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Chapter 33     Entire Code
‹ Chapter 32B  |  Chapter 34 › Printer Friendly Versions
Chapter 33  |  Article 33 - 13D

1 - DEFINITIONS

2 - INSURANCE COMMISSIONER

3 - LICENSING, FEES AND TAXATION OF

3A - STATE OF ENTRY FOR FOREIGN INS

4 - GENERAL PROVISIONS

4A - ALL-PAYER CLAIMS DATABASE

5 - ORGANIZATION AND PROCEDURES OF

6 - THE INSURANCE POLICY

6A - CANCELLATION OR NONRENEWAL OF

6B - DECLINATION OF AUTOMOBILE LIAB

6C - GUARANTEED LOSS RATIOS AS APPL

6D - MOTOR VEHICLE REPAIR AND REPLA

6F - DISCLOSURE OF NONPUBLIC PERSON

7 - ASSETS AND LIABILITIES

8 - INVESTMENTS

8A - USE OF CLEARING CORPORATIONS A

9 - ADMINISTRATION OF DEPOSITS

10 - REHABILITATION AND LIQUIDATIO

11 - UNFAIR TRADE PRACTICES

11A - INSURANCE SALES CONSUMER PRO

12 - INSURANCE PRODUCERS AND SOLIC

12A - CONTRACTUAL RELATIONSHIPS BE

12B - ADJUSTERS

12C - SURPLUS LINE

13 - LIFE INSURANCE

13A - VARIABLE CONTRACTS

13B - CHARITABLE GIFT ANNUITIES

13C - VIATICAL SETTLEMENTS ACT

13D - UNCLAIMED LIFE INSURANCE BEN
    33 - 13 D- 1
    33 - 13 D- 2

14 - GROUP LIFE INSURANCE

15 - ACCIDENT AND SICKNESS INSURAN

15A - WEST VIRGINIA LONG-TERM CARE

15B - UNIFORM HEALTH CARE ADMINIST

15C - DIABETES INSURANCE

15D - INDIVIDUAL LIMITED HEALTH BE

15E - DISCOUNT MEDICAL PLAN ORGANI

16 - GROUP ACCIDENT AND SICKNESS I

16A - GROUP HEALTH INSURANCE CONVE

16B - ACCIDENT AND SICKNESS RATES

16C - EMPLOYER GROUP ACCIDENT AND

16D - MARKETING AND RATE PRACTICES

16E - CONTRACEPTIVE COVERAGE

16F - GROUP LIMITED HEALTH BENEFIT

16G - WEST VIRGINIA HEALTH BENEFIT

16H - REVIEW OF ADVERSE DETERMINAT

17 - FIRE AND MARINE INSURANCE

17A - PROPERTY INSURANCE DECLINATI

18 - CASUALTY INSURANCE

19 - SURETY INSURANCE

20 - RATES AND RATING ORGANIZATION

20A - WEST VIRGINIA ESSENTIAL INSU

20B - RATES AND MALPRACTICE INSURA

20C - CANCELLATION OR NONRENEWAL O

20D - TAIL INSURANCE

20E - WEST VIRGINIA MEDICAL PROFES

20F - PHYSICIANS' MUTUAL INSURANCE

21 - RECIPROCAL INSURERS

22 - FARMERS' MUTUAL FIRE INSURANC

23 - FRATERNAL BENEFIT SOCIETIES

24 - HOSPITAL SERVICE CORPORATIONS

25 - HEALTH CARE CORPORATIONS

25A - HEALTH MAINTENANCE ORGANIZAT

25B - FEDERAL INSURANCE SUBSIDY FO

25C - HEALTH MAINTENANCE ORGANIZAT

25D - PREPAID LIMITED HEALTH SERVI

25E - PATIENTS' EYE CARE ACT

25F - COVERAGE FOR PATIENT COST OF

25G - PROVIDER SPONSORED NETWORKS

26 - WEST VIRGINIA GUARANTY ASSOCI

26A - WEST VIRGINIA LIFE AND HEALT

26B - WEST VIRGINIA HEALTH MAINTEN

27 - INSURANCE HOLDING COMPANY SYS

28 - INDIVIDUAL ACCIDENT AND SICKN

29 - LIFE AND ACCIDENT AND SICKNES

30 - MINE SUBSIDENCE INSURANCE

31 - CAPTIVE INSURANCE

31A - SPONSORED CAPTIVE INSURANCE

32 - RISK RETENTION ACT

33 - ANNUAL AUDITED FINANCIAL REPO

34 - ADMINISTRATIVE SUPERVISION

34A - STANDARDS AND COMMISSIONER'S

35 - CRIMINAL SANCTIONS FOR FAILUR

36 - BUSINESS TRANSACTED WITH PROD

37 - MANAGING GENERAL AGENTS

38 - REINSURANCE INTERMEDIARY ACT

39 - DISCLOSURE OF MATERIAL TRANSA

40 - RISK-BASED CAPITAL (RBC) FOR

40A - RISKED-BASED CAPITAL FOR HEA

41 - PRIVILEGES AND IMMUNITY

42 - WOMEN'S ACCESS TO HEALTH CARE

43 - INSURANCE TAX PROCEDURES ACT

44 - UNAUTHORIZED INSURERS ACT

45 - ETHICS AND FAIRNESS IN INSURE

46 - THIRD-PARTY ADMINISTRATOR ACT

46A - PROFESSIONAL EMPLOYER ORGANI

47 - INTERSTATE INSURANCE PRODUCT

48 - MODEL HEALTH PLAN FOR UNINSUR

49 - FLOOD INSURANCE

50 - PATIENT PROTECTION AND TRANSP

WVC 33 - CHAPTER 33. INSURANCE.
WVC 33 - 13 D- ARTICLE 13D. UNCLAIMED LIFE INSURANCE BENEFITS ACT
WVC 33-13D-1

§33-13D-1. Definitions.

(a) Definitions. --- For purposes of this section:

(1) “Account owner” means the owner of a retained asset account who is a resident of this state.

(2) “Annuity contract” means an annuity contract issued in this state. The term “annuity contract” shall not include an annuity used to fund an employment-based retirement plan or program where: (1) The insurer does not perform the record-keeping services; or (2) the insurer is not committed by terms of the annuity contract to pay death benefits to the beneficiaries of specific plan participants.

(3) "Death Master File” means the United States Social Security Administration’s Death Master File or any other database or service that is at least as comprehensive as the United States Social Security Administration’s Death Master File for determining whether a person has died.

(4) “Death Master File match” means a search of the Death Master File that results in a match of the person’s first and last name and Social Security number or the first and last name and date of birth of an insured, annuity owner or retained asset account holder.

(5) “Knowledge of death” shall, for the purposes of this section, mean: (a) Receipt of an original or valid copy of a certified death certificate; or (b) a Death Master File match validated by the insurer in accordance with section two of this article.

(6) “Person” means the policy insured, annuity contract owner, annuitant or account owner, as applicable under the policy, annuity contract or retained asset account at issue in this act.

(7) “Policy” means any policy or certificate of life insurance issued in this state that provides a death benefit. The term “policy” shall not include: (i) Any policy or certificate of life insurance that provides a death benefit under an employee benefit plan: (a) subject to the Employee Retirement Income Security Act of 1974, as periodically amended; or (b) under any federal employee benefit program: or (ii) any policy or certificate of life insurance that is used to fund a preneed funeral contract or prearrangement; or (iii) any policy or certificate of credit life or accidental death insurance; or (iv) any policy issued to a group master policyholder for which the insurer does not provide record-keeping services.

(8) “Record-keeping services” means those circumstances under which the insurer has agreed with a group policy or contract customer to be responsible for obtaining, maintaining and administering in its own or its agents' systems information about each individual insured under an Insured’s group insurance contract (or a line of coverage thereunder), at least the following information: (1) Social Security number or name and date of birth; and (2) beneficiary designation information; (3) coverage eligibility; (4) benefit amount; and (5) premium payment status.

(9) “Retained asset account” means any mechanism whereby the settlement of proceeds payable under a policy or annuity contract is accomplished by the insurer or an entity acting on behalf of the insurer depositing the proceeds into an account with check- or draft-writing privileges, where those proceeds are retained by the insurer or its agent, pursuant to a supplementary contract not involving annuity contract benefits other than death benefits.

WVC 33-13D-2

§33-13D-2. Insurer conduct.

(a) An insurer shall perform a comparison of its insureds’ in-force policies, annuity contracts and account owners against a Death Master File to identify potential death master file matches of its insureds, annuitants and account owners, on at least an annual basis, by using the full Death Master File once and thereafter using the Death Master File update files for future comparisons to identify potential Death Master File matches. The comparison using the full Death Master File should be completed within two years of the effective date of this article and must be completed on policies in force as of 1986, and all policies issued thereafter: Provided, That the Insurance Commissioner shall promulgate legislative rules requiring that the comparison against a Death Master File be completed on policies issued at earlier times if the commissioner determines that reliable technology and data exist to make such comparison accurate and cost-effective to match to the established Master Death Database.

(b) The insurer comparison of policies, annuity contracts and account owners shall be conducted first to the extent that such records are available electronically and then using the most easily accessible insurer data for records that are not available electronically.

(c) This section shall not apply to policies or annuity contracts for which the insurer is receiving premiums from outside the policy value, by check, bank draft, payroll deduction or any other similar method of active premium payment within the eighteen months immediately preceding the Death Master File comparison.

(d) Nothing in this section shall limit the insurer from requesting a valid death certificate as part of any claims validation process.

(e) For those potential matches identified as a result of a Death Master File match, or if an insurer learns of the possible death of a person otherwise, then the insurer shall, within ninety days of a Death Master File match:

(1) Complete a good faith effort, which shall be documented by the insurer, to confirm the death of the person against other available records and information;

(2) Review its records to determine whether the deceased person has any other products with the insurer;

(3) Determine whether benefits may be due in accordance with any applicable policy, annuity contract or retained asset account.

(f) Every insurer shall implement procedures to account for:

(1) Common nicknames, initials used in lieu of a first or middle name, use of a middle name, compound first and middle names, and interchanged first and middle names;

(2) Compound last names, maiden or married names, and hyphens, blank spaces or apostrophes in last names;

(3) Transposition of the “month” and “date” portions of the date of birth; and

(4) Incomplete Social Security number.

(g) If the beneficiary or other authorized representative has not communicated with the insurer within the ninety-day period, the insurer shall take reasonable steps and use good faith efforts, which shall be documented by the insurer, to locate and contact the beneficiary or beneficiaries or other authorized representative on any such policy, annuity contract or retained asset account, including, but not limited to, sending the beneficiary information regarding the insurer’s claims process, including the need to provide an official death certificate if applicable under the policy, annuity contract or retained asset account.

(h) To the extent permitted by law, the insurer may disclose minimum necessary personal information about a person or beneficiary to a person who the insurer reasonably believes may be able to assist the insurer in locating the beneficiary or a person otherwise entitled to payment of the claims proceeds.

(i) An insurer or its service provider shall not charge any beneficiary or other authorized representative for any fees or costs associated with a Death Master File search or verification of Death Master File match conducted pursuant to this section.

(j) The benefits from a policy, annuity contract or a retained asset account, plus any applicable accrued contractual interest shall first be payable to the designated beneficiaries or owners, and in the event said beneficiaries or owners cannot be found, shall be paid to the state as unclaimed property pursuant to article eight, chapter thirty-six of this code.

(k) The West Virginia Office of the Insurance Commissioner has exclusive authority to promulgate such rules and regulations as may be required or reasonably necessary to implement the provisions of this section.

(l) The commissioner may, in his or her reasonable discretion, make an order to:

(1) Limit an insurer’s Death Master File comparisons required under subsection (a) of this section to the insurer’s electronic searchable files or approve a plan and timeline for conversion of the insurer’s files to searchable electronic files upon a demonstration of hardship by the insurer;

(2) Exempt an insurer from the Death Master File comparisons required under subsection (a) of this section or permitting an insurer to perform such comparisons less frequently than annually upon a demonstration of hardship by the insurer; or

(3) Phase-in compliance with this section according to a plan and timeline approved by the commissioner.

Note: WV Code updated with legislation passed through the 2016 Regular Session
The West Virginia Code Online is an unofficial copy of the annotated WV Code, provided as a convenience. It has NOT been edited for publication, and is not in any way official or authoritative.


Recent legislation affecting the Code

Citation Year/Session Short Title
§33 - 51 - 1 - (New Code)
§33 - 51 - 2 - (New Code)
§33 - 51 - 3 - (New Code)
§33 - 51 - 4 - (New Code)
§33 - 51 - 5 - (New Code)
§33 - 51 - 6 - (New Code)
§33 - 51 - 7 - (New Code)
§33 - 51 - 8 - (New Code)
SENATE BILL - 522
PASSED - Regular Session

SB522 SUB1 enr  (Uploaded - 10/02/2017)
Relating to pharmacy audits
§33 - 2 - 2 - (Amended Code)
SENATE BILL - 523
PASSED - Regular Session

SB523 SUB1 enr  (Uploaded - 10/02/2017)
Converting to biweekly pay cycle for state employees
§33 - 16 G- 1 - (Repealed Code)
§33 - 16 G- 2 - (Repealed Code)
§33 - 16 G- 3 - (Repealed Code)
§33 - 16 G- 4 - (Repealed Code)
§33 - 16 G- 5 - (Repealed Code)
§33 - 16 G- 6 - (Repealed Code)
§33 - 16 G- 7 - (Repealed Code)
§33 - 16 G- 8 - (Repealed Code)
§33 - 16 G- 9 - (Repealed Code)
HOUSE BILL - 2119
PASSED - Regular Session

hb2119 ENR  (Uploaded - 10/06/2017)
Repealing West Virginia Health Benefit Exchange Act
§33 - 15 - 4 O - (New Code)
§33 - 16 - 3AA - (New Code)
§33 - 24 - 7 P - (New Code)
§33 - 25 - 8 M - (New Code)
§33 - 25 A- 8 O - (New Code)
HOUSE BILL - 2300
PASSED - Regular Session

hb2300 ENR  (Uploaded - 10/06/2017)
Regulating step therapy protocols
§33 - 4 A- 1 - (Amended Code)
§33 - 4 A- 2 - (Amended Code)
§33 - 4 A- 3 - (Amended Code)
§33 - 4 A- 5 - (Amended Code)
§33 - 4 A- 6 - (Amended Code)
§33 - 4 A- 7 - (Amended Code)
§33 - 16 D- 16 - (Amended Code)
HOUSE BILL - 2459
PASSED - Regular Session

HB2459 SUB ENR  (Uploaded - 10/06/2017)
Relating to regulation of health care and the certificate of need process
§33 - 6 F- 1 - (Amended Code)
HOUSE BILL - 2486
PASSED - Regular Session

HB2486 SUB ENR  (Uploaded - 10/06/2017)
Providing that when a party's health condition is at issue in a civil action, medical records and releases for medical information may be requested and required without court order
§33 - 40 B- 1 - (New Code)
§33 - 40 B- 2 - (New Code)
§33 - 40 B- 3 - (New Code)
§33 - 40 B- 4 - (New Code)
§33 - 40 B- 5 - (New Code)
§33 - 40 B- 6 - (New Code)
§33 - 40 B- 7 - (New Code)
§33 - 40 B- 8 - (New Code)
§33 - 40 B- 9 - (New Code)
§33 - 40 B- 10 - (New Code)
§33 - 40 B- 11 - (New Code)
HOUSE BILL - 2619
PASSED - Regular Session

HB2619 SUB ENR  (Uploaded - 10/06/2017)
Risk Management and Own Risk and Solvency Assessment Act
§33 - 26 - 2 - (Amended Code)
§33 - 26 - 3 - (Amended Code)
§33 - 26 - 4 - (Amended Code)
§33 - 26 - 5 - (Amended Code)
§33 - 26 - 8 - (Amended Code)
§33 - 26 - 9 - (Amended Code)
§33 - 26 - 10 - (Amended Code)
§33 - 26 - 11 - (Amended Code)
§33 - 26 - 12 - (Amended Code)
§33 - 26 - 13 - (Amended Code)
§33 - 26 - 14 - (Amended Code)
§33 - 26 - 18 - (Amended Code)
HOUSE BILL - 2683
PASSED - Regular Session

HB2683 SUB ENR  (Uploaded - 11/30/2017)
Relating to West Virginia Insurance Guaranty Association Act
§33 - 3 - 33 A - (Amended Code)
SENATE BILL - 1010
PASSED - 1st Special Session

sb1010 enr  (Uploaded - 10/06/2017)
Relating to Volunteer Fire Department Workers' Compensation Premium Subsidy Fund
§33 - 15 - 14 - (Amended Code)
SENATE BILL - 1014
PASSED - 1st Special Session

sb1014 enr  (Uploaded - 10/06/2017)
Relating generally to physician assistants
§33 - 20 F- 2 - (Amended Code)
§33 - 20 F- 4 - (Amended Code)
SENATE BILL - 278
PASSED - Regular Session

SB278 SUB1 enr  (Uploaded - 03/16/2016)
Clarifying physicians' mutual insurance company is not state or quasi-state actor
§33 - 6 A- 1 - (Amended Code)
SENATE BILL - 330
PASSED - Regular Session

SB330 SUB1 ENR  (Uploaded - 03/11/2016)
Requiring automobile liability insurers provide 10 days' notice of intent to cancel due to nonpayment of premium
§33 - 24 - 4 - (Amended Code)
§33 - 25 - 6 - (Amended Code)
§33 - 25 A- 24 - (Amended Code)
§33 - 25 D- 26 - (Amended Code)
§33 - 40 - 1 - (Amended Code)
§33 - 40 - 2 - (Amended Code)
§33 - 40 - 3 - (Amended Code)
§33 - 40 - 6 - (Amended Code)
§33 - 40 - 7 - (Amended Code)
§33 - 40 A- 1 - (New Code)
§33 - 40 A- 2 - (New Code)
§33 - 40 A- 3 - (New Code)
§33 - 40 A- 4 - (New Code)
§33 - 40 A- 5 - (New Code)
§33 - 40 A- 6 - (New Code)
§33 - 40 A- 7 - (New Code)
§33 - 40 A- 8 - (New Code)
§33 - 40 A- 9 - (New Code)
§33 - 40 A- 10 - (New Code)
§33 - 40 A- 11 - (New Code)
§33 - 40 A- 12 - (New Code)
SENATE BILL - 429
PASSED - Regular Session

SB429 SUB1 ENR  (Uploaded - 03/11/2016)
Adopting two National Association of Insurance Commissioners' models to protect enrollees and general public and permit greater oversight
§33 - 31 - 2 - (Amended Code)
§33 - 46 A- 9 - (Amended Code)
SENATE BILL - 465
PASSED - Regular Session

SB465 SUB1 enr  (Uploaded - 03/18/2016)
Allowing professional employer insure certain risks through pure insurance captive
§33 - 15 - 4 M - (New Code)
§33 - 16 - 3 Y - (New Code)
§33 - 24 - 7 N - (New Code)
§33 - 25 - 8 K - (New Code)
§33 - 25 A- 8 M - (New Code)
HOUSE BILL - 4038
PASSED - Regular Session

HB4038 SUB ENR  (Uploaded - 03/23/2016)
Relating to insurance requirements for the refilling of topical eye medication
§33 - 15 - 4 O - (New Code)
§33 - 16 - 3AA - (New Code)
§33 - 24 - 7 P - (New Code)
§33 - 25 - 8 M - (New Code)
§33 - 25 A- 8 O - (New Code)
HOUSE BILL - 4040
PASSED - Regular Session

HB4040 SUB ENR  (Uploaded - 03/18/2016)
Regulating step therapy protocols in health benefit plans
§33 - 15 - 4 N - (New Code)
§33 - 16 - 3 Z - (New Code)
§33 - 24 - 7 O - (New Code)
§33 - 25 - 8 L - (New Code)
§33 - 25 A- 8 N - (New Code)
HOUSE BILL - 4146
PASSED - Regular Session

HB4146 SUB ENR  (Uploaded - 03/23/2016)
Providing insurance cover abuse-deterrent opioid analgesic drugs
§33 - 25 E- 2 - (Amended Code)
§33 - 25 E- 5 - (New Code)
HOUSE BILL - 4655
PASSED - Regular Session

hb4655 ENR  (Uploaded - 03/23/2016)
Prohibiting insurers, vision care plan or vision care discount plans from requiring vision care providers to provide discounts on noncovered services or materials
§33 - 30 - 6 - (Amended Code)
§33 - 30 - 8 - (Amended Code)
HOUSE BILL - 4734
PASSED - Regular Session

HB4734 ENR  (Uploaded - 03/11/2016)
Relating to mine subsidence insurance
§33 - 13 D- 1 - (New Code)
§33 - 13 D- 2 - (New Code)
HOUSE BILL - 4739
PASSED - Regular Session

hb4739 ENR  (Uploaded - 03/17/2016)
Unclaimed Life Insurance Benefits Act
§33 - 3 - 33 A - (Amended Code)
HOUSE BILL - 128
PASSED - 1st Special Session

hb128 ENR  (Uploaded - 06/21/2016)
Extending the Volunteer Fire Department Workers' Compensation Premium Subsidy Fund
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