The Commissioner of Insurance is accepting applications from Attorneys and Insurance Adjusters, licensed in the State of Georiga to be arbitrators for the arbitration panel described below.

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To provide procedures for the expeditious and efficient settlement of first-party property damage claims under peronsal private passenger motor vehicle policies the Commissioner of Insurance and Safety Fire can establish a panel for arbitration of disputed property damage claims, where such claims involve total losses. O.C.G.A. § 33-34-8(6); Ga. Comp. R. & Regs. r. 120-2-52-.03(6). The panel of arbitrators shall consist of attorneys authorized to practice law in this State and insurance adjusters licensed to act as such in this State. Any panelists selected under this rule will be chosen from the applications received by the Department.

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Applicants need to complete the attached application and provide:

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- Applicant’s Legal Name - Applicant’s Email Address - Applicant’s Phone Number - Applicant’s Mailing Address - GA Letter of Good Standing (Attorneys) - GA Disciplinary History (Attorneys) - GA License Number and National Producer Number (Adjusters) - Citizenship Affidavit (Form GID-276-GN)

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_____________________________________________ JOHN F. KING INSURANCE AND SAFETY FIRE COMMISSIONER Application for Arbitration Panel The Commissioner of Insurance is accepting applications from licensed Attorneys and Insurance Adjusters licensed in the State of Georgia to establish an arbitration panel for disputes related to disputed property claims, where such claims involve total losses. O.C.G.A.§ 33-34-8(6); Ga. Comp. R & Regs. r. 120-2-52-.03(6).

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The panel of arbitrators shall consist of attorneys authorized to practice law in this State and insurance adjusters licensed to act as such in this State. Attorneys and Adjusters must complete this form and provide the respective documents requested below to be considered under this rule.

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Applicant Type: ☐ Attorney (check one) ☐ Adjuster Legal Name:

Email Address:

Phone Number:

Mailing Address:

GA License Number: (Adjusters only) National Producer Number: (Adjusters only)

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Enclose Required Documents: ☐ GA Letter of Good Standing (Attorneys) (check all that apply) ☐ GA Disciplinary History (Attorneys) ☐ Citizenship Affidavit - Form GID-276-GN (All Applicants)

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Email completed applications and the required supporting document(s) to the Administrative Procedure Division at ArbitrationPanel@oci.ga.gov. Please include “Arbitration Panel Application” in the subject line.