West Virginia Code of State Rules Agency 114 - Insurance Commission
West Virginia Code of State Rules Agency 114 – Insurance Commission
Overview
Agency 114 contains the rules that govern the administration, regulation, and enforcement functions of the West Virginia Insurance Commission. This agency oversees the insurance industry within the state to ensure compliance with regulatory standards, protect consumers, and maintain market stability.
Purpose and Scope
To establish clear procedures for licensing, regulating, and monitoring insurance companies, agents, and brokers operating in West Virginia.
To provide guidelines for the fair treatment of policyholders and compliance with insurance regulations.
To define enforcement powers and administrative processes related to insurance matters.
Key Provisions
1. Licensing and Registration
The Commission sets requirements for obtaining and maintaining licenses for insurance companies, agents, brokers, and adjusters.
Application processes, including documentation and fees, are specified.
Grounds for denial, suspension, or revocation of licenses are outlined, including misrepresentation, fraud, or failure to meet financial standards.
2. Financial and Reporting Requirements
Insurers must submit periodic financial statements and reports to the Commission.
The rules detail required formats, deadlines, and auditing standards.
Capital and surplus requirements for insurers are established to ensure solvency.
3. Market Conduct and Consumer Protection
The Commission regulates marketing practices to prevent unfair competition and deceptive advertising.
Procedures for investigating consumer complaints against insurance entities are provided.
Rules include mandates on claims handling, disclosure of policy terms, and fair claims settlement.
4. Rate and Form Filing
Insurers must file insurance policy forms and premium rates with the Commission for approval.
Criteria for acceptance or rejection of filings are specified.
Procedures for public notice and hearings related to rate changes are included.
5. Enforcement and Penalties
The Commission has authority to conduct hearings, issue orders, impose fines, or take corrective actions against violators.
The process for administrative hearings, appeals, and final decisions is laid out.
Violations can lead to sanctions such as license suspension, fines, or cease-and-desist orders.
6. Consumer Information and Education
The Commission may publish educational materials to help consumers understand insurance products and their rights.
Outreach efforts to promote transparency and consumer protection are encouraged.
Administrative Procedures
The rules describe how official notices, communications, and service of process are handled.
Recordkeeping and confidentiality requirements for insurance entities are stated.
The Commission holds regular meetings and hearings to conduct business and enforce regulations.
Summary
Agency 114 provides a comprehensive regulatory framework for the insurance industry in West Virginia. It covers licensing, financial oversight, consumer protection, market conduct, and enforcement actions. The Insurance Commission’s rules are designed to maintain a fair, solvent, and transparent insurance marketplace while protecting the interests of consumers and industry participants alike.
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