicant a level 2 licence and, towards the obtainment of a level 3 licence, shall credit the applicant with any courses successfully completed and any work experience acquired as an adjuster as provided in subsection (1).
Level 4 licence - conditions for issuing
22(1)An applicant for a level 4 licence shall have successfully completed the following program offered by the Insurance Institute of Canada:
(a) course number C11 Principles and Practice of Insurance or course numbers C81 General Insurance Essentials - Part 1 and C82 General Insurance Essentials - Part 2;
(b) course number C12 Insurance on Property;
(c) course number C13 Insurance Against Liability - Part 1;
(d) course number C14 Automobile Insurance - Part 1;
(e) course number C32 Bodily Injury Claims;
(f) course number C110 Essentials of Loss Adjusting or C17 Claims 1;
(g) course number C111 Advanced Loss Adjusting or course numbers C33 Insurance on Property - Part 2 and C46 Claims 2; and
(h) course number C112 Practical Issues in Claims Management.
22(2)The applicant shall have acquired 24 months of work experience in claims adjusting while holding a level 3 licence.
Level 4 licence - foreign adjuster
23(1)Despite section 22, a level 4 licence may be issued to an applicant who meets the following conditions:
(a) the applicant is an adjuster in good standing in another province or territory of Canada or a state of the United States of America;
(b) the applicant has acquired 60 months of work experience as an adjuster in a province or territory of Canada or state of the United States of America; and
(c) the applicant has successfully completed the program set out in subsection 22(1), or the applicant establishes to the satisfaction of the Superintendent that he or she has equivalent training or work experience.
23(2)If an applicant meets the conditions for issuing a level 3 licence but not a level 4 licence, the Superintendent may issue the applicant a level 3 licence and, towards the obtainment of a level 4 licence, shall credit the applicant with any courses successfully completed and any work experience acquired as an adjuster as provided in subsection (1).
Reinstatement
24(1)A person who ceases to hold a level 3 or a level 4 licence may apply for reinstatement of his or her licence, if he or she is eligible, subject to any conditions that may be imposed by the Superintendent under the Act.
24(2)Despite subsection (1), a person who ceases to hold a level 3 or level 4 licence for a period of 10 years or more shall be eligible to apply only for a level 1 licence.
24(3)A person who is issued a level 1 licence under this section shall not be credited with work experience acquired before the issuance, although any courses successfully completed under subsections 15(1), 20(1) and 22(1) shall be recognized, subject to any conditions that may be imposed by the Superintendent under the Act.
2016, c.36, s.8
MISCELLANEOUS
Requirements for holding an adjuster’s licence
25The following requirements apply to a licensee or an applicant for an adjuster’s licence:
(a) he or she shall not violate or fail to comply with the Act or regulations;
(b) he or she shall not commit an offence under the laws of any jurisdiction involving crimes of violence or moral turpitude, theft, fraud, forgery, breach of trust, misrepresentation, perjury, furnishing of false information or carrying on a regulated business or career while unlicensed;
(c) he or she shall not be the subject of a disciplinary action taken against him or her by an insurance regulator, a financial services regulator or a professional body; and
(d) he or she shall not be the subject of a judgment rendered against him or her in relation to financial activities, fraud or breach of trust.
Notice to Superintendent
26(1)A licensee or an applicant for an adjuster’s licence shall immediately notify the Superintendent in writing of any of the following:
(a) an investigation commenced or a disciplinary action taken against the licensee by an insurance regulator, a financial services regulator or a professional body;
(b) a judgment rendered against the licensee in relation to financial activities, fraud or breach of trust; and
(c) a charge or a conviction for an offence under any jurisdiction involving theft, fraud, forgery, breach of trust, misrepresentation, perjury, furnishing of false information, carrying on any regulated business or career while not licensed or crimes of violence or moral turpitude.
26(2)The notice required under subsection (1) shall be given within 10 business days of the disciplinary action, judgment, charge or conviction.
Prohibitions
27(1)With respect to the adjustment of claims, no adjuster shall
(a) possess an interest, other than professional, in the settlement of a claim,
(b) fail to disclose to his or her employer or the person retaining him any information known to him or her with respect to policy violations and cases of fraud, misrepresentation, concealment, falsification of facts and records or any other information material to the decision of his or her employer or the person retaining him or her in the settlement of a claim,
(c) fail, when acting for more than one insurer in the same matter, to immediately notify each insurer of the interests of all insurers for whom he or she is acting or has been requested to act in the same matter,
(d) seek or make a profit or seek or acquire an interest in any matter entrusted to his or her care, other than his or her fees or salary,
(e) represent falsely to an insurer that he or she has been instructed by another insurer to act in the settlement of a claim,
(f) act or hold himself or herself out as acting for an insurer without authorization of that insurer,
(g) advise a claimant to refrain from seeking legal counsel,
(h) knowingly interview or settle a claim with a claimant represented by a barrister or solicitor without the consent of that barrister or solicitor, or
(i) mislead an interested party as to the identity or the interest of the insurer.
Disclosure
28(1)Subject to subsection (2), unless obliged by law, no adjuster shall disclose any information obtained in the performance of his or her work to any person other than his or her employer or the person retaining him or her without the authorization of the employer or that person.
28(2)On the request of the Superintendent, an adjuster shall furnish to the Superintendent any information obtained in the performance of the adjuster’s work.
Bond
29(1)Except for an adjuster who is a salaried employee of an insurer, a holder of an adjuster’s licence shall furnish, in favour of the Superintendent, a bond or other security in the amount of $5,000 issued by an insurer licenced in the Province to provide that class of insurance.
29(2)The Superintendent shall hold the bond or other security in trust for any person who may incur a financial loss as the result of any improper or illegal act of the adjuster.
29(3)If the Superintendent becomes aware of any improper or illegal act on the part of an adjuster that may necessitate a call on the proceeds of the bond or other security, he or she shall notify the insurer who issued the bond or other security, and the insurer shall immediately conduct an investigation.
29(4)The insurer conducting the investigation shall furnish all the resulting information to the Superintendent.
29(5)If the investigation establishes that a financial loss has resulted from an improper or illegal act of an adjuster, a claim is payable under the bond or other security and the proceeds of the bond or other security shall be remitted to the Superintendent, who shall distribute the proceeds to those persons incurring financial loss in proportion to their respective financial losses.
Deposit of money received for and on behalf of others
30A holder of an adjuster’s licence, other than an adjuster who is a salaried employee of an insurer, who receives money for and on behalf of others in the course of adjusting an insurance claim shall
(a) deposit the money in a trust account maintained in a chartered bank, credit union or trust company,
(b) maintain a record of every amount of money received or disbursed in the course of adjusting an insurance claim, and
(c) maintain a record of the main particulars concerning each claim in a register of claims.
TRANSITIONAL PROVISIONS, REPEAL
AND COMMENCEMENT
Definition of “Regulation 85-151”
31For the purposes of sections 32 to 35, “Regulation 85-151” means New Brunswick Regulation 85-151 under the Insurance Act, in force immediately before the commencement of this section.
Student adjuster’s licence - scenario 1
32(1)A level 1 licence shall be issued to a person who, immediately before the commencement of this section, is the holder of a student adjuster’s licence issued under Regulation 85-151 and who does not meet the conditions in paragraphs 33(1)(b) and (c).
32(2)For the purpose of obtaining a level 2 licence, a person issued a level 1 licence under subsection (1) shall be credited with the months of work experience that he or she acquired as an adjuster before being issued the level 1 licence.
Student adjuster’s licence - scenario 2
33(1)A level 2 licence shall be issued to a person who, immediately before the commencement of this section, meets the following conditions:
(a) the person is a holder of a student adjuster’s licence issued under Regulation 85-151;
(b) the person has acquired 12 months of work experience as an adjuster; and
(c) within 12 months after being issued his or her student’s licence under Regulation 85-151, the person successfully completed at least one course in the course of studies prescribed in section 7 of Regulation 85-151 for an automobile, a property or a liability adjuster’s licence.
33(2)Either before or within 12 months after the date a person is issued a level 2 licence under subsection (1), the person shall, if he or she has not already done so, successfully complete one of the following programs offered by the Insurance Institute of Canada:
(a) course number C11 Principles and Practices of Insurance; or
(b) course numbers C81 General Insurance Essentials - Part 1 and C82 General Insurance Essentials - Part 2.
33(3)The requirements in subsection (2) are in addition to any other requirements applicable to a level 2 licensee, and sections 16 to 19 apply with the necessary modifications.
33(4)For the purpose of obtaining a level 3 licence, a person issued a level 2 licence under subsection (1) shall be credited with any work experience beyond 12 months that he or she acquired as an adjuster before being issued the level 2 licence.
Automobile, property or liability adjuster’s licence
34(1)A level 3 licence shall be issued to a person who, immediately before the commencement of this section, is the holder of an automobile, a property or a liability adjuster’s licence issued under Regulation 85-151.
34(2)A person issued a licence under subsection (1) shall be deemed to have satisfied the conditions set out in section 20.
34(3)A person issued a licence under subsection (1) shall advise the Superintendent as soon as possible of the type of adjusting under subsection 4(2) in which the person is specialized and shall provide sufficient information to the Superintendent regarding his or her training and experience to substantiate the specialization.
34(4)The Superintendent shall review the information under subsection (3) and assign the person a specialization.
34(5)For the purpose of obtaining a level 4 licence, a person issued a level 3 licence under subsection (1) shall be credited with any work experience beyond 36 months that he or she acquired as an adjuster before being issued the level 3 licence.
General adjuster’s licence
35(1)A level 4 licence shall be issued to a person who, immediately before the commencement of this section, is the holder of a general adjuster’s licence issued under Regulation 85-151.
35(2)A person issued a licence under subsection (1) shall be deemed to have satisfied the conditions set out in section 22.
Repeal of Regulation 85-151
36New Brunswick Regulation 85-151 under the Insurance Act is repealed.
Commencement
37This Regulation comes into force on July 1, 2009.
N.B. This Regulation is consolidated to July 8, 2016.