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2023 West Virginia Code › Chapter 33. Insurance › Article 6. The Insurance Policy › §33-6-37. Cancellation or Nonrenewal of a Combination Insurance Policy; Offer of Optional Coverage; Date of Inception of Optional Coverage

Notwithstanding of any provision of this chapter to the contrary, an insurer may cancel or nonrenew a combination automobile and homeowners policy of insurance if either the automobile or homeowners insurance in such policy may be cancelled or nonrenewed pursuant to the cancellation or nonrenewal provisions of this chapter pertaining to such insurance: Provided, That the insurer shall offer, on a form approved by the commissioner, to issue a policy of insurance, effective as of the date of cancellation of the combination policy, to the insured for the insurance that was not cancelled or nonrenewed and shall issue such policy if the offer is accepted by the insured. For the purposes of cancellation, nonrenewal and termination of policies provided for in articles six-a and seventeen-a of this chapter, the inception date of a reissued policy is the inception date of the combination policy.
2023 West Virginia Code › Chapter 33. Insurance › Article 6. The Insurance Policy › §33-6-38. Lyme Disease to Be Covered by All Health Insurance Policies

All individual and group health insurance policies providing coverage on an expense-incurred basis and individual and group service or indemnity type contracts issued by a nonprofit corporation shall provide coverage for long-term antibiotic therapy for a patient with Lyme disease when determined to be medically necessary and ordered by a licensed physician after making a thorough evaluation of the patient’s symptoms, diagnostic test results, or response to treatment.
2023 West Virginia Code › Chapter 33. Insurance › Article 6. The Insurance Policy › §33-6-39. Prohibitions Related to Dental Insurance Plans, Agreements, Charges, and Reimbursements; Definitions

(a) For purposes of this section:
"Covered services" means dental care services for which reimbursement is available/ under an enrollees plan contract, or for which reimbursement would be available but for the application of contractual limitations such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximum, frequency limitations, alternative benefit payments, or any other limitation.
"Contractual discount" means a percentage reduction from the providers usual and customary rate for covered dental services and materials required under a participating provider agreement.
"Dental plan" includes any policy of insurance which is issued by a health care service contractor which provides for coverage of dental services not in connection with a medical plan.
"Materials" includes, but is not limited to, any material or device utilized within the scope of practice by a licensed dentist.
(b) No contract of any health care service contractor that covers any dental services, and no contract or participating provider agreement with a dentist may require, directly or indirectly, that a dentist who is a participating provider, provide services to an enrolled participant at a fee set by, or a fee subject to the approval of, the health care services contractor unless the dental services are covered services.
(c) A health care service contractor or other person providing third-party administrator services shall not make available any providers in its dental network to a plan that sets dental fees for any services except covered services.
(d) A dentist may not charge more for services and materials that are noncovered services under a dental benefits policy than his or her usual and customary fee for those services and materials.
(e) Reimbursement paid by a dental plan for covered services and materials shall be reasonable and may not provide nominal reimbursement in order to claim that services and materials are covered services.
(f) This section applies to dental plans, contracts, and participating provider agreements which take effect or are renewed on or after July 1, 2019.
2023 West Virginia Code › Chapter 33. Insurance › Article 6. The Insurance Policy › §33-6-40. Military Service as Factor in Insurance Rates

With respect to any fire, marine, or casualty insurance contract, no person may deny, refuse to renew, cancel coverage, or charge increased premiums for applicants or insureds solely as a result of a uniformed service members performance of active military duty in the United States armed forces or as a member of a reserve component of the United States armed forces, to include the National Guard of a state or territory, because the uniformed service member fails to meet underwriting standards that require continuous coverage unless the failure to maintain continuous coverage existed prior to the applicants or insureds entry into active duty status and was not related in any way to the applicants or insureds military service. For the purposes of this section, service in the National Guard includes any full-time active duty for training in the National Guard, active duty operational support, active duty special work, state active duty as a member of a National Guard unit, or any other periods of service pursuant to Title 32 of the United States Code or active service of the state or territory. For purposes of determining premiums, an insurer shall consider such persons as having maintained continuous coverage.
2023 West Virginia Code › Chapter 33. Insurance › Article 6A. Cancellation or Nonrenewal of Automobile Liability Policies › §33-6A-1a. Loss Payee Defined; Notification of Cancellation and Nonrenewal to Loss Payee

(a) For purposes of this article, a loss payee is defined as the person or persons not a named insured designated on an automobile liability insurance policy contract as being entitled to the proceeds of or payments under such policy.
(b) In every instance in which an insurer notifies an insured of its intent to cancel or not renew an automobile liability insurance contract or policy, the insurer shall also provide notice to the loss payee of such cancellation and nonrenewal in accordance with the same notice requirements established for the insured pursuant to sections one and four of this article.
2023 West Virginia Code › Chapter 33. Insurance › Article 6A. Cancellation or Nonrenewal of Automobile Liability Policies › §33-6A-2. Cancellation for Other Reasons Void

Any purported cancellation by an insurer of a policy of automobile liability insurance which has been in effect for sixty days and which has been renewed shall be void if the purported cancellation is contrary to section one of this article. For purposes of this article, the transfer of an insured between insurance companies within the same group is not considered a cancellation or nonrenewal of an automobile liability insurance policy if the transfer is based upon any valid underwriting reason involving a substantially increased risk associated with the policy.
2023 West Virginia Code › Chapter 33. Insurance › Article 6A. Cancellation or Nonrenewal of Automobile Liability Policies › §33-6A-3. Insurer to Specify Reasons for Cancellation; Immunity From Liability or Suit

In every instance in which a policy or contract of automobile liability insurance which has been in effect sixty days or which has been renewed is canceled by the insurer, the insurer or its duly authorized agent shall, in the notice of cancellation or at the written request of the named insured, specify the reason or reasons relied upon by the insurer for the cancellation. These reasons shall be stated in a written notice and shall, if not provided in the notice of cancellation, be made within thirty days after the request: Provided, That there shall be no liability on the part of, and no cause of action shall arise against, any insurer or its agents or its authorized investigative sources for any statements made with probable cause by the insurer, agent or investigative source in a written notice required to be given pursuant to this section. A notice of cancellation for nonpayment of premium is not void on the grounds that the notice includes the amount of premium due or the date by which payment was to be paid.
2023 West Virginia Code › Chapter 33. Insurance › Article 6A. Cancellation or Nonrenewal of Automobile Liability Policies › §33-6A-4b. Manner of Making Election Relating to Nonrenewals

(a) Each insurer licensed to write automobile liability or physical damage insurance policies in this state, as of July 1, 2004, may elect to issue all nonrenewal notices either pursuant to section four or section four-a of this article. Each insurer may notify the commissioner of its election any time after July 1, 2004, and shall remain bound by the election for a period of five years. For each subsequent five-year period each insurer shall notify the commissioner of its election to issue all nonrenewal notices either pursuant to section four or section four-a of this article.
(1) If no election is made by July 1, 2004, then, until July 1, 2005, the insurer shall continue to issue all nonrenewal notices pursuant to the existing nonrenewal provisions in section four prior to the amendments enacted therein by the acts of the Seventy-Sixth Legislature during the second session, 2004.
(2) As of July 1, 2005, each insurer licensed to write automobile liability or physical damage insurance policies in this state, and that has not previously made an election under this section, shall elect to issue all nonrenewal notices either pursuant to section four or section four-a of this article. Each insurer which has not previously made an election must notify the commissioner of its election no later than July 1, 2005, and shall remain bound by the election for a period of five years. For each subsequent five-year period each insurer shall notify the commissioner of its election to issue all nonrenewal notices either pursuant to section four or section four-a of this article.
(b) An insurer that is not licensed to write automobile liability or physical damage insurance policies in this state, as of July 1, 2004, but becomes licensed to write such policies after that date shall, no later than two years after the date the insurer becomes licensed to write such policies, make an election to issue all nonrenewal notices either pursuant to section four or section four-a of this article, and shall notify the commissioner of its election. If the insurer elects to issue all nonrenewal notices pursuant to section four-a of this article, the total number of nonrenewals may not exceed the percentage limitations set forth in section four-a of this article. An insurer first becoming licensed to issue automobile liability and physical damage insurance policies in this state after July 1, 2004, shall be bound by its election for a period of five years, and for each subsequent five-year period shall notify the commissioner of its election to issue all nonrenewal notices either pursuant to section four or section four-a of this article.
(c) Notwithstanding any provision of this article to the contrary, a named insured by restrictive endorsement may specifically exclude from automobile liability or physical damage insurance policy an operator who has violated the provisions of subdivision (6) or (7), subsection (b), section four of this article.
2023 West Virginia Code › Chapter 33. Insurance › Article 6A. Cancellation or Nonrenewal of Automobile Liability Policies › §33-6A-4c. Report to the Legislature

By January 1, 2009, the commissioner shall submit a report to the Legislature. The report shall contain the following:
(1) An analysis of the impact of legislation enacted during the two thousand four legislative session upon rates and insurance availability in the state;
(2) Statistics reflecting the rate history of insurers conducting business in West Virginia from July 1, 2004, until July 1, 2008.
2023 West Virginia Code › Chapter 33. Insurance › Article 6A. Cancellation or Nonrenewal of Automobile Liability Policies › §33-6A-5. Hearings and Review by Commissioner; Action by Commissioner; Judicial Review

For the implementation of this article and for advising all persons of their rights and privileges under this article, the commissioner, by regulation and in accordance with section thirteen, article two of this chapter, shall establish a procedure whereby any person whose automobile liability insurance policy has been cancelled or whose policy has not been renewed without proper notice being given to such insured, may within forty-five days after the mailing of notice of cancellation or nonrenewal appeal such cancellation or nonrenewal to the commissioner for hearing and review. The appeal and hearing shall relate to the ground or grounds upon which the insurer's action is based. The commissioner after such hearing may affirm the insurer's cancellation or nonrenewal, or may reinstate the policy and if reinstated such policy shall become effective from the date of cancellation or nonrenewal. Either party may appeal the commissioner's ruling to the circuit court of the county in which the applicant or the insured resides in accordance with section fourteen, article two of this chapter.
2023 West Virginia Code › Chapter 33. Insurance › Article 6B. Declination of Automobile Liability Insurance › §33-6B-2. Definitions

"Declination" means either the refusal of an insurer to issue an automobile liability insurance policy upon receipt of a written nonbinding application or written request for coverage from its agent or an applicant. For the purposes of this article, the offering of insurance coverage with a company within an insurance group which is different from the company requested on the nonbinding application or written request for coverage, or the offering of policy coverage or rates substantially less favorable than requested in the nonbinding application or written request for coverage, shall not be considered a declination. Further, for the purposes of this article "declination" shall include the cancellation of an automobile liability policy which has been in effect less than sixty days and the nonrenewal of an automobile liability policy which has been in effect less than two years.
2023 West Virginia Code › Chapter 33. Insurance › Article 6B. Declination of Automobile Liability Insurance › §33-6B-3. Declinations; Prohibited Reasons

The declination of an application for a private passenger policy of automobile liability insurance by an insurer, agent or broker is prohibited if the declination is:
(a) Based upon the race, religion, nationality or ethnic group, of the applicant or named insured;
(b) Based solely upon the lawful occupation or profession of the applicant or named insured, unless the decision is for a business purpose that is not a mere pretext for unfair discrimination: Provided, That this provision does not apply to any insurer, agent or broker that limits its market to one lawful occupation or profession or to several related lawful occupations or professions;
(c) Based upon the principal location of the insured motor vehicle unless the decision is for a business purpose which is not a mere pretext for unfair discrimination;
(d) Based solely upon the age, sex or marital status of an applicant or an insured, except that this subsection does not prohibit rating differentials based on age, sex or marital status;
(e) Based upon the fact that the applicant has previously obtained insurance coverage with a substandard insurance carrier;
(f) Based upon the fact that the applicant has not previously been insured;
(g) Based upon the fact that the applicant did not have insurance coverage for a period of time prior to the application;
(h) Based upon the fact that the applicant or named insured previously obtained insurance coverage through a residual market insurance mechanism;
(i) Based upon the fact that another insurer previously declined to insure the applicant or terminated an existing policy in which the applicant was the named insured;
(j) Based solely upon an adverse credit report or adverse credit scoring.
Nothing in this section may be construed to prohibit an insurer, agent or broker from using legitimate, documented, underwriting data in making their own independent risk assessment of an applicant for insurance.
2023 West Virginia Code › Chapter 33. Insurance › Article 6B. Declination of Automobile Liability Insurance › §33-6B-6. Sanctions

If the commissioner determines in a final order that:
(a) An insurer has violated section three or four of this article, he may require the insurer to:
(1) Accept the application or written request for insurance coverage at a rate and on the same terms and conditions as are available to its other risks with similar characteristics; or
(2) Reinstate insurance coverage to the end of the policy period; or
(3) Continue insurance coverage at a rate and on the same terms and conditions as are available to its other risks with similar characteristics.
(b) Any person has violated any provision of this article, he may:
(1) Issue a cease and desist order to restrain the person from engaging in practices which violate this article;
(2) Assess a penalty against the person of up to $5,000 for each willful and knowing violation of this article.
2023 West Virginia Code › Chapter 33. Insurance › Article 6C. Guaranteed Loss Ratios as Applied to Individual Sickness and Accident Insurance Policies › §33-6C-1. Loss Ratio Guarantees; Definitions

As used in this article:
(a) "Commissioner" means the Insurance Commissioner of West Virginia;
(b) "Experience period" means, for any given rate filing for which a loss ratio guarantee is made, the period beginning on the first day of the calendar year during which the guaranteed rates first take effect and ending on the last day of the calendar year during which the insurer earns $1 million in premiums on the form in West Virginia or, if the annual premium earned on the form in West Virginia is less than $1 million, earns nationally;
(c) "Form" means individual sickness and accident policy forms of any insurer offering such benefits, other than a form for a limited benefits policy or certificate as defined in section two, article sixteen-e of this chapter;
(d) "Loss ratio" means the ratio of incurred claims to earned premium; and
(e) "Successive experience period" means the experience period beginning on the first day following the end of the preceding experience period.
2023 West Virginia Code › Chapter 33. Insurance › Article 6C. Guaranteed Loss Ratios as Applied to Individual Sickness and Accident Insurance Policies › §33-6C-2. Insurance Commissioner to Establish Guaranteed Loss Ratios; Minimum Rates; Participation by Insurer; Calculation of Ratios; Minimum Rate; Application

(a) The Insurance Commissioner shall establish a guaranteed loss ratio which may be implemented by any insurer offering individual sickness and accident insurance policies other than limited benefits accident and sickness insurance policies or certificates, which are subject to loss ratio requirements set forth in sections three and four, article sixteen-e of this chapter. The loss ratios shall be calculated by the commissioner and each individual insurer and shall be based upon studies and relevant information collected from various sources, including, but not limited to, the health care cost review authority and the national association of Insurance Commissioners' rate filing guidelines: Provided, That the guaranteed loss ratio shall not be less than sixty percent. The guaranteed loss ratio for each insurer shall be published by the Insurance Commissioner in the register maintained by the Secretary of State.
(b) The guaranteed loss ratio shall be based upon experience periods during which the insurer earns $1 million in premium in West Virginia: Provided, That if the annual earned premium volume in West Virginia is less than $1 million, the loss ratio guarantee shall be based on such other actuarially sound methods as the commissioner may determine are appropriate, including, but not limited to, the actual nationwide loss ratios: Provided, however, That if the aggregate earned premium for all states is less than $1 million , the experience period will be extended until the end of the calendar year in which $1 million of earned premium is attained.
(c) Any insurer may apply to the commissioner to operate on a guaranteed loss ratio basis. The Insurance Commissioner may review each application and, in his or her discretion, approve or reject the same. Any insurer approved by the commissioner shall be exempt from filing rate increase applications as required by the commissioner and other provisions of this chapter.
2023 West Virginia Code › Chapter 33. Insurance › Article 6C. Guaranteed Loss Ratios as Applied to Individual Sickness and Accident Insurance Policies › §33-6C-3. Duties of Insurance Commissioner; Promulgation of Rules

(a) The Insurance Commissioner shall promulgate rules and regulations pursuant to chapter twenty-nine-a of this code establishing procedures for implementing the provisions of this article.
(b) The commissioner shall have the authority to examine the records and files of any insurer to determine compliance with the provisions of this article, the costs of which such examination shall be borne by the insurer.
(c) The Insurance Commissioner shall develop all forms, contracts or other documents to be used for the purposes outlined in this article.
2023 West Virginia Code › Chapter 33. Insurance › Article 6C. Guaranteed Loss Ratios as Applied to Individual Sickness and Accident Insurance Policies › §33-6C-4. Form of Guarantee; Requirements

(a) Individual sickness and accident policy benefits under a policy form other than a limited benefits policy form or certificate shall be deemed reasonable in relation to the premium charged, as required by subdivision (e), section nine, article six of this chapter, if the premium rates are filed pursuant to a loss ratio guarantee which meets the requirements of this article. The Insurance Commissioner shall not withdraw approval of a form on the grounds that benefits are unreasonable in relation to premiums charged so long as the insurer complies with the terms of the loss ratio guarantee.
(b) Each insurer of individual sickness and accident policy benefits other than benefits under limited benefits policy forms or certificates shall execute and deliver to the Insurance Commissioner a loss ratio guarantee, to be provided by the commissioner, which guarantee shall be signed by an officer of the insurer.
(c) Each loss ratio guarantee shall contain, at a minimum, the following:
(1) A recitation of the anticipated lifetime and durational target loss ratios contained in the original actuarial memorandum filed with the policy form when it was originally approved;
(2) A guarantee that the actual West Virginia loss ratios for the experience period in which the new rates take effect, and for each experience period thereafter until new rates are filed, will meet or exceed the anticipated lifetime and durational target loss ratios contained in the original actuarial memorandum noted above;
(3) A guarantee that the actual West Virginia or, if applicable, national, loss ratio results for the experience period at issue will be independently audited at the insurer's expense; that such audit will be completed in the second quarter of the year following the end of the experience period; and that the results of such audit will be reported to the Insurance Commissioner not later than June 30 following the end of the experience period;
(4) A guarantee that if the actual loss ratio during an experience period is less than the anticipated loss ratio for that period, then West Virginia policyholders will receive a proportional refund based on premium earned, which refunds shall be calculated and paid pursuant to section thirty-nine of this article; and
(5) A guarantee that the insurer does not engage in any discriminatory practices prohibited by section four, article eleven of this chapter or any such practice which discriminates against any individual on the basis of his or her legal occupation, race, religion or residence.
2023 West Virginia Code › Chapter 33. Insurance › Article 6C. Guaranteed Loss Ratios as Applied to Individual Sickness and Accident Insurance Policies › §33-6C-5. Premium Refunds; Calculation of the Same; Payments

(a) Refunds to West Virginia policyholders made pursuant to section four of this article and based upon annual earned premium volume in West Virginia shall be calculated by multiplying the anticipated loss ratio by the applicable earned premium during the experience period and subtracting from that result the actual incurred claims during the experience period.
(b) Refunds to West Virginia policyholders made pursuant to section four of this article and based upon national annual earned premium volume shall be calculated by:
(1) Multiplying the anticipated loss ratio by the applicable earned premium during the experience period and subtracting from that result the actual incurred claims during the experience period; and
(2) Multiplying the results of subsection (1) by the total earned premium during the experience period from all West Virginia policyholders eligible for refunds; and
(3) Dividing the results of subsection (2) by the total earned premium during that period in all states on the policy form.
(c) Refunds must be made to all West Virginia policyholders who are insured under the applicable policy form as of the last day of the experience period. Such refund shall include interest, at the current accident and health reserve interest rate established by the national association of Insurance Commissioners, from the end of the experience period until the date of payment. Payment shall be made during the third quarter of the year following the experience period for which a refund is determined to be due.
(d) Refunds of less than $10 shall be aggregated and held by the insurer in a policyholder's liability fund and shall be used to offset any future rate increases.
2023 West Virginia Code › Chapter 33. Insurance › Article 6C. Guaranteed Loss Ratios as Applied to Individual Sickness and Accident Insurance Policies › §33-6C-6. Disclosure of Rating Practices; Renewability Provisions

Each insurer providing individual sickness and accident policy benefits shall make reasonable disclosure in solicitation and sales materials provided to individuals of the following:
(a) The extent to which premium rates for individuals are established or adjusted according to the claim experience, health status or duration of coverage of the individual or his or her dependents;
(b) Provisions concerning the insurer's right to change premium rates and factors, including case characteristics, which affect changes in premium rates;
(c) A description of the class of insureds to which the individual is or will be included; and
(d) Provisions relating to renewability of coverage.
2023 West Virginia Code › Chapter 33. Insurance › Article 6C. Guaranteed Loss Ratios as Applied to Individual Sickness and Accident Insurance Policies › §33-6C-7. Rejection of Guarantees; Notice; Hearing

(a) The Insurance Commissioner may reject any loss ratio guarantee filed by an insurer within sixty days from the date on which it was filed for any of the following reasons:
(1) The insurer has demonstrated an inability to adequately monitor its loss ratios;
(2) The insurer has failed to take timely rate increases in accordance with sound actuarial principles during the three-year period prior to filing the loss ratio guarantee;
(3) The insurer has not complied with the terms of a previously filed loss ratio guarantee;
(4) The insurer has submitted false, misleading or fraudulent material or information to the commissioner;
(5) The insurer is impaired, insolvent or such other similar financial condition as defined in article ten or any other article of this chapter; or
(6) Such other criteria as the commissioner, by legislative rule or regulation, may determine is appropriate.
(b) The Insurance Commissioner may reject or cancel any loss ratio guarantee filed by an insurer which had been previously approved if, upon review and investigation, the commissioner determines that the insurer has not complied with the provisions of the guarantee or this article.
(c) In the event a newly submitted loss ratio guarantee is rejected, the commissioner shall, within sixty days after the date the loss ratio guarantee was filed, mail notice of the rejection to the insurer. In the event an existing or previously approved loss ratio guarantee is cancelled, the commissioner shall mail notice of the rejection or cancellation to the insurer within fifteen days of the decision to cancel. In either situation, the insurer may, within ten days of being notified of its rejection or cancellation, request a hearing before the commissioner, which hearing shall be held within forty-five days from the date the request is made.
2023 West Virginia Code › Chapter 33. Insurance › Article 6D. Motor Vehicle Repair and Replacement Referrals › §33-6D-1. Required Use of Particular Companies or Locations Providing Automobile Glass Replacement or Repair Services or Products Prohibited

No insurer issuing or renewing in this state any motor vehicle insurance policy, nor any agent or adjuster thereof, may require the insured or any person making a claim under such policy to use a particular company or location to obtain automobile glass replacement or repair services or products insured, in whole or in part, by that policy.
2023 West Virginia Code › Chapter 33. Insurance › Article 6D. Motor Vehicle Repair and Replacement Referrals › §33-6D-2. Intimidation, Coercion and Other Acts Prohibited; Permissive Agreements

No such insurer, agent or adjuster may engage in any act or practice of intimidation, coercion or threat for or against any such insured or claimant to use a particular company or location to obtain automobile glass replacement or repair services or products covered, in whole or in part, by the insurance policy: Provided, That nothing contained in this article shall prohibit an insurer, agent or adjuster from entering into an agreement or arrangement with any company regarding automobile glass prices or services for the repair or replacement of automobile glass.
2023 West Virginia Code › Chapter 33. Insurance › Article 6D. Motor Vehicle Repair and Replacement Referrals › §33-6D-3. Permissible Referrals; Freedom of Choice; Payment of Costs at Prevailing Market Rates

(a) Nothing contained in this article prohibits any insurer, agent or adjuster from providing to an insured or claimant a list that includes the names of automobile glass companies or locations that are reasonably close and convenient to the insured or claimant, and with which the insurer may have made special arrangements with respect to automobile glass prices or services.
(b) If an insurer, agent or adjuster provides an insured or claimant with a list of automobile glass companies or locations, such insurer, agent or adjuster shall advise the insured or claimant that he or she may use any other automobile glass company or location of his or her choice.
(c) All insurers shall fully and promptly pay the cost of automobile glass replacement or repair services or products from any nonlisted automobile glass company or location, less any applicable deductible amount payable by the insured according to the terms of the insurance policy, at no less than the prevailing market price charged by other automobile glass companies or locations providing comparable services or products in the same geographic area within the state.
(d) No automobile glass company or location may waive insurance deductibles or offer rebates, discounts or other incentives for automobile glass repair which is being reimbursed by insurance. An insurer may limit payment of all glass claims to a glass company or location that has violated this provision to the lowest competitive price. The glass company or location may not seek reimbursement for any amounts not paid directly from the insured or claimant.
2023 West Virginia Code › Chapter 33. Insurance › Article 6F. Disclosure of Nonpublic Personal Information › §33-6F-1. Privacy; Rules

(a) No person shall disclose any nonpublic personal information contrary to the provisions of Title V of the Gramm-Leach-Bliley Act, Pub. L. 106-102 (1999).
(b) On or before July 1, 2001, the commissioner shall propose rules for legislative approval in accordance with article twenty, chapter twenty-nine-a of this code necessary to carry out the provisions of Title V of the Gramm-Leach-Bliley Act, Pub. L. 106-102 (1999) and this article.
(c) Medical records and medical billing records obtained by insurers in connection with insurance claims or civil litigation shall be confidentially maintained by insurers in accordance with state and federal law, including the provisions of Title 114, Series 57 of the Code of State Rules, and no additional restrictions or conditions may be imposed that contradict or are inconsistent with any applicable policy of insurance or the performance of insurance functions permitted or authorized by state and federal law. The Insurance Commissioner shall review the provisions of Title 114, Series 57 of the Code of State Rules and, to the extent determined necessary, shall propose new rules or modify existing rules by December 31, 2017 to address:
(1) The circumstances under which an insurance company may disclose medical records and medical billing records to other persons or entities;
(2) The circumstances under which personal identifying information of a person must be redacted before that person’s medical records or medical billing records may be disclosed to other persons or entities;
(3) The steps an insurance company is required to undertake before medical records or medical billing records are disclosed to other persons or entities to assure that any person or entity to which an insurance company is disclosing a person’s medical records or medical billing records will be using such records only for purposes permitted by law; and,
(4) The implementation of the requirement that the insurance company has processes or procedures in place to prevent the unauthorized access by its own employees to a person’s confidential medical records or medical billing records.
2023 West Virginia Code › Chapter 33. Insurance › Article 6F. Disclosure of Nonpublic Personal Information › §33-6F-2. Disclosure of Certain Insurance Information Required

Notwithstanding the provisions of section one of this article:
(a) Each insurer that provides personal lines liability insurance coverage, as that term is defined in section nine, article twelve of this chapter, to pay all or a portion of a claim asserted against an insurance policy insuring a motor vehicle shall provide, within thirty days of its receipt of a written request from a claimant's attorney who has given written notice that he or she represents the claimant:
(1) A response providing the following information relating to each of the insurer's known policies of insurance, including excess or umbrella insurance, which does or may provide liability coverage for the claim:
(A) The name of the insurer;
(B) The name of each named insured of the subject policy; and
(C) The limits of any motor vehicle liability insurance policy at the time of the events that are the subject of the claim; or
(2) The declarations page of any motor vehicle liability policy applicable at the time of the events that are the subject of the claim, appropriately redacted to comply with applicable privacy laws or rules;
(b) Any written request by the claimant's attorney under this section must include:
(1) The date and location of the events that are the subject of the claim;
(2) The name and, if known, the last known address of the insured;
(3) A copy of the accident or incident report, if any;
(4) The insurer's claim number;
(5) A good-faith estimate and documentation of all of the claimant's medical expenses if any and any wage loss documentation as of the date of the request, if any; and
(6) Documentation as of the date of the request of any and all property damage.
(c) Disclosure of the information required by subsection (a) of this section is not an admission that the alleged injury or damage is subject to the policy, nor does the disclosure waive any reservation of rights an insurer may have.
(d) The information disclosed by any party pursuant to this section, by reason of the disclosure, is not admissible as evidence at trial.
(e) An insurer's compliance with this section does not constitute a violation of this article, or subsection (12), section four, article eleven of this chapter.
(f) An insurer that fails to comply with this section is subject to a penalty of $500, plus reasonable attorneys' fees and expenses incurred in obtaining disclosure of the information required by subsection (a) of this section. This penalty is the sole and exclusive remedy for an insurer's failure to comply with this section.
2023 West Virginia Code › Chapter 33. Insurance › Article 7. Assets and Liabilities › §33-7-2. Deductions From Assets and Liabilities

Assets may be allowed as deductions from corresponding liabilities, and liabilities may be charged as deductions from assets, and deductions from assets may be charged as liabilities, in accordance with the form of annual statement applicable to such insurer as prescribed by the commissioner, or otherwise in his discretion.
2023 West Virginia Code › Chapter 33. Insurance › Article 7. Assets and Liabilities › §33-7-3. Assets Not Allowed

In addition to assets impliedly excluded by the provisions of section one of this article, the following expressly shall not be allowed as assets in any determination of the financial condition of an insurer:
(a) Goodwill, trade names and other like intangible assets.
(b) Advances to officers (other than policy loans) whether secured or not, and advances to employees, agents and other persons on personal security only.
(c) Stock of the insurer, owned by it, or any equity therein or loans secured thereby, or any proportionate interest in the stock acquired or held through the ownership by the insurer of an interest in another firm, corporation or business unit.
(d) Furniture, fixtures, furnishings, safes, vehicles, libraries, stationery, literature and supplies, and except, in the case of any insurer, personal property the insurer is permitted to hold pursuant to article eight of this chapter, or which is acquired through foreclosure of chattel mortgages acquired pursuant to said article or which is reasonably necessary for the maintenance and operation of real estate lawfully acquired and held by the insurer other than real estate used by it for home office, branch office and similar purposes.
(e) The amount, if any, by which the aggregate book value of investments as carried in the ledger assets of the insurer exceeds the aggregate value thereof as determined under this chapter.
2023 West Virginia Code › Chapter 33. Insurance › Article 7. Assets and Liabilities › §33-7-4. Reporting Assets Not Allowed or of Doubtful Value

All assets not allowed and all other assets of doubtful value or character included as assets in any statement by an insurer to the commissioner, or in any examiner's report to him shall also be reported, to the extent of the value disallowed, as deductions from the gross assets of such insurer except where the commissioner permits a reserve to be carried among the liabilities of such insurer in lieu of any such deduction.
2023 West Virginia Code › Chapter 33. Insurance › Article 7. Assets and Liabilities › §33-7-5. Liabilities

In any determination of the financial condition of an insurer, capital stock and liabilities to be charged against its assets shall include:
(a) The amount of its capital stock outstanding, if any;
(b) The amount, estimated consistent with the provisions of this chapter, necessary to pay all of its unpaid losses and claims incurred on or prior to the date of statement, whether reported or unreported, together with the expenses of adjustment or settlement thereof;
(c) With reference to life and accident and sickness insurance and annuity contracts:
(1) The amount of reserves on life insurance policies and annuity contracts in force, valued according to the tables of mortality, rates of interest, and methods adopted pursuant to this chapter which are applicable thereto,
(2) Reserves for disability benefits, for both active and disabled lives,
(3) Reserves for accidental death benefits, and
(4) Any additional reserves which may be reasonably required by the commissioner on account of such insurance.
(d) With reference to insurance other than specified in paragraph (c) of this section, the amount of reserves equal to the unearned portions of the gross premiums charged on policies in force, computed in accordance with this article;
(e) Taxes, expenses and other obligations due or accrued at the date of the statement.
2023 West Virginia Code › Chapter 33. Insurance › Article 7. Assets and Liabilities › §33-7-6. Unearned Premium Reserve

(a) With reference to insurance against loss or damage to property (except as provided in paragraph (e) of this section) and with reference to all general casualty insurance, and surety insurance, every insurer shall maintain an unearned premium reserve on all policies in force.
(b) The commissioner may require that such reserves shall be equal to the unearned portions of the gross premiums in force after deducting reinsurance in solvent insurers effected in the manner provided in this chapter as computed on each respective risk from the policy's date of issue.
(c) All of such reserves may be computed, at the option of the insurer, on a yearly or more frequent pro rata basis.
(d) After adopting a method for computing such reserve, an insurer shall not change methods without approval of the commissioner.
(e) With reference to marine insurance, premiums on trip risks not terminated shall be deemed unearned, and the commissioner may require the insurer to carry a reserve thereon equal to one hundred percent on trip risks written during the month ended as of the date of statement.
2023 West Virginia Code › Chapter 33. Insurance › Article 7. Assets and Liabilities › §33-7-7. Reserves for Accident and Sickness Insurance

For all accident and sickness policies the insurer shall maintain an active life reserve which shall place a sound value on its liabilities under such policies and which shall not be less than the reserve according to standards set forth in regulations issued by the commissioner and which,
(a) For credit accident and sickness policies, in no event shall be less than the unearned premium reserve for such policies calculated on the sum of the digits formula, commonly known as the "Rule of 78";
(b) For all other accident and sickness policies, in no event shall be less than the pro rata gross unearned premium reserve for such policies.
2023 West Virginia Code › Chapter 33. Insurance › Article 7. Assets and Liabilities › §33-7-8. Increased Reserves

(a) If the commissioner determines that an insurer's unearned premium reserve, however computed, is inadequate, he may require the insurer to compute such reserve or any part thereof according to such other method or methods as are prescribed in this article.
(b) If the loss experience of an insurer shows that its loss reserves, however estimated, are inadequate, the commissioner shall require the insurer to maintain loss reserves in such increased amount as is needed to make them adequate.
2023 West Virginia Code › Chapter 33. Insurance › Article 7. Assets and Liabilities › §33-7-9a. Annuity Mortality Tables

The commissioner shall propose rules, on or before July 1, 1998, adopting the national association of Insurance Commissioners' model proposal "Recognizing Annuity Mortality Tables For Use In Determining Reserve Liabilities," which incorporates the "Annuity 2000 Mortality Table" and the "1994 Group Annuity Reserving Table."
2023 West Virginia Code › Chapter 33. Insurance › Article 7. Assets and Liabilities › §33-7-10. Valuation of Bonds

(a) All bonds or other evidences of debt having a fixed term and rate of interest held by any insurer may, if amply secured and not in default as to principal or interest, be valued as follows:
(1) If purchased at par, at the par value.
(2) If purchased above or below par, on the basis of the purchase price adjusted so as to bring the value to par at maturity and so as to yield in the meantime the effective rate of interest at which the purchase was made, or in lieu of such method, according to such accepted method of valuation as is approved by the commissioner.
(3) Purchase price shall in no case be taken at a higher figure than the actual market value at the time of purchase, plus actual brokerage, transfer, postage or express charges paid in the acquisition of such securities.
(4) Unless otherwise provided by valuation established or approved by the commissioner, no such security shall be carried at above the call price for the entire issue during any period within which the security may be so called.
(b) The commissioner shall have full discretion in determining the method of calculating values according to the rules set forth in this section: Provided, That no such method or valuation shall be inconsistent with any applicable valuation or method used by insurers in general or any such method then currently formulated or approved by the committee on valuation of securities of the national association of Insurance Commissioners or its successor organization.
2023 West Virginia Code › Chapter 33. Insurance › Article 7. Assets and Liabilities › §33-7-11. Valuation of Other Securities

(a) Securities, other than those referred to in section ten of this article, held by an insurer shall be valued, in the discretion of the commissioner, at their market value, or at their appraised value, or at prices determined by him as representing their fair market value, all consistent with any current method for the valuation of any such security formulated or approved by the commissioner.
(b) Preferred or guaranteed stocks or shares while paying full dividends may be carried at a fixed value in lieu of market value, at the discretion of the commissioner and in accordance with such method of computation as he may approve.
(c) Stock of a subsidiary corporation of an insurer shall not be valued in excess of the net value thereof as based upon those assets only of the subsidiary which would be eligible pursuant to the provisions of this article, and article eight of this chapter, for investment of funds of the insurer directly.
(d) No valuations under this section shall be inconsistent with any applicable valuation or method then currently formulated or approved by the committee on valuation of securities of the national association of Insurance Commissioners or its successor organization.
2023 West Virginia Code › Chapter 33. Insurance › Article 7. Assets and Liabilities › §33-7-12. Valuation of Real Property

(a) In the event of a default real property acquired pursuant to a mortgage loan or contract for sale shall not be valued at an amount greater than the unpaid principal of the defaulted loan or contract at the date of such acquisition, together with any taxes and expenses paid or incurred in connection with such acquisition, and the cost of improvements thereafter made by the insurer and any amounts thereafter paid by the insurer on assessments levied for improvements in connection with the property.
(b) The value of other real property acquired or held by an insurer shall in no event be valued at more than the purchase price. Purchase price includes capitalized permanent improvements, less depreciation as allowed by the current accounting practices and procedures manuals of the national association of Insurance Commissioners. Real property that has been affected by permanent declines in value shall be valued at not more than market value.
2023 West Virginia Code › Chapter 33. Insurance › Article 7. Assets and Liabilities › §33-7-13. Valuation of Mortgages or Deeds of Trust

Mortgages or deeds of trust on real property shall be valued in an amount equal to the unpaid balance but not exceeding sixty- six and two-thirds percent of the fair value of such real property, except that any amount in excess of sixty-six and two- thirds percent may be included to the extent the loan evidenced by such deed of trust or mortgage is guaranteed by an agency of the federal government.