New York State Seal
STATE OF NEW YORK
INSURANCE DEPARTMENT

25 BEAVER STREET
NEW YORK, NEW YORK 10004

Eliot Spitzer
Governor
Eric R. Dinallo
Superintendent

The Office of General Counsel issued the following opinion on April 25, 2007, representing the position of the New York State Insurance Department.

Re: Licensing and Continuing Education Requirements for Resident/Non-Resident Workers’ Compensation Independent Adjusters

Questions Presented:

1. What type of workers’ compensation claims does an “independent adjuster, motor vehicle no-fault and workers’ compensation health service charges” license permit a workers’ compensation adjuster to handle?

2. Are independent adjusters (resident or nonresident) exempt from the continuing education requirements of N. Y. Ins. Law § 2108 (McKinney 2006)?

Conclusions:

1. N.Y. Comp. Codes R. & Regs. tit. 11, 26.3(e) (2004) (Regulation 25) provides that the “independent adjuster, motor vehicle no-fault and workers’ compensation health service charges, shall have authority to investigate and adjust all claims for health service charges arising under policies of mandatory and/or additional personal injury protection insurance (no-fault); and workers’ compensation insurance.”

2. Independent adjusters (resident or nonresident) are not subject to the continuing education requirements of Insurance Law § 2108.

Facts:

The question is general in nature, without reference to specific facts.

Analysis:

Regulation 25 pertains to independent adjusters: it prescribes the types of licenses that independent adjusters may obtain pursuant to Insurance Law § 2108; sets forth independent adjusters’ authority with respect to each type of license; and delineates the types of examinations required for independent adjusters. One type of license that independent adjusters may obtain is the one the inquirer has asked about: the “independent adjuster, motor vehicle no-fault and workers’ compensation health service charges license.”

Specifically, § 26.3(e) of Regulation 25 reads, in pertinent part, as follows:

(e) …The independent adjuster, motor vehicle no-fault and workers’ compensation health service charges, shall have authority to investigate and adjust all claims for health service charges arising under policies of mandatory and/or additional personal injury protection insurance (no-fault); and workers’ compensation insurance.

Therefore, an independent adjuster with such a license is authorized to investigate all claims that come within the scope of § 26.3(e), i.e., claims for health service charges arising under policies of mandatory and/or additional personal injury protection insurance (no-fault), and workers’ compensation insurance.

The second question asks whether independent adjusters (resident or non-resident) are exempt from continuing education requirements, when Insurance Law § 2108(r) specifically makes such requirements applicable to licensed public adjusters. There is, however, no similar continuing education requirement for independent adjusters. Therefore, Insurance Law § 2108 does not require independent adjusters to comply with the continuing education requirements set forth therein.

For further information you may contact Associate Attorney D. Monica Marsh at the New York City Office.