(1) Except as provided in Subsection (2):

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Terms Used In Utah Code 31A-26-201

  • 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 (187). 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 :
         (57)(a) an individual employed by an employer; or
         (57)(b) an individual who meets the requirements of Subsection (55)(b). See Utah Code 31A-1-301
  • Group insurance policy: means a policy covering a group of persons that is issued:
              (79)(a)(i) to a policyholder on behalf of the group; and
              (79)(a)(ii) for the benefit of a member of the group who is selected under a procedure defined in:
                   (79)(a)(ii)(A) the policy; or
                   (79)(a)(ii)(B) an agreement that is collateral to the policy. See Utah Code 31A-1-301
  • Individual: means a natural person. See Utah Code 31A-1-301
  • Insurance: includes :
              (96)(b)(i) a risk distributing arrangement providing for compensation or replacement for damages or loss through the provision of a service or a benefit in kind;
              (96)(b)(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
              (96)(b)(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:
              (103)(a)(i) a policyholder;
              (103)(a)(ii) a subscriber;
              (103)(a)(iii) a member; and
              (103)(a)(iv) a beneficiary. See Utah Code 31A-1-301
  • License: includes a certificate of authority issued to an insurer. See Utah Code 31A-1-301
  • Person: includes :
         (146)(a) an individual;
         (146)(b) a partnership;
         (146)(c) a corporation;
         (146)(d) an incorporated or unincorporated association;
         (146)(e) a joint stock company;
         (146)(f) a trust;
         (146)(g) a limited liability company;
         (146)(h) a reciprocal;
         (146)(i) a syndicate; or
         (146)(j) another similar entity or combination of entities acting in concert. See Utah Code 31A-1-301
  • Policy: includes a service contract issued by:
              (150)(b)(i) a motor club under Chapter 11, Motor Clubs;
              (150)(b)(ii) a service contract provided under Chapter 6a, Service Contracts; and
              (150)(b)(iii) a corporation licensed under:
                   (150)(b)(iii)(A) Chapter 7, Nonprofit Health Service Insurance Corporations; or
                   (150)(b)(iii)(B) Chapter 8, Health Maintenance Organizations and Limited Health Plans. See Utah Code 31A-1-301
  • 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.
     (1)(a) a person may not perform, offer to perform, or solicit the opportunity to perform an act of insurance adjusting without a valid license under Section 31A-26-203; and
     (1)(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:

     (2)(a) an individual engaged in insurance adjusting as a regular salaried employee of, and not an independent contractor for, an insurer;
     (2)(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;
     (2)(c) an attorney at law acting in an attorney-client relationship;
     (2)(d) an insurance producer, but only as to:

          (2)(d)(i) a class of insurance for which the insurance producer is licensed under Section 31A-23a-106; and
          (2)(d)(ii) a claim adjusted on the request of an insurer for which the insurance producer is a producer;
     (2)(e) a regular salaried employee of, and not an independent contractor for, a policyholder or claimant under an insurance policy;
     (2)(f) an employee of a licensed insurance adjuster who provides only administrative or clerical assistance;
     (2)(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:

          (2)(g)(i) a photographer;
          (2)(g)(ii) an estimator;
          (2)(g)(iii) an appraiser;
          (2)(g)(iv) a marine surveyor;
          (2)(g)(v) a private detective;
          (2)(g)(vi) an engineer; and
          (2)(g)(vii) a handwriting expert;
     (2)(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;
     (2)(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
     (2)(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.