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  • Lighthouse Public Adjuster's Retainer Agreement

Get Lighthouse Public Adjuster's Retainer Agreement

__________, 20____ by and between, ___________________________________________________________________the "INSURED" and Lighthouse Public Adjusters, Inc. The "INSURED" hereby retains Lighthouse Public Adjusters, Inc., a public adjusting firm, to represent in the adjustment and negotiation of his/her insurance claim for the loss or damages caused by_______________ ________________________________________________________________________ on or about____/____/______ At:______________________________.

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How to fill out the Lighthouse Public Adjuster's Retainer Agreement online

Filling out the Lighthouse Public Adjuster's Retainer Agreement is a straightforward process that ensures you have professional representation for your insurance claim. This guide will walk you through each section of the form, providing clear and concise instructions to help you complete it online effectively.

Follow the steps to complete the agreement successfully.

  1. Locate and click the ‘Get Form’ button to access the Lighthouse Public Adjuster's Retainer Agreement. This will open the document in your preferred online editor, allowing you to fill it out easily.
  2. In the first section of the form, enter the date when the agreement is being completed. This should be placed on the line indicated as the day, month, and year.
  3. Identify yourself as the 'INSURED' by filling in your full name in the designated area following the introductory sentence.
  4. Specify the loss or damages you are claiming by clearly stating the details in the provided space.
  5. Record the date of the incident related to your claim.
  6. Complete the address section with the location where the loss occurred.
  7. Input your client home number, cell phone number, work number, and email address in the respective fields to ensure proper communication.
  8. Provide the name of your insurance company and their contact phone number.
  9. Enter your policy number and claim number.
  10. Fill in the payment received amount to reflect any initial payments made.
  11. Indicate your mortgage company and loan number, and clarify your status on mortgage payments by marking 'Yes' or 'No'. If applicable, indicate the number of months behind.
  12. Specify the percentage to be paid to Lighthouse Public Adjusters from your settlement in the corresponding area.
  13. If there are any additional costs associated with your claim, note them accordingly.
  14. Provide the necessary authorizations for Lighthouse Public Adjusters regarding checks issued by the insurance company.
  15. In the field concerning prior claims, disclose any relevant previous claims made for the same property and their details.
  16. Review the cancellation policy thoroughly, noting the number of days allowed to cancel the agreement.
  17. Complete the signature section by signing and dating the document where indicated. Ensure all signatories have printed their names and signed in the correct places.
  18. Once finished, save your changes in the form, and if necessary, download, print, or share the completed document as needed.

Take the next step towards managing your insurance claim effectively by completing your documents online.

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Questions & Answers

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Businesses or people that negotiate settlements for fire damage need a license. This license is for a "public adjuster." Individuals applying must have a clear criminal record without convictions for felonies or fraud. Contact the New York State Department of Financial Services for more information.

Regulation 10 does not require a public adjuster to provide an insurer with a copy of the public adjuster's compensation agreement with the insured, unless the insured requests that the insurer's check be issued to the public adjuster and the insured or the public adjuster as payee.

A Public Adjuster is any person, firm, association or corporation who acts on behalf of an insured in negotiating the settlement of a claim or claims for loss or damage to property of the insured.

(a) No public adjuster shall charge a fee in excess of 12.5 percent of the recovery for services rendered by the adjuster , with respect to a claim, except a public adjuster may charge a fee of up to 20 percent on a supplemental claim if the aggregate fee charged is less than or equal to 12.5 percent of the full claim ...

Your notice of cancellation must be made in writing and sent by certified mail, with a return receipt requested, or another form of mailing that will provide proof to the Public Adjuster at the address listed in the contract.

A public adjuster is an independent insurance professional that a policyholder may hire to help settle an insurance claim on his or her behalf.

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