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Introduced Version Senate Bill 545 History

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Key: Green = existing Code. Red = new code to be enacted
Senate Bill No. 545

(By Senators Chafin, Kessler and Hunter)

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[Introduced March 15, 2005; referred to the Committee

on Banking and Insurance; and then to the Committee on Finance.]

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A BILL to amend the Code of West Virginia, 1931, as amended, by adding thereto four new sections, designated §5-3-6, §5-3-7, §5-3-8 and §5-3-9, all relating to the Attorney General generally; creating an Insurance Advocacy Unit in the office of the Attorney General; providing for the appointment of an Insurance Advocate; setting forth the authority of the Insurance Advocate; and providing for the duties of the Insurance Advocate.

Be it enacted by the Legislature of West Virginia:
That the Code of West Virginia, 1931, as amended, be amended by adding thereto four new sections, designated §5-3-6, §5-3-7, §5- 3-8 and §5-3-9, all to read as follows:
ARTICLE 3. ATTORNEY GENERAL.
§5-3-6. Office of Insurance Advocate created; purpose.
The office of Insurance Advocate is hereby established under the authority of and subject to the policies and procedures of the Attorney General.
§5-3-7. Insurance advocacy unit; Insurance Advocate; appointment; term of office; continuation in office of current Insurance Advocate; office space, regulations and reports.

(a) There is hereby created within the agency of the Attorney General the Insurance Advocacy Unit. The unit shall be under the supervision of the Insurance Advocate. The Insurance Advocate shall serve full time and shall be appointed by the Attorney General for a term of four years to coincide with the term of the Attorney General. The Insurance Advocate may be discharged only for failure to carry out the duties of office, malfeasance or nonfeasance in office, or for any other cause which renders him or her ineligible for the office, or incapable or unfit to discharge the duties of the Insurance Advocate's Office or for other good and sufficient cause: Provided, That the current Insurance Advocate shall continue in the position until the Attorney General appoints a new Insurance Advocate. If a vacancy occurs in the position of Insurance Advocate, the vacancy shall be filled for the unexpired term in the same manner as an original appointment.
(b) The Attorney General shall provide office space, equipment and supplies for the office. (c) The Attorney General may promulgate rules, in order to effect the purposes of this section.
(d) On or before the first day of each regular session of the Legislature, the Insurance Advocate shall file with the Governor, the Clerk of the Senate and the Clerk of the House of Delegates, a report detailing the actions taken by the unit in the preceding calendar year.
§5-3-8. Authority of Insurance Advocate; duties; retroactive effect of authority prohibited.

In addition to the authority established under the rules promulgated by the Attorney General the Insurance Advocate is authorized to: (1) Institute, intervene in, or otherwise participate in proceedings in state and federal courts, before administrative agencies, or before the Health Care Authority concerning applications or proceedings before the Health Care Authority or the review of any act, failure to act, or order of the Health Care Authority as an advocate for the public interest and the interest of insurance consumers; (2) At the request of one or more policyholders, or whenever the public interest is served, to advocate for the interests of those policyholders in proceedings arising out of any filing made with the Insurance Commissioner by any insurance company or relating to any complaint alleging an unfair or deceptive act or practice in the business of insurance; (3) Institute, intervene in, or otherwise participate in proceedings in state and federal courts, before administrative agencies, or before the Insurance Commissioner, concerning applications or proceedings before the Commissioner or the review of any act, failure to act, or order of the Insurance Commissioner as an advocate for the public interest and the interest of insurance consumers; (4) Review and compile information, data and studies of the reasonable and customary rate schedules of health care providers and health insurers, for the purposes of reviewing, establishing, investigating, or supporting any policy regarding health care insurance rates; (5) Exercise all the same rights and powers regarding examination and cross-examination of witnesses, presentation of evidence, rights of appeal and other matters as any party in interest appearing before the Insurance Commissioner or the Health Care Authority; (6) Hire consultants, experts, lawyers, actuaries, economists, statisticians, accountants, clerks, stenographers, support staff, assistants, and other personnel necessary to carry out the provisions of this section, which personnel shall be paid from special revenue funds appropriated pursuant to section eight, subsection (b) of this article; (7) Contract for the services of technically qualified persons in the area of insurance matters to assist in the preparation and presentation of matters before the courts, the Insurance Commissioner, administrative agencies, or the Health Care Authority, which persons shall be paid from special revenue funds appropriated for the use of the office;
(8) Make recommendations to the Legislature concerning legislation to assist the office in the performance of its duties; (9) Communicate and exchange data and information with other federal or state agencies, divisions, departments or officers, and with other interested parties including, but not limited to, health care providers, insurance companies, consumers or other interested parties; and
(10) Perform other duties to effect the purposes of this article relating to insurance.
(11) Investigate the legality of all rates, charges, rules, and practices of all persons under the jurisdiction of the Insurance Commission, and institute civil proceedings before any court or administrative agency to correct any illegality on the part of any person. In any investigation, the person acting for the office of the Insurance Advocate shall have the power to ask the Insurance Commissioner to issue subpoenas, compel the attendance and testimony of witnesses, and the production of papers, books and documents;
(12) Make recommendations to the Legislature regarding insurance regulation;
(13) Make recommendations to the Insurance Commissioner or any other governmental agency which has an impact on insurance regulation in the state through rule making and review and, if the Insurance Advocate deems it to be in the public interest, appeal the rule making or contested case decisions of the Insurance Commissioner or other governmental agency which has an impact on insurance regulation in the state;
(14) Represent the interests of the public relating to insurance reform, coverage, and rates where action is necessary for the protection of public rights.
(15) Institute judicial review of final or interlocutory action of the Insurance Division if the review is deemed to be in the public interest.
(16) Appear and participate as a party in the name of the office of the Attorney General on insurance in the performance of the duties of the office.
(b) The provisions of this section do not apply to any filing made by an insurance company, or act or order performed or issued by the Insurance Commissioner, or complaint filed by a policyholder with the Insurance Commissioner prior to the date of enactment of this statute. All proceedings and orders in connection with these prior matters shall be governed by the law in effect at the time of the filing, or performance or issuance of the act or order.
§5-3-8. Office of the Insurance Advocate; employees, expenses.
The Insurance Advocate shall be located within the office of the Attorney General. Administrative support services shall be provided to the Insurance Advocate by the office of the Attorney General.
(a) The salary of the Insurance Advocate shall be fixed by the Attorney General.
(b) The Insurance Commissioner shall make an annual assessment against each insurance company for payment of all reasonable expenditures incurred by the Attorney General in administering the duties of the Insurance Advocate Unit. The assessments shall be in an amount annually determined and certified by the Attorney General to the Insurance Commissioner as sufficient reimbursement for the expenditures of the Attorney General in administering the duties of the Insurance Advocate and shall be proportionately assessed by the Insurance Commissioner against each company.
An insurance company may meet its obligations under this section by directly reimbursing the Attorney General and by notifying the Commissioner of the amount of the payment.
Assessments made pursuant to this section may be credited to the normal operating costs of each company and shall be deposited as general revenue.
Notwithstanding all existing statutory language to the contrary, the role and position of Insurance Advocate is under the exclusive domain of the office of the Attorney General.


NOTE: The purpose of this bill is to establish the position of Insurance Advocate to be appointed by the Attorney General and to be located in the office of the Attorney General. This bill establishes the duties of the Insurance Advocate, provides for the employment of staff by the office of the Attorney General. The bill also sets forth the authority of the Insurance Advocate and it provides for the duties of the Insurance Advocate.

§5-3-6, §5-3-7 and §5-3-8 are new; therefore, strike-throughs and underscoring have been omitted.
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