reglab/statecodes huggingface dataset:
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-01 - Mine Subsidence Insurance › Appendix C

Current through Register Vol. XLI, No. 28, July 12, 2024
STATE OF WEST VIRGINIA
COAL MINE SUBSIDENCE RATES
EFFECTIVE AUGUST 1, 2021
THE FOLLOWING ANNUAL PREMIUM RATES PER STRUCTURE HAVE BEEN
				  APPROVED BY THE WEST VIRGINIA INSURANCE COMMISSIONER:
AMOUNT OF COAL MINE SUBSIDENCE INSURANCE ON THE
								STRUCTURE
PREMIUM DWELLING STRUCTURE
PREMIUM
NON-DWELLING (1) STRUCTURE
$10,000 or LESS
$5.00
$10.00
$10,001 to $15,000
$6.00
$12.00
$15,001 to $20,000
$7.00
$14.00
$20,001 to $25,000
$8.00
$16.00
$25,001 to $30,000
$9.00
$18.00
$30,001 to $35,000
$10.00
$20.00
$35,001 to $40,000
$11.00
$22.00
$40,001 to $45,000
$12.00
$24.00
$45,001 to $50,000
$13.00
$26.00
$50,001 to $55,000
$14.00
$28.00
$55,001 to $60,000
$15.00
$30.00
$60,001 to $65,000
$16.00
$32.00
$65,001 to $70,000
$17.00
$34.00
$70,001 to $75,000
$18.00
$36.00
$75,001 to $80,000
$19.00
$38.00
$80,001 to $85,000
$20.00
$40.00
$85,001 to $90,000
$21.00
$42.00
$90,001 to $95,000
$22.00
$44.00
$95,001 to $100,000
$23.00
$46.00
$100,001 to $105,000
$24.00
$48.00
$105,001 to $110,000
$25.00
$50.00
$110,000 to $115,000
$26.00
$52.00
$115,001 to $120,000
$27.00
$54.00
$120,001 to $125,000
$28.00
$56.00
$125,001 to $130,000
$29.00
$58.00
$130,001 to $135,000
$30.00
$60.00
$135,001 to $140,000
$31.00
$62.00
$140,001 to $145,000
$32.00
$64.00
$145,001 to $150,000
$33.00
$66.00
$150,001 to $155,000
$34.00
$68.00
$155,001 to $160,000
$35.00
$70.00
$160,001 to $165,000
$36.00
$72.00
$165,001 to $170,000
$37.00
$74.00
$170,001 to $175,000
$38.00
$76.00
$175,001 to $180,000
$39.00
$78.00
$180,001 to $185,000
$40.00
$80.00
$185,001 to $190,000
$41.00
$82.00
$190,001 to $195,000
$42.00
$84.00
$195,001 to $200,000 (2)
$43.00
$86.00
NOTE: (1) A NON-DWELLING STRUCTURE IS DEFINED, FOR RATING
				  PURPOSES, AS A BUILDING THAT IS NOT USED PRINCIPALLY FOR RESIDENTIAL PURPOSES
				  OR WHICH HOUSES MORE THAN FOUR FAMILY UNITS.
(2) $200,000 IS THE MAXIMUM AMOUNT OF INSURANCE REINSURED BY
				  THE WEST VIRGINIA COAL MINE SUBSIDENCE FUND.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-01 - Mine Subsidence Insurance › Appendix D

Current through Register Vol. XLI, No. 28, July 12, 2024
STATE OF WEST VIRGINIA - BOARD OF RISK AND INSURANCE
				  MANAGEMENT
COAL MINE SUBSIDENCE INSURANCE
The following procedures apply to the handling of Coal Mine
				  Subsidence claims:
1) The insured should report the possibility of Coal Mine
				  Subsidence damage directly to the Company or his/her Authorized Agent.
2) Upon notice of a potential Coal Mine Subsidence claim, the
				  Company shall immediately forward a completed ACCORD claim form (or other
				  appropriate Company claim form) to the Board at the address provided on the
				  Board's website at
http://www.brim.wv.gov/
.
In addition to the claim form, the Company is required to
				  furnish the Board with a copy of the policy declaration page or other
				  documentation showing the amount of Coal Mine Subsidence Insurance purchased by
				  the insured applicable to the damaged structure.
3) The board will then assign the claim to an independent
				  adjusting firm for investigation. The adjusting cost of the independent firm
				  will be paid directly by the Board.
4) The adjusting firm will report directly back to the Board
				  with copies of all correspondence to the Company.
5) All payment authorizations will come from the Board. No
				  reinsurance will be available for claims paid by the Company without prior
				  approval from the Board.
6) After the Company has made an authorized payment to its
				  insured, the Company should remit to the Board a copy of the draft and
				  settlement papers, including subrogation receipt, if available, for
				  reimbursement from the West Virginia Coal Mine Subsidence
				  fund.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-02 - Public Entities Insurance Program › Section 115-2-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope. -- This
				rule establishes the procedures for implementing and administering the public
				entities insurance program established pursuant to W. Va. Code §§
									29-12-5(b)
				and
				29-12A-1 et
				seq. The purpose of the program is to provide liability insurance coverage and
				property insurance coverage to eligible and qualified political subdivisions,
				charitable or public service organizations and emergency medical service
				agencies.
1.2. Authority. -- W. Va.
				Code §§
									29-12-5.
1.3. Filing Date. -- April 19,
				2021
1.4. Effective Date. -- May
				1, 2021
1.5. Sunset Provision --
				This rule shall terminate and have no further force and effect on August 1,
				2026.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-02 - Public Entities Insurance Program › Section 115-2-2 - Definitions

Current through Register Vol. XLI, No. 28, July 12, 2024
2.1. "Board" means
				the state board of risk and insurance management.
2.2. "Entity" means the political
				subdivisions, charitable or public service organizations and emergency medical
				service agencies requesting or obtaining liability or property insurance.
2.3. "Fee agreement" means the
				agreement between the entity and producer designating the producer as producer
				of record for the entity and authorizing the board to pay the producer of
				record the commission established in the agreement.
2.4. "Producer" means a person licensed by
				the West Virginia Insurance Commissioner under the laws of West Virginia to
				sell, solicit or negotiate property and casualty insurance.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-02 - Public Entities Insurance Program › Section 115-2-3 - Designation of Producer of Record

Current through Register Vol. XLI, No. 28, July 12, 2024
3.1. An entity may not procure or renew
				insurance through the public entities insurance program unless it does so
				through a producer who has entered into a fee agreement with the entity.
				Failure to comply with this requirement will result in declination of the
				entity's application for coverage or non-renewal of existing
				coverage.
3.2. The board shall
				provide all forms, documents and instructions necessary to apply for coverage
				to the entity's producer of record upon request by the entity or the producer
				of record. The entity and its producer of record are jointly responsible for
				submitting all forms, documents, and underwriting information needed to apply
				for coverage in a manner and within a time period acceptable to the
				board.
3.3. Before the end of
				December during each fiscal year, the board will provide notification to
				producers of record of the date by which the underwriting questionnaire and any
				other information needed for renewal of existing coverage is due for the next
				fiscal year. The notification will be sent at least 45 days prior to the date
				the underwriting questionnaire and other information is due. If the
				underwriting questionnaire or any other information needed for renewal of any
				coverage is not received by the designated date, the board will issue a written
				non-renewal notice informing the entity that coverage will cease on July 1 at
				12:01 AM if the entity fails to take further action.
3.3.1 The non-renewal notice will also
				provide a date by which the underwriting questionnaire or other information
				will still be accepted by the board as a late submission, and will state that
				submission of the underwriting questionnaire or other information after the
				late submission date but before July 1 will result in an assessment of $500.00.
				The board may assess the penalty of $500.00 against any entity that submits the
				needed renewal information after the late submission date provided in the
				non-renewal notice and before July 1.
3.3.2. As stated in the non-renewal notice,
				coverage will cease on July 1 at 12:01 AM for any entity that fails to submit
				the underwriting questionnaire or other information needed for renewal by June
				30 and pay a $500.00 late submission penalty. Should the entity desire to
				procure coverage through the public entities insurance program during the year
				following non-renewal it will be required to apply for coverage as a new entity
				and pay a penalty of $500.00, however, this penalty shall not apply if the
				non-renewal was due to the entity's decision to procure coverage other than
				through the program.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-02 - Public Entities Insurance Program › Section 115-2-4 - Producer's Commission

Current through Register Vol. XLI, No. 28, July 12, 2024
4.1. The
				amount of the producer of record's commission is a matter of agreement between
				the entity and its producer of record and established in the fee agreement.
4.2. The commission may not exceed
				eight percent of the earned annual premium. The earned premium will be computed
				on an annual basis of July 1 of each year to June 30 of the following year. The
				difference between the maximum of eight percent and the producer of record's
				commission shall be credited to the entity's account. Commission is based on
				premium paid by the entity for the policy year. In the event that coverage is
				canceled during the term of the policy, the commission will be based on premium
				paid for the period of time the insurance was in force.
4.3. The entity may change its producer of
				record and/or the amount of commission to be paid to the producer by
				notification to the board and submission of a new fee agreement. Commission
				will be paid to the producer of record annually following the end of the policy
				year for which the producer completed the underwriting questionnaire for the
				entity. Should the entity change its producer of record during a policy year,
				the commission for that policy year will only be paid to the producer who
				completed the underwriting questionnaire for the entity for that policy year.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-02 - Public Entities Insurance Program › Section 115-2-5 - Ineligible Classes

Current through Register Vol. XLI, No. 28, July 12, 2024
5.1. The
				following classes of entities have been determined by the board to be
				ineligible for coverage under W. Va. Code §
									29-12-5(b):
5.1.1. Hospitals - except those owned and
				operated by political subdivisions already insured with the state program, or
				critical access hospitals as specified in W. Va. Code §
										29-12-5(b).
5.1.2. Airports and airport
				authorities.
5.1.3. Churches and
				religious organizations.
5.1.4.
				Country clubs.
5.1.5. Homeowners
				associations.
5.1.6. Lobbying
				organizations.
5.1.7. Political
				organizations.
5.1.8. Any "for
				profit" organizations, except emergency medical service agencies as specified
				in W. Va. Code §
										29-12-5(b).
				"For profit" organizations includes any for profit organization that may be
				owned in full or in part by an otherwise eligible entity.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-02 - Public Entities Insurance Program › Section 115-2-6 - Rates and Coverages

Current through Register Vol. XLI, No. 28, July 12, 2024
6.1. The
				board shall determine and establish rates, rate programs, deductibles, and
				coverages as needed.
6.2. An
				entity may procure liability insurance through the public entities insurance
				program without also procuring property insurance. However, property insurance
				may only be procured if the entity also procures liability insurance through
				the public entities insurance program.
6.3. The board's administrative costs
				associated with operation of the public entities insurance program will be
				included in the actuarial model for determination of premium due from insured
				entities.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-02 - Public Entities Insurance Program › Section 115-2-7 - Cancellation and Nonrenewal Provisions

Current through Register Vol. XLI, No. 28, July 12, 2024
7.1. The board may cancel or non-renew an
				entity's insurance coverage for any of the following reasons:
7.1.1 The entity's failure to make a premium
				payment within thirty (30) days of the premium due date;
7.1.2. Fraud or substantial misrepresentation
				by the entity or a representative of the entity procuring or renewing the
				insurance coverage or in presenting a claim under the insurance coverage;
7.1.3. A substantial increase in
				the risk of loss to which the public entity insurance program is exposed under
				the policy, including, but not limited to, the following:
7.1.3.a The conviction of the entity or any
				officer, employee, or volunteer of the entity of any crime having as one of its
				necessary elements an act increasing any hazard insured against;
7.1.3.b. Discovery of willful or reckless
				acts or omissions on the part of any officer, employee or volunteer of the
				entity which substantially increases any hazard insured against;
7.1.3.c. The occurrence of a change in the
				risk which substantially increases any hazard insured against after insurance
				coverage has been issued or renewed;
7.1.3.d. The entity has a loss ratio
				exceeding one hundred percent in at least three of the past five years in the
				program;
7.1.3.e. The entity's
				violation of any local fire, health, safety, building or construction
				regulation or ordinance with respect to any insured property or the occupancy
				thereof which substantially increases any hazard insured against;
7.1.4. The entity violates any of
				the material terms or conditions of the insurance coverage or the public entity
				insurance program; or
7.1.5. The
				entity no longer qualifies for participation in the public entity insurance
				programs administered by the board.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-03 - Administrative Regulations of State Board of Risk and Insurance Management › Section 115-3-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope. --
				These rules establish procedures for the general administration of the state
				board of risk and insurance management and to assist interested persons dealing
				with the agency.
1.2. Authority. --
				W.Va. Code §
									29-12-5.
1.3. Filing Date. - August 18,
				2020.
1.4. Effective Date. -
				September 18, 2020.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-03 - Administrative Regulations of State Board of Risk and Insurance Management › Section 115-3-2 - Definitions

Current through Register Vol. XLI, No. 28, July 12, 2024
2.1. "Chairperson"
				means the member elected to be the presiding officer at Board meetings and to
				control discussion on each item of the agenda.
2.2 "Agency" means the state agency known as
				the West Virginia Board of Risk and Insurance Management created pursuant to W.
				Va. Code §
									20-12-1,
et. seq
.
2.3. "The
				Board" means those individuals appointed by the Governor pursuant to W. Va.
				Code §
									29-12-1.
2.4 "Meeting" means the convening
				of the Board for which a quorum is required in order to make a decision or to
				deliberate toward a decision on any matter. Any subcommittee meeting shall meet
				the definition of "meeting" for those members required to attend the
				subcommittee meeting.
2.5. "Quorum"
				means the presence of three voting members of the Board.
2.6. "Hearing Examiner" means the person
				engaged by the Director to conduct a hearing.
2.7. "Hearing" means any proceeding under
				authority granted to the agency by law and held in accordance with these rules,
				in the absence of any other applicable rules relating a specific type of
				hearing or proceeding before the agency.
2.8. "Director" means the executive director
				of the West Virginia Board of Risk and Insurance Management.
2.9. "Person" means any individual or
				business organization.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-03 - Administrative Regulations of State Board of Risk and Insurance Management › Section 115-3-3 - Administration

Current through Register Vol. XLI, No. 28, July 12, 2024
3.1. The Board may
				utilize any management and staff of the agency as needed to accomplish its
				duties under this rule, which may include at a minimum preparation of agendas,
				public filing requirements, and any responsibilities relating to administrative
				hearings.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-03 - Administrative Regulations of State Board of Risk and Insurance Management › Section 115-3-5 - Settlement of Claims

Current through Register Vol. XLI, No. 28, July 12, 2024
5.1. The
				Board is hereby authorized and empowered to negotiate and effect settlement of
				any and all insurance claims arising on or incident to losses of and damages to
				state properties, activities and responsibilities.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-04 - Discontinuation Of Professional Malpractice Insurance › Section 115-4-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope. -- This
				Legislative Rule provides for the discontinuation of the professional
				malpractice insurance program provided by W. Va. Code '29-12-5c, as amended by
				House Bill 4151, enacted March 10, 1990.
1.2. Authority. -- W. Va. Code '29-12-5c.
1.3. Filing Date. -- April 13, 1992
1.4. Effective Date. -- April 14,
				1992
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-04 - Discontinuation Of Professional Malpractice Insurance › Section 115-4-2 - Authority

Current through Register Vol. XLI, No. 28, July 12, 2024
Pursuant to W. Va. Code '29-12-5c, if
				  participation in the professional malpractice insurance program is insufficient
				  to make the program economically feasible, then the program may be discontinued
				  by rules and regulations promulgated by the Board of Risk and Insurance
				  Management with approval of the Insurance Commissioner.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-04 - Discontinuation Of Professional Malpractice Insurance › Section 115-4-3 - Findings

Current through Register Vol. XLI, No. 28, July 12, 2024
3.1. Survey. -- To
				determine the level of participation to be expected and the appropriate premium
				charge, on June 15, 1990 the Board of Risk and Insurance Management mailed the
				attached survey to 691 obstetricians, obstetricians/gynecologists and family
				practitioners. The survey was also mailed by the West Virginia Hospital
				Association to its members for emergency room practitioners to
				complete.
3.2. Survey Results. --
				The attached survey results show that of the 691 plus medical practitioners
				surveyed, 509 did not respond or did not complete the survey. In particular,
				question #5 of the survey, asking if the practitioner would participate in a
				State liability program, was not answered. Of the 182 practitioners responding
				to question #5, only 65 indicated that they would participate in either an
				excess or primary liability program. Furthermore, at least twenty percent (20%)
				of the 65 responding in the affirmative to question #5 are already insured by
				the Board of Risk and Insurance Management, either as a State employee or an an
				employee of a non-profit clinic insured through the Public Entities Insurance
				Program.
3.3. Approval by Insurance
				Commissioner. -- Following a review of the survey, the Insurance Commissioner
				approved the discontinuation of the professional malpractice insurance program.
				The letter of approval is attached.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-04 - Discontinuation Of Professional Malpractice Insurance › Section 115-4-4 - Discontinuation of the Program

Current through Register Vol. XLI, No. 28, July 12, 2024
Pursuant to W. Va. Code '29-12-5c, the Board of
				  Risk and Insurance Management, with the approval of the Insurance Commissioner,
				  hereby discontinues the professional malpractice insurance
				  program.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-05 - Procedure for Providing Written Notification of Claims of Potential Liability to the State or its Employees (Repealed) › Section 115-5-1 - General (Repealed)

Current through Register Vol. XLI, No. 28, July 12, 2024
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-05 - Procedure for Providing Written Notification of Claims of Potential Liability to the State or its Employees (Repealed) › Section 115-5-2 - Purpose (Repealed)

Current through Register Vol. XLI, No. 28, July 12, 2024
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-05 - Procedure for Providing Written Notification of Claims of Potential Liability to the State or its Employees (Repealed) › Section 115-5-3 - Definitions (Repealed)

Current through Register Vol. XLI, No. 28, July 12, 2024
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-05 - Procedure for Providing Written Notification of Claims of Potential Liability to the State or its Employees (Repealed) › Section 115-5-4 - Reporting Requirements (Repealed)

Current through Register Vol. XLI, No. 28, July 12, 2024
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-06 - Preferred Medical Liability And High Risk Medical Liability Program › Section 115-6-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope. --
				These rules and regulations are to be applied to implement, clarify and/or
				explain the administration of the preferred Medical Liability Program and the
				High Risk Medical Liability Program. The purpose of the program is to assist in
				making Professional Liability Insurance available for certain necessary health
				care providers in West Virginia to assure that quality medical care is
				available for the citizens of the State.
1.2. Authority. -- W. Va. Code §
									29-12-5(c)
				(2) (N).
1.3. Filing Date. -- March 27,
				2002.
1.4. Effective Date. -- March
				27, 2002.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-06 - Preferred Medical Liability And High Risk Medical Liability Program › Section 115-6-2 - Definitions

Current through Register Vol. XLI, No. 28, July 12, 2024
2.1. "Board" means
				the state of board of risk and insurance management.
2.2. "Health Care Provider" means a person
				licensed by his or her respective Board to practice medicine in this state as a
				medical doctor or an osteopath or a podiatrist, pharmacist, registered nurse
				holding an advanced practice announcement, a physician's assistant, a dentist,
				a physical therapist, a chiropractor, a professional limited liability company
				or medical corporation, an association, partnership or other entity organized
				for the purpose of rendering professional services by persons who are health
				care providers, a hospital medical clinic, psychiatric hospital, or other
				medical facility authorized by law to provide professional medical services or
				such other health care provider as the Board may from time to time approve. A
				"health care provider" does not include any provider of professional medical
				services that has Medical Malpractice Insurance pursuant to article twelve of
				Chapter Twenty-Nine (29).
2.3.
				"Sexual Acts" means that sexual conduct which constitutes a criminal or
				tortious act under the laws of West Virginia.
2.4. "Prior acts" coverage means coverage for
				claims arising out of the providing of medical services, including medical
				treatment, which are first reported to the board during the effective policy
				period, but which occurred on or after the retroactive date reported in the
				policy declarations.
2.5. "High
				risk" means the probability of loss is greater than average based on criteria
				specified in W.Va. Code §
									29-12B-9
				and established by the board.
2.6.
				"Retroactive date" means the date designated in the policy declarations, before
				which coverage is not applicable.
2.7. "Tail coverage" or "extended reporting
				coverage" is coverage that protects the health care provider against all claims
				arising from professional services performed while the claims-made policy was
				in effect and included in the policy but reported after the termination of the
				policy.
2.8. The "preferred medical
				liability program and the high risk medical liability program" is also known as
				the "West Virginia Health Care Provider Professional Liability Insurance
				Availability Act."
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-06 - Preferred Medical Liability And High Risk Medical Liability Program › Section 115-6-4 - Miscellaneous Provisions

Current through Register Vol. XLI, No. 28, July 12, 2024
4.1.
				Administration of Claims. The board may implement such policies and procedures
				for the administration of all claims as against the preferred medical liability
				program and the high risk medical liability program.
4.2. Designation of Agents. The board may
				implement such policies and procedures for the use and commissions of
				designated agents, if any, for the procurement of insurance.
4.3. Settlement of Claims. The board may
				implement such policies and procedures as needed to negotiate and effect
				settlement of any and all insurance claims arising from losses or damages under
				the preferred medical liability program or the high risk medical liability
				program. The execution and delivery and settlement of claims and releases, need
				not be done with the consent of either the insured or the knowledge and consent
				of the Attorney General.
4.3.a. The board is
				hereby authorized and empowered to negotiate and effect settlement of any and
				all insurance claims arising from the insurance coverage afforded by the West
				Virginia Health Care Provider Professional Liability Availability Act [W. Va.
				Code §
										29-12B-1
				et seq.].
4.3.b. The Executive
				Director, or his designees, shall have the authority to issue a written
				settlement determination on behalf of the board and/or to approve payment of
				judgments or settlements under this program after receipt and review of one of
				the following:
4.3.b.1. A certified copy of a
				final judgment against a health care provider insured by either of the medical
				liability programs created pursuant to the act;
4.3.b.2. A certified copy of an order
				approving settlement in a summary proceeding; or
4.3.b.3. Appropriate documentation that
				justifies the proposed settlement.
4.3.c. The form and substance of what
				constitutes "a written settlement determination" shall be developed by, and at
				the discretion of, the Executive Director.
4.3.d. All payments in satisfaction of any
				settlement or judgment shall be in accordance with established board policies
				and procedures.
4.3.e. If claim
				payments are issued by way of a check or draft drawn on an account issued to
				the State of West Virginia, payment shall be deemed to have been made at the
				time a request for issuance of a state check or draft is made by or on behalf
				of the board notwithstanding the length of time required for actual issuance of
				the check or draft.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-07 - Patient Injury Compensation Fund › Section 115-7-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope -- This
				rule governs the implementation, administration and operation of the patient
				injury compensation fund, established by W. Va. Code §
									29-12D-1
				et seq. by the state board of risk and insurance management.
1.2. Authority. -- W. Va. Code §
									29-12D-2(a)(6).
1.3. Filing Date. -- April 24,
				2017.
1.4. Effective Date. -- May
				1, 2017.
1.5. Sunset Provision:
				This rule shall terminate and have no further force or effect on May 1,
				2022.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-07 - Patient Injury Compensation Fund › Section 115-7-2 - Purpose

Current through Register Vol. XLI, No. 28, July 12, 2024
Subject to applicable limitations, the purpose of the patient
				  injury compensation fund is to provide fair and reasonable compensation to
				  qualified claimants in medical professional liability actions for economic
				  damage awards that are uncollectible because of statutory limitations on the
				  recovery of economic damages.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-07 - Patient Injury Compensation Fund › Section 115-7-4 - Patient Injury Compensation Fund

Current through Register Vol. XLI, No. 28, July 12, 2024
The fund shall be operated as a fund of last resort. Payment
				  by the fund to a qualified claimant for uncollectible economic damages may be
				  made only when all insurance coverages have been exhausted.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-07 - Patient Injury Compensation Fund › Section 115-7-5 - Fund Administration

Current through Register Vol. XLI, No. 28, July 12, 2024
5.1.
				The director may employ or contract for personal, professional or consulting
				services regarding the administration, operation and defense of the fund and
				for services necessary or advisable to implement the authority and discharge
				the responsibilities imposed on the board by the act, including, but not by way
				of limitation:
5.1.a. Retaining the services
				of a qualified, competent, independent consulting actuary to advise and consult
				with the agency on all aspects of the fund's administration, operation, and
				defense which require application of actuarial science and to perform and
				submit an annual actuarial study;
5.1.b. Employing or contracting with legal
				counsel to advise and represent the agency and represent the fund in matters
				relating to the operation of the fund or payment from the fund. Legal counsel
				may assist in the investigation of the claim for compensation and whether all
				applicable insurance in the underlying action has been exhausted;
5.1.c. Retaining the services of a qualified
				independent auditor to conduct an annual audit of the fund. The annual audit
				may be conducted as part of the annual fiscal year-end audit of the other
				programs administered by the agency; and
5.1.d. Retaining the services of qualified
				experts in the fields of accounting, economics, medicine, life care planning,
				or other field or fields relevant to one or more claims.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-07 - Patient Injury Compensation Fund › Section 115-7-6 - Payment of Compensation

Current through Register Vol. XLI, No. 28, July 12, 2024
6.1.
				If the agency's fund's actuary determines that the fund is actuarially sound
				and fully funded, or otherwise sufficiently funded to make payments to eligible
				claimants using any of the methods set forth in this section, the agency may,
				but is not required to, make a payment or payments out of the fund to a
				qualified claimant following a judgment or settlement of a claim arising under
				the medical professional liability act.
6.2. The agency, in exercising its discretion
				regarding payments to eligible claimants following judgment or settlement of a
				claim, shall determine whether a payment from the fund to a qualified claimant
				is in the best interests of the fund and other claimants. In making this
				determination the agency may consider the following:
6.2.a. The current actuarial soundness of the
				fund;
6.2.b. The sufficiency and
				strength of the proof in the claim settlement or the underlying medical
				professional liability civil action establishing the following:
6.2.b.1. Legal liability under the medical
				professional liability act;
6.2.b.2. The fault of the respective
				responsible persons;
6.2..b.3. The
				exhaustion of all reasonable means to recover from all available insurance and
				collateral sources;
6.2.c. Any other matter deemed relevant by
				the agency, including but not limited to the total amount of awards that become
				final in a fiscal year. The agency reserves the right to fully investigate all
				relevant issues prior to reaching a determination.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-07 - Patient Injury Compensation Fund › Section 115-7-8 - Initial Review and Determination

Current through Register Vol. XLI, No. 28, July 12, 2024
8.1. The director shall appoint an
				application review committee, consisting of three individuals, including an
				agency claims manager or assistant claims manager, and two other managerial or
				professional employees or contractors.
8.2. Upon receipt of an application for
				compensation, the application review committee shall undertake an evaluation,
				investigation and review of the application for compensation.
8.3. Based upon its review, analysis and
				investigation, the application review committee shall make a written
				recommendation to the executive review committee whether payment should be made
				from the fund and the amount of payment to be made from the fund consistent
				with the award in the underlying medical liability action, the evidence, the
				applicable law, and the purpose and best interests of the fund.
8.4. The application review committee shall
				determine on the basis of evidence presented to it or gathered by it, the
				following matters:
8.4.a. Whether the
				claimant is a qualified claimant;
8.4.b. Whether the petition for compensation
				was filed in accordance with the act and these rules;
8.4.c. Whether there has been an award of
				economic damages as a result of a medical injury in a civil action filed under
				the medical professional liability act;
8.4.d. Whether the claimant has
				satisfactorily established that he or she has exhausted all reasonable means to
				recover economic damages from all applicable liability insurance, including
				pursuing all available legal means to determine applicability and availability
				of liability insurance coverages from all responsible persons;
8.4.e. The portion of the economic damages
				awarded that is uncollectible as a result of the statutory limitations on
				recovery of economic damage.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-07 - Patient Injury Compensation Fund › Section 115-7-9 - Executive Review Committee

Current through Register Vol. XLI, No. 28, July 12, 2024
9.1. The board shall appoint an executive
				review committee, consisting of three individuals, one of whom shall be the
				director. The other two individuals shall be a professional and an agency
				claims manager.
9.2. The executive
				review committee shall meet upon call of the director or chairperson of the
				board to review the recommendations of the application review
				committee.
9.3. The executive
				review committee may adopt, modify, remand or reject the recommendations of the
				application review committee. The executive review committee shall provide the
				reason or reasons for modification, rejection or remand of a recommendation of
				the application review committee. On remand, the application review committee
				shall reconsider its recommendation and address the issues identified by the
				executive review committee.
9.4. If
				the recommendation of the application review committee is accepted by the
				executive review committee, notice of the determination shall promptly be sent
				to the claimant or his or her authorized representative stating with reasonable
				specificity the grounds for the determination. The notice shall be sent by
				certified mail, return receipt requested.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-07 - Patient Injury Compensation Fund › Section 115-7-10 - Administrative Appeal

Current through Register Vol. XLI, No. 28, July 12, 2024
10.1.
				Claimant aggrieved by the determination of the executive review committee may
				appeal the decision to the board within thirty (30) days of receipt of the
				determination for an administrative hearing as provided in the administrative
				hearing rules promulgated by the board.
10.2. At the hearing, BRIM and the claimant,
				or their counsel, shall be afforded an opportunity to review the evidence, to
				cross-examine the witnesses, and present testimony and enter evidence in
				support of the parties' respective positions.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-07 - Patient Injury Compensation Fund › Section 115-7-11 - Judicial Appeal of Final Decision

Current through Register Vol. XLI, No. 28, July 12, 2024
A claimant adversely affected by a final administrative order
				  or decision of the board, pursuant to section 11 of this rule, has the right to
				  appeal the decision to circuit court pursuant to W. Va. Code §
									29A-5-4,
				  and may request, at his or her expense, a transcript of the administrative
				  hearing.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-07 - Patient Injury Compensation Fund › Section 115-7-12 - Confidentiality of Information

Current through Register Vol. XLI, No. 28, July 12, 2024
To the extent required by law or by court order, the agency
				  shall maintain as confidential and exempt from disclosure personal or medical
				  information regarding the claimant. The agency may maintain as exempt from
				  disclosure, to the extent permitted by law, its internal
				  memoranda.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-07 - Patient Injury Compensation Fund › Section 115-7-13 - Attorneys' Fees

Current through Register Vol. XLI, No. 28, July 12, 2024
If the board determines that the fund is actuarially sound,
				  the board may authorize the payment out of the fund for the reasonable
				  attorneys' fees of qualified claimants receiving
				  compensation.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-07 - Patient Injury Compensation Fund › Section 115-7-14 - Confidentiality of Information

Current through Register Vol. XLI, No. 28, July 12, 2024
To the extent required by law or by court order, the agency
				  shall maintain as confidential and exempt from disclosure personal or medical
				  information regarding the claimant. The agency may maintain as exempt from
				  disclosure, to the extent permitted by law, its internal
				  memoranda.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-08 - Administrative Appeal Hearing Rules For The Patient Injury Compensation Fund › Section 115-8-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope. --
				These rules are established for conducting all administrative appeal hearings
				requested of the Patient Injury Compensation Fund (PICF).
1.2. Authority. -- W. Va. Code §§
									29-12D-2(a)(6);
				29-12D-3(c);
				29-12D-3(f);
				29-12D-3(g).
1.3. Filing Date. -- March 14,
				2011.
1.4. Effective Date. -- April
				14, 2011.
1.5. Definitions.
1.5.a. "BRIM" means the state Board of Risk
				and Insurance Management.
1.5.b.
				"Claimant" means the person submitting an application for compensation from the
				patient injury compensation fund created by W. Va. Code §
										29-12D-1(a),
				and is both a "patient" and a "plaintiff" as those terms are defined in the
				medical professional liability insurance act found in W. Va. Code §55-7B
				as amended.
1.5.c. "Economic
				damages" means those special damages which are reduced to an actual dollar
				amount that can be presented to a jury in an action brought under the medical
				professional liability act to compensate a plaintiff for the monetary costs of
				a medical injury, such as lost earning, past and future medical care and
				rehabilitation services. Economic damages do not include non-economic damages,
				such as pain and suffering, or hedonic damages, court costs, post-judgment
				interest, attorneys' fees, extra-contractual damages, or punitive
				damages.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-08 - Administrative Appeal Hearing Rules For The Patient Injury Compensation Fund › Section 115-8-2 - Administration

Current through Register Vol. XLI, No. 28, July 12, 2024
2.1. The
				administrative appeal hearing shall be conducted in accordance with the
				provisions of W. Va. Code §
									29A-5-1,
				et seq. The hearing may be conducted by the Executive Director of BRIM or a
				hearing officer appointed by the Executive Director.
2.2. The Executive Director of BRIM or his
				designee shall provide the claimant with written notice stating the time and
				place of a hearing. The claimant shall appear to show cause why the claimant is
				entitled to his/her claims of economic damages. At the hearing, BRIM and the
				claimant shall be afforded an opportunity to review the evidence, to
				cross-examine the witnesses, and present testimony and enter evidence in
				support of the parties' respective position.
2.3. The Executive Director or hearing
				officer has the power to subpoena witnesses, papers, records, documents and
				other data and things in connection with the proceeding under this subsection
				and to administer oaths or affirmations in the hearing.
2.4. If the Executive Director appoints a
				hearing officer to conduct an administrative appeal hearing, upon conclusion of
				the hearing, the hearing officer shall provide a Recommended Decision of
				findings of fact and conclusions of law to the Executive Director.
				Subsequently, the Executive Director shall determine whether the claimant is
				entitled to his/her claims of economic damages by issuing a final order. The
				Executive Director may adopt, approve, modify, revise, reject, or remand the
				hearing examiner's Recommended Decision of findings of fact and conclusions of
				law. The final order shall be mailed to the claimant by certified mail, return
				receipt requested.
2.5. If the
				Executive Director conducts the administrative appeal hearing, after reviewing
				the record of the hearing, the Executive Director shall determine whether the
				claimant is entitled to his/her claims of economic damages. The Executive
				Director shall issue a final order setting forth findings of fact and
				conclusions of law in support of the decision. The final order shall be mailed
				to the claimant by certified mail, return receipt requested.
2.6. Any appeal by the claimant shall be
				brought in accordance with the provisions of W. Va. Code §
									29A-5-4.
				The scope of the court's review of the final order shall be as provided in W.
				Va. Code §
									29A-5-4.
				If the claimant does not appeal the final order within thirty days, it is
				final.
West Virginia Code of State Rules › Agency 115 - Risk And Insurance Management › Title 115 - LEGISLATIVE RULES STATE BOARD OF RISK AND INSURANCE MANAGEMENT › Series 115-09 - Procurement › Section 115-9-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope. -- This procedural rule is an
				explanation and clarification of procedures for the purchase of commodities,
				services, and insurance products and insurance services relating to insurance
				on state properties, activities, and responsibilities, and purchases related to
				the State Privacy Office, by the West Virginia Board of Risk and Insurance
				Management.
1.2. Authority. - W.
				Va. Code, §§
									5A-1-12,
				29-12-5,
				and
				29-12-8.
1.3. Filing Date. -August 18, 2020.
1.4. Effective Date. - September 18,
				2020.