Morgan’s Tip of the Week- Contact with Represented Claimants

Greetings, there is a lot of confusion surrounding contact with a claimant who is represented by an attorney in Florida.   Very often, the claimant’s attorney advises that neither the adjuster nor the nurse case manager can have any contact with the claimant. 

While that does hold true, the one exception is communicating appointment information to the claimant.  The adjuster,  nurse can and should communicate to the claimant the appointment information, and this should always be copied to the claimant’s attorney and the defense attorney.  This way there can be no allegations about the claimant being unaware of the appointment as their attorney knew as well.  Email and letters are preferable to texts so there are no issues, or at least an email to the attorneys confirming a text was sent to the claimant.

The same holds true for outside scheduling entities, all parties should be copied on appointments.

Below is from the FL Adjuster Code of Ethics, just a few reminders on dealing with represented claimants.  As always, please let me know if you have any questions.

69B-220.201 Ethical Requirements.

(3) Code of Ethics. The work of adjusting insurance claims engages the public trust. An adjuster shall put the duty for fair and honest treatment of the claimant above the adjuster’s own interests in every instance. The following are standards of conduct that define ethical behavior, and shall 74 constitute a code of ethics that shall be binding on all adjusters:

(i) An adjuster shall not negotiate or effect settlement directly or indirectly with any third-party claimant represented by an attorney, if the adjuster has knowledge of such representation, except with the consent of the attorney. For purposes of this subsection, the term “third-party claimant” does not include the insured or the insured’s resident relatives.

(j) An adjuster is permitted to interview any witness, or prospective witness, without the consent of opposing counsel or party. In doing so, however, the adjuster shall scrupulously avoid any suggestion calculated to induce a witness to suppress or deviate from the truth, or in any degree affect the witness’s appearance or testimony during deposition or at the trial. If any witness making or giving a signed or recorded statement so requests, the witness shall be given a copy of the statement.

(k) An adjuster shall not advise a claimant to refrain from seeking legal advice, nor advise against the retention of counsel to protect the claimant’s interest.

(m) An adjuster shall not knowingly fail to advise a claimant of the claimant’s claim rights in accordance with the terms and conditions of the contract and of the applicable laws of this state. An adjuster shall exercise care not to engage in the unlicensed practice of law as prescribed by the Florida Bar.


Morgan Indek | Managing Partner