Exceptions to License Requirement

The definition of adjuster shall not be deemed to include, and a license as an adjuster shall not be required of the following:

(a)attorneys-at-law admitted to practice on Guam, when acting in their professional capacity as an attorney;

(b)a person employed solely to obtain facts surrounding a claim or to furnish technical assistance to a licensed adjuster; COL 1/26/2024 CH. 15 BUSINESS OF INSURANCE

(c)an individual who is employed to investigate suspected fraudulent insurance claims but who does not adjust losses or determine claims payments;

(d)a person who solely performs executive, administrative, managerial or clerical duties, or any combination thereof, and who does not investigate, negotiate or settle claims with policyholders, claimants or their legal representative;

(e)a licensed health care provider or any of its employees who provides managed care services so long as the services do not include the determination of compensability;

(f)a managed care organization or any of its employees or an employee of any organization providing managed care services so long as the services do not include the determination of compensability;

(g)a person who settles only reinsurance or subrogation claims;

(h)an officer, director, manager, or employee of an authorized insurer, surplus lines insurer, a risk retention group, or an attorney-in-fact of a reciprocal insurer;

(i)a U.S. Manager of the United States branch of an alien insurer;

(j)an employee who coordinates with a licensed adjusting firm acting as a Third-Party Administrator

(TPA)for a self-insured arrangement, and who does not engage in the direct adjustment of claims;

(k)a licensed insurance producer, attorney-in-fact of a reciprocal insurer, or a managing general agent of the insurer to whom claim authority has been granted by the insurer; or

(l)an “appraiser” who is employed by an insurer specifically for the purpose of valuing damage resulting from claims related to a declared “catastrophe” to alleviate the immediate and substantial workload placed on the licensed adjusting staff due to the effects of a catastrophe. COL 1/26/2024 CH. 15 BUSINESS OF INSURANCE