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LEGAL DIVISION

                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.  Responsibilities include:

LEGISLATION – 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.

ADMINISTRATIVE HEARINGS – The LEGAL DIVISION is responsible for reviewing and ascertaining need for administrative hearings in First and Third Party Unfair Trade Practice issues or other issues as required by the West Virginia Code.  The process is described respectively in W.Va. Code of State R. §114-13-1, et seq. (First & Third Party) & §114-76-1, et seq. (Third Party supplemental rule).

INVESTIGATIONS – The LEGAL DIVISION investigates complaints dealing with all aspects of insurance compliance contained in Chapters 33 and 23 of the West Virginia Code.

MARKET CONDUCT – 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.

REVENUE RECOVERY – 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.

FRAUD PROSECUTION – 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.

 

PLEASE ADDRESS FURTHER QUESTIONS OR INQUIRIES TO:

WVOIC LEGAL DIVISION

Telephone number: (304) 558-0401

Facsimile number: (304) 558-1362

Email address: Legal @wvinsurance.gov

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