The Legal Division of the West Virginia Offices of the Insurance Commissioner (“WVOIC”) is responsible for general advice, representation and counsel to the Insurance Commissioner and all associated divisions thereof as well as carrying out many day to day legal responsibilities entrusted to the Insurance Commissioner by the West Virginia Legislature. Click on the links below to view responsibilities:
The Legal Division consults, researches and drafts proposed legislation and rules that are submitted for Legislative approval. Further, the Legal Division drafts workers’ compensation rules that are submitted to the Industrial Council for review and approval. Additionally, Informational Letters and other means of dissemination of policy and legal guidance from the Insurance Commissioner are drafted in the Division.
The Regulatory Compliance Unit of the Legal Division is responsible for reviewing consumer complaints and determining if an administrative hearing should be granted with respect to various issues, including actions under the Unfair Trade Practices Act. The Unit also has investigators who investigate complaints dealing with all aspects of insurance compliance contained in Chapters 33 and 23 of the West Virginia Code. Further, the Unit brings administrative actions against insurance companies and agents who are not in compliance with West Virginia Insurance laws. Civil actions seeking injunctions are also brought against employers who fail to maintain workers' compensation insurance pursuant to the workers' compensation laws.
The Legal Division houses the Market Conduct Unit that performs market wide research and analysis as well as examines insurance entities regulated by the West Virginia Offices of the Insurance Commissioner.
Consumer, Industry and Other Stakeholder Inquiries
While the Legal Division can generally not give legal advice concerning any matter to outside parties, it does endeavor to point inquiries into the appropriate direction where possible.
The Legal Division houses Revenue Recovery which endeavors to seek compliance with employers who have been in default with the West Virginia Code by either failing to obtain workers’ compensation coverage or allowing their coverage to terminate. Revenue Recovery may obtain fines, collect monies owed and enjoin companies in non-compliance.
The Legal Division has attorneys who directly represent the WVOIC in regards to prosecution of fraudulent insurance activity or who provide support in an advisory role with other state and federal prosecutors on similar criminal issues.
Workers' Compensation Privatization
The Legal Division has attorneys who support the “Old Fund” as created by privatization legislation in 2005 as well as open market issues. Assistance includes working with claimants and their counsel, defense counsel, third party administrators in all tribunals and courts including West Virginia Circuit Courts, the Office of Judges, the Board of Review and the West Virginia Supreme Court of Appeals.