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TITLE 28INSURANCE
PART 1TEXAS DEPARTMENT OF INSURANCE
CHAPTER 5PROPERTY AND CASUALTY INSURANCE
SUBCHAPTER ETEXAS WINDSTORM INSURANCE ASSOCIATION
DIVISION 4CONSUMER ASSISTANCE; CLAIM PROCESSES
RULE §5.4214Appraisal Process - Umpire Qualifications and Conflicts of Interest

(a) Required qualifications. To qualify as an umpire, a person must:

  (1) be one of the following:

    (A) an engineer or architect with experience and training in building construction, repair, estimating, or investigation of property damage;

    (B) an adjuster or public adjuster with experience and training in estimating property damage;

    (C) a general contractor with experience and training in building construction, repair, or estimating property damage;

    (D) a licensed attorney; or

    (E) a current or former judge of any Texas court of record or the State Office of Administrative Hearings; and

  (2) not have any disqualifying conflicts of interest listed in subsection (d) of this section.

(b) Preferred qualifications. The following qualifications are preferred:

  (1) experience with the appraisal of property damage claims; and

  (2) experience as an appraisal umpire on at least three property damage claims in the previous 12 months.

(c) Potential conflicts. A potential conflict of interest exists when an umpire:

  (1) is a former association or claimant employee or contractor or contractor's employee;

  (2) is related within a degree of relationship described by Government Code §573.002 to:

    (A) a former association employee;

    (B) a former association contractor or contractor's employee;

    (C) a former claimant employee; or

    (D) a former claimant contractor or contractor's employee;

  (3) is a current association policyholder;

  (4) previously filed a claim with the association;

  (5) is a current employee or contractor of an insurance company or public insurance adjusting company; or

  (6) was a party or represented a party to a lawsuit with the association within the previous five years.

(d) Disqualifying conflicts. A potential umpire has a disqualifying conflict of interest if the potential umpire:

  (1) is a current association or claimant employee;

  (2) is a current association or claimant contractor, or contractor's employee, except that it is not a conflict for the umpire to be a contractor solely to work on the pending appraisal;

  (3) is related within a degree of relationship described by Government Code §573.002 to:

    (A) a current association employee;

    (B) a current association contractor or contractor's employee;

    (C) the claimant or a representative of the claimant;

    (D) a current claimant employee; or

    (E) a current claimant contractor or contractor's employee;

  (4) currently has an open claim, or acts as a representative or public adjuster on an open claim with the association;

  (5) is a party to or represents a party to a current lawsuit with the association;

  (6) adjusted the loss or acted as a public adjuster on the loss involved in the claim;

  (7) is related to the adjuster or public adjuster who adjusted the loss;

  (8) is an employee of the adjusting company or public insurance adjusting company that adjusted the loss or represented the claimant on the loss; or

  (9) has any other direct or indirect interest, financial or otherwise, of any nature that substantially conflicts with the umpire's duties.


Source Note: The provisions of this §5.4214 adopted to be effective February 14, 2013, 38 TexReg 653

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