The West Virginia Insurance Commission Office of the Inspector General Fraud Unit was established in 2004 by House Bill 4004 and is a criminal justice agency by statute under all federal and state laws and regulations. It authorizes the investigation of suspected violations of the Insurance Code relating to fraud as well as requires the reporting of suspected insurance fraud by licensees, and encourages the reporting by others.
The Office of the Inspector General Fraud Unit is responsible for criminal investigations as it relates to the business of insurance. Insurance Fraud is the intentional and deliberate falsification of information and/or lies and deception for monetary gain and can touch all aspects of insurance including medical fraud, workers compensation fraud, staged accidents, diversion of settlement monies, premium theft, disability scams and falsified claims.
The Office of the Inspector General utilizes many investigative resources to combat insurance fraud and is made up of 25 investigators, 3 West Virginia State Trooper positions and 14 support positions statewide. Investigators hired by the Fraud Unit must have 5 years of law enforcement experience with 2 years of criminal investigative background. All Fraud unit Investigators are armed and can be identified by official issued state employee credentials and badges. The support staff is made up of Intelligence Analysts, Forensic Computer Analyst, Forensic Auditor, Legal and Secretarial staff.
Information in the possession and control of the Fraud Unit is confidential by law and is not subject to public inspection.