• Telos Public Adjuster Contract

    Telos Public Adjuster Contract


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  • Referral Company

  • I/We (the “insured”), hereby agree to the retention of Telos Adjusting LLC, a public adjusting firm, to provide representation of the insured's interest for loss or damage that occurred at the address of loss specified above. I/We hereby authorize Telos Adjusting LLC to discuss all information relevant to the insured’s claim to all parties necessary or beneficial to the settlement of such claim, including but not limited to: contractors, attorneys, and the insurance company. I/We further authorize the insurer to name Telos Adjusting LLC as a co-payee on any claim payments. I/We acknowledge that Telos Adjusting LLC will receive payment for its services from the funds distributed by the insurance company pursuant to this claim at a rate of ten percent (10%) of the distribution, subject to the limitations found in Code of Virginia § 38.2-1845.14 (I) and code of Maryland § 10-41. I/We acknowledge that any claim related expenses incurred by Telos Adjusting LLC will be reimbursed from the funds distributed by the insurance company, provided these expenses are approved by the insured prior to being incurred. I/We understand that, pursuant to the Code of Virginia § 38.2-1845.13 (A)(12) and code of Maryland § 10-41, I/We have the right to rescind this contract within three business days after I/We have signed, or within five business days in the event of a catastrophic disaster. I/We understand that such rescission shall be in writing and mailed or delivered to Telos Adjusting LLC at the address listed below. Nothing in this contract shall in any way limit the parties’ ability to pursue civil remedies arising out of the matters contemplated in this contract in a court of law. 


    I/We acknowledge that I/We have the right to consult an attorney regarding this agreement.

  • Payment Authorization

  • I/We authorize Telos Adjusting LLC to receive payout from the insurance company and to distribute it on my/our behalf. I/We acknowledge that this is a convenience and is not a requirement of this agreement.

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  • Disclosure Statement

  • As required in the Code of Virginia § 38.2 – 1845.13 (B), code of Maryland § 10-411 Telos Adjusting LLC is required to make the following disclosures: 

    1. You, the insured, are not required to hire a public adjuster, but you have the right to do so. (VA, MD) 

    2. Telos Adjusting LLC is not an employee or representative of your insurance company. (VA, MD) 

    3. All commissions paid to Telos Adjusting LLC are your obligation to pay as the insured; they are not the obligation of your insurance company. (VA, MD) 

    4. Property insurance policies obligate you, the insured, to present a claim to the insurance company for consideration. (VA, MD) 

    5. You, the insured, have the right to initiate direct communications with your attorney, the insurer, the insurer's adjuster, the insurer's attorney, and any other person regarding the settlement of your claim. (VA, MD) 

    6. You, the insured, may contact the Virginia State Corporation Commission for the licensing status of the public adjuster. (VA, MD) 

    7. Telos Adjusting LLC may incur out-of-pocket expenses on behalf of you, the insured. (MD) 

    8. These expenses incurred by Telos Adjusting LLC and approved by the insured will be reimbursed to the public adjuster from the insurance proceeds. (MD) 

    9. If you, the insured, exercises the right to rescind or cancel the contract, the public adjuster shall, within 15 business days after the public adjuster receives the notice, return anything of value given by the insured under the contract. (MD) 


    (MD) There are three types of adjusters that could be involved in the claims process. The definitions of the three types are: 

    (i) “Company adjuster” means an insurance adjuster who is an employee of an insurance company. A company adjuster represents the interest of the insurance company and is paid by the insurance company. A company adjuster will not charge you a fee. 

    (ii) “Independent adjuster” means an insurance adjuster who is hired on a contractual basis by an insurance company to represent the insurance company's interest in the settlement of the claim. An independent adjuster is paid by your insurance company. An independent adjuster will not charge you a fee. 

    (iii) “Public adjuster” means an insurance adjuster who does not work for any insurance company. A public adjuster works for the insured to assist in the preparation, presentation, and settlement of a claim. The insured hires a public adjuster by signing a contract agreeing to pay the public adjuster a fee or commission based on a percentage of the settlement, or another method of compensation.

  • I/We acknowledge that I/We have received a Disclosure Statement as required in the Code of Virginia § 38.2 – 1845.13 (B), and that I/We has read and understands it.

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  • Signatures

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