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ADJUSTING FIRM ATTESTATION FORM Level Five (5) Independent Adjuster (Designated Representative) Emailed March 13, 2023The Level Five (5) Independent Adjuster (Designated Representative) must complete
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Read the agreement carefully and understand all terms and conditions
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Who needs agreement for independent adjusting?

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Independent adjusters who are entering into a contract or agreement to provide their services to an insurance company or other party
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An agreement for independent adjusting is a contractual document that outlines the terms and conditions under which an independent adjuster will evaluate and settle insurance claims.
Insurance companies that engage independent adjusters to handle claims are required to file an agreement for independent adjusting with the relevant regulatory authority.
To fill out an agreement for independent adjusting, the insurance company must provide details such as the adjuster's name, their license number, the scope of services, and the effective dates of the agreement.
The purpose of the agreement for independent adjusting is to ensure compliance with regulatory standards, define the responsibilities of the adjuster, and protect the interests of both the insurance company and policyholders.
The agreement must report the names and license numbers of the adjusters, details of the insurance company, the nature of the claims being adjusted, and any compensation arrangements.
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