You work for a firm that specializes in representing financial services clients, with a specialty in insurance industry compliance. Albert Boyd walks into your office one day and explains that he has an issue that he needs help resolving.
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Albert works as public insurance claims adjuster in the state of Freedonia. He spends most of his days evaluating policyholder’s claims by reading through policies, interviewing witnesses, conducting inspections of the property damage and fighting with insurers to make sure his clients get a fair claims settlement.
Freedonia DOI Regulation 101 states, “No person shall act as an adjuster in this state without first obtaining an insurance adjuster license.” Thus, to work as a public insurance claims adjuster in the state of Freedonia, you need an adjuster’s license granted by the Freedonia Department of Insurance (DOI).
Albert recently received a letter from the DOI stating that he was in violation of Freedonia DOI regulation 101. Albert was perplexed by this letter, since he went through great lengths to ensure he followed all the right steps in order to obtain an adjuster’s license. He called the DOI and spoke with Sarah Tudor, who told him that in order to obtain a license; he needed to fill out an application and mail in $100, payable to the DOI. Sarah said that once he did this, he could begin adjusting claims for the public. Albert followed Sarah’s instructions and then began operating as a public insurance adjuster. The DOI’s letter said that Albert did not take the exam requirement, which is necessary before obtaining an adjuster’s license.
The letter ended with a statement saying that Albert could submit written evidence that he had complied with the exam requirement, but that no formal hearing would be granted. Also, if Albert was indeed found to have acted as an adjuster without being properly licensed, he would have to pay a fine in the amount of $10,000 to the DOI.
Albert is obviously concerned about paying the fine, which he believes is exorbitant. However, Albert is also concerned about the legal costs associated with litigating this issue.
Your supervising attorney has asked you to prepare a memo that identifies all potential issues relative to administrative law and determines which options are available to Albert in order to contest the fine.
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