West Virginia State Regulations & NAIC Insurance Law

Licensing

To apply for a West Virginia resident producer’s license, you must:

Be at least 18 years old
Be a resident of West Virginia before you submit your application

Pre-licensing course and exam

West Virginia requires 20 hours of prelicensing education for each line of authority (life, accident and sickness, property, casualty and personal lines) before the producer examination (WV Offices of the Insurance Commissioner).

The passing score on a West Virginia producer examination is a scaled score of 70 (Pearson VUE, West Virginia Insurance Candidate Handbook).

Fingerprints/background check

West Virginia requires a criminal history record check on each applicant for a resident producer license, and each applicant must submit a full set of fingerprints for the FBI check (W. Va. Code § 33-12-37(d)).

Controlled business

Controlled business is insurance written on the producer’s own life, property or interests, or on those of the producer’s family, employer or a business the producer controls. A producer may insure themselves and their family, but a license exists to sell insurance to the public, so states generally restrict obtaining or using a license principally to write controlled business.

Before issuing a West Virginia producer license, the Commissioner must find that the applicant does not intend to use the license principally to insure themselves, their family or relatives, or (outside life and accident and sickness insurance) the property or interests of their family, relatives, employer, employees or a firm or corporation in which they own a substantial interest (W. Va. Code § 33-12-6(a)(7)).

Non-resident license

A producer licensed in another state can obtain a West Virginia nonresident license without taking West Virginia’s examination. Under the NAIC’s Producer Licensing Model Act, which most states have adopted in some form, a nonresident receives the license if the person:

Is currently licensed as a resident, and in good standing, in the home state
Has applied (the home-state application or the Uniform Application) and paid the fees
Lives in a home state that grants nonresident licenses to residents of this state on the same basis (reciprocity)

Under the same model, a producer who moves to another state files a change of address, with certification from the new home state, within 30 days. A licensed producer who moves into a state applies for a resident license there within 90 days and does not repeat prelicensing education or the examination for lines already held.

Temporary license

Most states allow the insurance regulator to issue a temporary license, without an examination, when one is needed to keep an insurance business serviced. Typical cases are:

The surviving spouse or personal representative of a producer who dies or becomes disabled, to allow time to sell the business or train new people
A member or employee of a business entity producer, on the death or disability of its designated producer
The designee of a producer entering active military service

The regulator may limit what a temporary licensee may do and may require a licensed sponsor who takes responsibility for the temporary licensee’s acts.

The West Virginia Insurance Commissioner may issue a temporary producer license for up to 180 days, without an examination, when one is necessary to service an insurance business (W. Va. Code § 33-12-16(a)).

Military service

A West Virginia producer who cannot comply with license renewal procedures because of military service, or another extenuating circumstance such as a long-term medical disability, may request a waiver of those procedures and of any examination requirement, fine or sanction for failing to comply with them (W. Va. Code § 33-12-9(d)).

Renewal and reinstatement

A producer license stays in effect only while the producer renews it on schedule: paying the renewal fee and completing continuing education by the due date.

West Virginia producer licenses expire on the last day of the licensee’s birth month, every two years (WV Offices of the Insurance Commissioner, Licensing and Education Division).

A producer who misses the deadline and lets the license lapse may be able to reinstate it without retaking the examination.

A producer who lets a West Virginia license lapse may reinstate the same license within 12 months of the renewal fee’s due date without passing a written examination, paying a penalty of double the unpaid renewal fee (W. Va. Code § 33-12-9©).

Continuing education

All states, including West Virginia, have continuing education (CE) requirements that must be met to renew any major lines (life, health, property, liability) insurance license. Individuals licensed in the state of West Virginia must complete continuing education before renewing their license. The number of hours required is set by state law and published by the state insurance department.

Notice of change of name or address

A West Virginia licensee must inform the Commissioner of a change of name, physical address, mailing address or email address within 30 days of the change (W. Va. Code § 33-12-9(f)).

The model also requires a producer to report to the regulator within 30 days any administrative action taken against the producer in another state or by another government agency, counted from the final disposition, and any criminal prosecution in any jurisdiction, counted from the initial pretrial hearing date. A producer who does business under any name other than their legal name must notify the regulator before using it.

Company regulations

An insurance company must be authorized by the Offices of the Insurance Commissioner to conduct business in West Virginia. To receive a certificate of authority, the company applies to the Commissioner and files its charter or articles of incorporation, financial statements showing that it meets the state’s capital and surplus requirements, and the other documents and fees the state requires.

Capital and surplus requirement

A company authorized to conduct insurance business in West Virginia must meet minimum corporate standards. The certificate of authority allows the insurer to conduct business in the state only if it maintains the minimum capital or permanent surplus required. In West Virginia, the Commissioner, after notice and hearing, must refuse to renew or must suspend or revoke the license of an insurer that no longer meets the requirements for the license originally granted, because of deficiency of assets or otherwise (W. Va. Code § 33-3-10). To be licensed, a stock insurer must have fully paid capital, and a mutual insurer surplus, of at least $1 million, and each must also keep additional surplus of at least $1 million (W. Va. Code § 33-3-5b(a)).

West Virginia Life and Health Insurance Guaranty Association

The West Virginia Life and Health Insurance Guaranty Association protects policyowners, insureds, beneficiaries, and annuitants if a licensed member insurer becomes financially impaired or insolvent.

Coverage applies to member insurers, those licensed to transact insurance in West Virginia (including one whose license has since been suspended, revoked, not renewed or voluntarily withdrawn, W. Va. Code § 33-26A-5(13)), and only when the insurer is impaired or insolvent. An impaired insurer is one the Commissioner deems potentially unable to fulfill its contractual obligations, or one a court has placed under rehabilitation or conservation; an insolvent insurer is one a court has ordered liquidated (W. Va. Code § 33-26A-5(11), (12)).

For any one insured life, the association will not pay more than $300,000 in the aggregate, regardless of the number of policies or types of coverage held with the insolvent insurer. Where health benefit plans are involved, the aggregate limit for one individual is $500,000 (W. Va. Code § 33-26A-3©(2)(D)(i)).

Within this overall $300,000 limit, the association will not pay more than:

$300,000 in life insurance death benefits
$100,000 in life insurance cash surrender values
$250,000 in present value of annuity benefits

Special limits apply to certain unallocated annuity contracts:

For unallocated annuities funding governmental retirement plans under Internal Revenue Code §§ 401(k), 403(b), or 457, the limit is $250,000 in present value annuity benefits per participating individual.
For certain other covered unallocated annuity contracts, a limit of $5 million in benefits per contract owner or plan sponsor applies (W. Va. Code § 33-26A-3©(2)(E)).

In all cases, the association cannot pay more than the amount the insurer would have owed under the policy or contract.

The association does not provide coverage for:

Policies issued by insurers not authorized to transact insurance in West Virginia
Self-funded employer or association plans
Stop-loss or administrative-services-only contracts
Policies or portions of policies in which the policyholder assumed the investment risk
Interest rates or dividends that exceed statutory limits

Insurance companies and producers are prohibited from using the existence of the West Virginia Life and Health Insurance Guaranty Association as an inducement to purchase insurance.

Duties of the Insurance Commissioner

The West Virginia Insurance Commissioner is a state executive position in the West Virginia government. The Commissioner is the chief executive of the West Virginia Offices of the Insurance Commissioner, which regulates insurance companies operating in West Virginia.

In West Virginia, the Insurance Commissioner is an appointed position. The governor nominates a candidate to the state Senate, and the state Senate confirms the nominee. Each appointment is for a term of six years, and an appointment to fill a vacancy runs for the rest of the term (W. Va. Code § 33-2-1).

The Commissioner is responsible for establishing and enforcing regulations in the West Virginia insurance market in a manner that protects consumers and encourages economic development.

Duties of the Commissioner include:

Investigate all claims and complaints of legal violations relating to insurance.
If the Commissioner finds that laws have been violated, the findings and supporting documents may be referred for criminal prosecution.
Monitor transactions of all companies including domestic, foreign, and alien insurance companies.
Audit the books and records of any resident producer as frequently as necessary. In West Virginia this reaches any licensed agent, broker, excess lines broker or solicitor (W. Va. Code § 33-2-9(g)).
Collect all fees associated with producers and insurers.
Determine and administer fines associated with violations for insurers and producers.
Issue reports pertaining to the suspension and revocation of licenses of producers and certificates of authority for insurers.
Approve documentation used by insurance companies such as forms and rates.

Sidenote

Know this...

The Commissioner does not have the authority to arrest, issue injunctions, or sentence jail time. The Commissioner can start the process, but a law officer must make an arrest, and a judge or court of law must issue injunctions or sentence jail time. The Commissioner may refer illegal activity for criminal prosecution.

In West Virginia, staff of the Commissioner’s Insurance Fraud Unit who are certified law-enforcement officers may execute search and arrest warrants and may arrest without a warrant a person found violating an insurance law, and the unit makes criminal referrals to county prosecutors (W. Va. Code § 33-41-8©).

Suspend, revoke or non-renew

The Commissioner has the authority to suspend, revoke, or refuse to renew a license for:

Providing false information on the application for an insurance license.
Omitting any relevant information on an application that would have disqualified the individual from being eligible to receive a license.
Being found guilty of a violation or the noncompliance of insurance regulations and laws…
Committing fraud while attempting to obtain an insurance license.
Improperly withholding, misappropriating or converting any money or property received in the course of doing insurance business.
Providing false information in reference to the terms and conditions of an insurance contract.
Having been convicted of or pleaded nolo contendere to any felony, or to a misdemeanor in connection with activities as an agent, solicitor or excess line broker (W. Va. Code § 33-12-24(b)(6)-(7)).
Having admitted or been found to have committed any insurance unfair trade practice or fraud.
Having engaged in activities of a fraudulent nature which allowed the person to involve themselves in dishonest, coercive, untrustworthy, and financially irresponsible practices.
Having had a prior insurance license revoked or suspended in a state other than West Virginia.
Using another person’s identity and forging their name on an insurance application.
Being found guilty of using unethical practices or cheating on an examination for an insurance license.

Cease and desist

If the Commissioner finds that a producer has violated the state’s insurance laws, the Commissioner may order the producer to cease and desist. A cease and desist order does not suspend or revoke the recipient’s registration, but it does require the recipient to stop or limit the activity addressed in the order.

Hearing and penalties

A person facing action by the Commissioner is entitled to notice and an opportunity for a hearing, within time limits set by West Virginia law, and may ask a court to review the final order. Under West Virginia’s unfair trade practices law the hearing comes first: if, after notice and hearing, the Commissioner finds a violation, the Commissioner must order the person to cease and desist (W. Va. Code § 33-11-6).

An applicant or licensee whose license is refused or not renewed may demand a hearing in writing within 10 days, and the hearing is held within 45 days (W. Va. Code § 33-12-24©).

A violation of the insurance laws can bring a civil penalty in addition to action against a license. State law sets the maximum, usually per violation and often with a cap on the total, and a higher tier commonly applies to a violation that was knowing or flagrant. Some violations are also crimes.

For an unfair trade practice, the Commissioner may impose a penalty of up to $1,000 per violation, not more than $10,000 in all, or, if the person knew or reasonably should have known of the violation, up to $5,000 per violation and $100,000 in any six months (W. Va. Code § 33-11-6(a)). In a license action, the Commissioner may impose a civil penalty of up to $5,000 in addition to or instead of other discipline (W. Va. Code § 33-12-24(e)).

Unfair claims settlement practices

Under the NAIC’s model act, these practices are violations when committed flagrantly and in conscious disregard of the law, or often enough to indicate a general business practice. West Virginia’s statute reaches these practices when committed with such frequency as to indicate a general business practice (W. Va. Code § 33-11-4(9)).

The intentional obstruction and delay of claims payment or the delay of a claims investigation is a violation of regulation.
Neglecting to provide a prompt response and written explanation of insurance policy terms, conditions, and laws related to the contract are examples of unfair claims settlement practices.
Failure to provide claims without launching a thorough investigation is a violation of regulation.
Making settlement claims based on information contained on an application that has been altered without the insured’s consent is a violation of regulation.
Denying a claim without conducting a thorough investigation.
Attempting to settle a claim for less than fair market value.

Policy forms

Insurers file their policy forms with the Commissioner.

In West Virginia, forms for noncommercial lines (insurance for personal, family and household needs) are filed at least 60 days before use and are deemed approved at the end of that period unless the Commissioner has acted on them. Commercial property and casualty forms need only be filed, and take effect unless the Commissioner disapproves them within 30 days (W. Va. Code § 33-6-8(b)).

If a policy provision conflicts with West Virginia law, the policy is read as amended to conform to the law.

The interest rate an insurer may charge on a life insurance policy loan is also limited by state law.

Record maintenance

A producer keeps records of each transaction (the policies placed, the insureds, the premiums received and any changes) and makes them available for the Commissioner’s inspection.

The producer of record keeps a file for each policy sold, with the work papers and written communications about it, for the current calendar year plus up to five more years, depending on the insurer’s examination cycle (W. Va. Code R. § 114-15-4.2).

Fraudulent producer representation

An insurance producer who represents to the public that they are licensed to conduct insurance business in West Virginia, but has not passed the appropriate licensing examination, is in violation of regulation. This includes any public communication, such as advertisements, letterheads, circulars, business cards, and other methods of representation.

A producer found guilty of conducting business in West Virginia in any line of insurance for which they are not properly licensed may have any other insurance license suspended or revoked.

Misrepresentation

Misrepresentation involving the creation or distribution of policies, quotes, and illustrations designed to provide inaccurate information about the terms and conditions of a policy is prohibited.
Providing inaccurate or incomplete information or comparisons regarding the benefits of a policy is an example of misrepresentation.
Providing inaccurate or incomplete information for the purpose of inducing, or tending to induce, the lapse, exchange, conversion, forfeiture, or surrender of a policy is a violation as well (twisting).

False advertising

Making, publishing or circulating an advertisement, announcement or statement about the business of insurance that is untrue, deceptive or misleading is an unfair trade practice under state law, based on the NAIC’s model act. The medium does not matter: the rule reaches newspapers, magazines, radio and television, and also notices, circulars, pamphlets, letters, posters and any other way of placing the statement before the public. The model act’s test is whether the statement is untrue, deceptive or misleading, not whether the person meant to deceive.

Defamation

Defamation of an insurer is an unfair trade practice under state law, based on the NAIC’s model act: making, publishing or circulating an oral or written statement that is false, or maliciously critical of or derogatory to the financial condition of an insurer, and that is calculated to injure that insurer or any other person engaged in the business of insurance. West Virginia’s definition is broader: it reaches a false or maliciously critical statement about the financial condition of any person that is calculated to injure that person (W. Va. Code § 33-11-4(3)). Spreading an untrue rumor that a competing insurer is about to fail is the classic example.

Boycott, coercion and intimidation

Entering into an agreement to commit, or by concerted action committing, any act of boycott, coercion or intimidation that results or tends to result in unreasonable restraint of, or monopoly in, the business of insurance is prohibited.

False financial statements

Knowingly making or circulating a false material statement of fact about a person’s financial condition, or knowingly making a false entry in a person’s books, is an unfair trade practice in West Virginia (W. Va. Code § 33-11-4(5)), and so is making false or fraudulent statements on or relative to an application for insurance to obtain a fee, commission, money or other benefit (§ 33-11-4(11)).

Illegal inducements

Offering anything of value not specified in the policy (money, a service, a favor or a gift) as an inducement to buy insurance is prohibited unless state law expressly allows it, and any agreement made as part of the sale must be written into the policy.

West Virginia prohibits rebating: no one may pay, allow or give, directly or indirectly, as an inducement to insurance, any rebate of premium or any valuable consideration not specified in the contract (W. Va. Code § 33-11-4(8)).

Educational materials, promotional materials or articles of merchandise that cost $25 or less are not prohibited valuable consideration under West Virginia’s rebating law, whether or not a policy is bought (W. Va. Code R. § 114-70-3.1).

Unfair discrimination

Unfair discrimination is treating people or risks that present the same hazard differently. The NAIC’s model act, on which state unfair trade practices laws are based, prohibits:

Unfair discrimination between individuals of the same class and equal expectation of life in life insurance and annuity rates, dividends, benefits or terms
Unfair discrimination between individuals of the same class and essentially the same hazard in health insurance premiums, benefits or terms
Refusing, limiting or canceling coverage because of a person’s sex, marital status, race, religion or national origin
In property and casualty insurance, refusing or limiting coverage solely because of a risk’s geographic location, unless sound underwriting and actuarial principles justify it, or solely because the applicant or insured is physically or mentally impaired

Many states also expressly forbid refusing or limiting coverage solely because a person is blind or partially blind. West Virginia’s own unfair discrimination provision is a same-class test: for life insurance and annuities, for accident and sickness insurance, and for other kinds among insureds with substantially like risk (W. Va. Code § 33-11-4(7)); it names no list of protected characteristics.

Errors & omissions

Errors & Omissions (E&O) insurance is a type of professional liability insurance that protects insurance agents if they are sued for negligent performance of their duties. E&O covers only honest mistakes that result in (financial) damage to customers/prospects. There is no coverage for violation of insurance regulation.

Rebating

West Virginia licensed producers are prohibited from directly or indirectly giving any refund, discount, favor, or credit to reduce premiums to induce the purchase of insurance. For property and casualty insurance, a rebate or discount is allowed to the extent an applicable filing with the Commissioner provides for it (W. Va. Code § 33-11-4(8)©).

Sidenote

Know this...

To “solicit” or “negotiate” insurance implies that the person is licensed.

Sharing commission

The splitting or sharing of commissions with a licensed producer is allowed. Both parties must be licensed in the line of business in which the proposed commission is to be split. Under the NAIC’s model act, a commission may also be paid to an insurance agency, or to a person who does not sell, solicit or negotiate insurance. West Virginia’s own law bars any producer from receiving or sharing any commission arising from the sale, solicitation or negotiation of an insurance contract for which that person is not then licensed (W. Va. Code § 33-12-3©). An individual producer may pay a commission on a West Virginia sale only to another licensed individual producer, or to a licensed business-entity producer (W. Va. Code R. § 114-2-4.1; W. Va. Code § 33-12-23(b)); an unlicensed person who refers a customer may receive no fee or only a nominal one, a one-time fee of $25 or less that does not depend on a sale (W. Va. Code R. §§ 114-2-6.1, 114-70-4).

Suitability in annuity transactions

When recommending an annuity, a producer must act in the best interest of the consumer under the circumstances known at the time, without placing the producer’s or the insurer’s financial interest ahead of the consumer’s (W. Va. Code R. § 114-11B-5.1).

Suitability is based on factors such as:

Age
Income and financial status
Financial objectives
Tax status
Risk tolerance
Liquidity needs
Existing assets

Producers must make reasonable efforts to obtain relevant financial information before making a recommendation.

If a consumer refuses to provide information, the refusal must be documented.

Insurers are responsible for supervising annuity recommendations.

Twisting

Providing false information or expressing derogatory ideas about the financial conditions of a competitor company with the intent to lapse or surrender an existing policy is a violation of the law. West Virginia’s rule requires a misrepresentation made to induce or tend to induce the lapse, forfeiture, exchange, conversion or surrender of a policy (W. Va. Code § 33-11-4(1)(f)); a true statement is not twisting. Any written or oral statements used to induce the lapse, termination, exchange, or surrender of an insurance contract based on inaccurate information is prohibited.

Under the NAIC’s model act, twisting is a misrepresentation made to induce a policyholder to lapse, forfeit, surrender, exchange or convert a policy. A false or maliciously critical statement about a competing insurer’s finances, made to injure it, is defamation.

Replacement of life insurance

Replacement occurs when a new life insurance policy is purchased and, as a result, an existing life policy is lapsed, surrendered, forfeited, assigned, or otherwise reduced in value.

When replacement is involved, the producer must:

Provide the applicant with a notice regarding replacement
Obtain a list of existing life insurance policies to be replaced
Submit required replacement documentation to the insurer

The replacing insurer must notify the existing insurer and maintain required replacement records.

Failure to comply with replacement requirements may result in fines or license discipline.

Unfair marketing practices

The Offices of the Insurance Commissioner is responsible for establishing minimum standards for the full and fair disclosure of policy content. The Department also requires the standardization and simplification of the terms used to describe insurance coverage. Advertising may not involve the following:

Any statement or implication that policies are approved, or that the financial condition of a company is endorsed, by any government agency or by any independent group, individual, organization or society, unless that is the fact.
Any statements regarding advertising that are false or untrue in reference to the time frame in which claims are paid.

Gramm-Leach Bliley Act (GLBA)

This law repealed the Glass-Steagall Act of 1933, allowing consolidation of commercial banks, investment institutions, and insurance companies. GLBA established a framework of responsibilities of federal and state regulators for these financial industries. It permits financial services companies to merge and engage in a variety of new business activities, including insurance, while attempting to address the regulatory issues raised by such combinations.

McCarran-Ferguson Act

Federal law signed in 1945 in which Congress declared that the insurance industry would be regulated at the state level. Grants insurers a limited exemption from federal antitrust legislation. Since 2021 the exemption does not cover the business of health insurance, apart from narrow activities such as sharing historical loss data (15 U.S.C. § 1013©).

National Association of Insurance Commissioners (NAIC)

The U.S. standard-setting and regulatory support organization is created and governed by the chief insurance regulators from the 50 states, the District of Columbia and five U.S. territories. Through the NAIC, state insurance regulators establish standards and best practices, conduct peer review, and coordinate their regulatory oversight. NAIC staff supports these efforts and represents the collective views of state regulators domestically and internationally. NAIC members, together with the central resources of the NAIC, form the national system of state-based insurance regulation in the U.S.

Fair Credit Reporting Act

The Fair Credit Reporting Act (FCRA, 15 U.S.C. 1681) regulates consumer reporting agencies and the use of consumer reports, such as credit reports, MIB records and investigative reports, including in insurance underwriting.

When an insurer requests an investigative consumer report, it must disclose that to the consumer within 3 days of the request
When an insurer takes adverse action based on a consumer report, it must notify the consumer and identify the reporting agency. The consumer then has 60 days to request a free copy of the report and may dispute inaccurate information

Privacy Act of 1974

The federal Privacy Act of 1974 governs how federal agencies handle personal information. It does not apply to private insurers. An insurer’s use of an applicant’s personal information is governed by the FCRA, the Gramm-Leach-Bliley Act and state insurance privacy law.

Under West Virginia’s insurance privacy rule, an authorization to disclose a consumer’s nonpublic personal health information must state how long it is valid, which may be no more than 24 months (W. Va. Code R. § 114-57-16.1(e)).

Telemarketing

The National Do Not Call Registry is a list of telephone numbers whose owners do not want to receive telemarketing calls. Telemarketers may not call registered numbers without the person’s permission or an established business relationship, and unsolicited sales calls:

May be made only between 8 a.m. and 9 p.m. in the recipient’s local time
Must disclose the caller’s identity, the company the caller represents and that the purpose is a sale

CAN-SPAM

A commercial email must:

Be identified clearly as an advertisement
Carry accurate header information and a subject line that is not deceptive
Include the sender’s valid physical postal address
Offer a way to opt out, and the sender must honor an opt-out within 10 business days

Licensing (Resident Producer)

Minimum age: 18; must be WV resident before applying
Requires 20 hours prelicensing education per line of authority
Passing exam score: scaled score of 70

Fingerprints/Background Check

Criminal history record check required for resident license applicants
Full set of fingerprints submitted for FBI check

Controlled Business

Insurance on producer’s own life/property/family/employer interests
License cannot be used principally to write controlled business
Commissioner must confirm this intent before issuing license

Non-resident License

No WV exam needed if licensed elsewhere in good standing
Requires reciprocity, application (home-state or Uniform Application), and fee payment
Address change: within 30 days; new resident license after move: within 90 days (no repeat of exam/prelicensing education)

Temporary License

Issued without exam to keep business serviced (e.g., death/disability of producer, military deployment)
WV allows up to 180 days
Regulator may limit activities and require a licensed sponsor

Military Service

Waiver available for renewal procedures, exams, fines/sanctions if unable to comply due to military service or long-term medical disability

Renewal and Reinstatement

WV licenses expire last day of birth month, every 2 years
Lapsed license: reinstate within 12 months without exam
Penalty: double the unpaid renewal fee

Continuing Education

Required for all major lines before renewal
Hours set by state law, published by insurance department

Notice of Change of Name/Address

Must notify Commissioner within 30 days of name/address change
Also 30 days to report administrative actions (from final disposition) or criminal prosecutions (from initial pretrial hearing) in other jurisdictions
Must notify before doing business under any assumed name

Company Regulations

Must obtain certificate of authority from WV Commissioner
Requires filing charter/articles, financial statements, meeting capital/surplus rules, and fees

Capital and Surplus Requirement

Stock insurer: minimum $1 million fully paid capital
Mutual insurer: minimum $1 million surplus
Both must maintain additional surplus of at least $1 million
Commissioner must refuse renewal or suspend/revoke license for asset deficiency

WV Life and Health Insurance Guaranty Association

Protects policyowners, insureds, beneficiaries, and annuitants if a licensed member insurer becomes financially impaired or insolvent
Applies only to member insurers (currently or formerly licensed in WV) when impaired or insolvent
Aggregate cap per insured life: $300,000 (health benefit plans: $500,000)
Sub-limits within the $300,000 cap: $300,000 life death benefits, $100,000 life cash surrender values, $250,000 present value annuity benefits
Special unallocated annuity limits: $250,000 per participant (governmental retirement plans under IRC §§401(k)/403(b)/457); $5 million per contract owner/plan sponsor (certain other unallocated contracts)
Payment never exceeds what the insurer itself would have owed
Excludes: unauthorized insurers, self-funded employer/association plans, stop-loss/ASO contracts, investment-risk-assumed policies, excess interest/dividends
Cannot be used by insurers/producers as a sales inducement

Duties of the Insurance Commissioner

Appointed by governor, confirmed by Senate; 6-year term
Investigates violations/complaints, audits producers, collects fees, imposes fines, approves forms/rates
Cannot arrest, issue injunctions, or sentence jail time (refers matters for prosecution)
WV Insurance Fraud Unit certified officers may execute warrants/arrests and refer cases to prosecutors

Suspend, Revoke or Non-renew License

Grounds include: false/omitted application info, fraud, felony/certain misdemeanor convictions, unfair trade practices, prior license revocation elsewhere, exam cheating, forging signatures, misappropriating funds

Cease and Desist

Issued when a violation is found; does not suspend/revoke license but stops/limits the activity

Hearing and Penalties

Right to notice and hearing before adverse action
Written hearing request: within 10 days; hearing held within 45 days
Civil penalties (unfair trade practice): up to $1,000/violation ($10,000 total) if unknowing; up to $5,000/violation ($100,000 per six months) if knowing
License-related civil penalty: up to $5,000

Unfair Claims Settlement Practices

Violation when frequent enough to indicate a general business practice
Includes: delaying claims/investigation, failing to explain policy terms, using altered applications without consent, denying without investigation, settling below fair value

Policy Forms

Noncommercial lines: filed 60 days before use, deemed approved if no Commissioner action
Commercial P&C forms: take effect unless disapproved within 30 days
Conflicting policy provisions read as amended to conform to law

Record Maintenance

Producers keep transaction records available for Commissioner inspection
Retain policy files: current calendar year plus up to 5 additional years

Fraudulent Producer Representation

Illegal to represent licensure without passing required exam
Applies to all public communications (ads, cards, letterhead)
May result in suspension/revocation of other licenses held

Misrepresentation

Prohibits inaccurate policies, quotes, illustrations, or comparisons
Includes inducing lapse/surrender via inaccurate information (twisting)

False Advertising

Untrue, deceptive, or misleading statements about insurance business prohibited
Applies across all media; intent to deceive not required

Defamation

False or maliciously critical statements about financial condition (of insurer, or in WV, any person) prohibited
Must be calculated to injure the target

Boycott, Coercion, Intimidation

Prohibited when resulting in unreasonable restraint or monopoly of insurance business

False Financial Statements

Prohibits knowingly false statements about financial condition or false book entries
Also prohibits false statements on applications to obtain fee/commission/benefit

Illegal Inducements

Cannot offer unlisted value to induce insurance purchase
WV prohibits rebating unless expressly allowed
Educational/promotional items ≤$25 exempt from rebating rule

Unfair Discrimination

Prohibits differing treatment for same-class/same-hazard risks
Model act bars discrimination by sex, marital status, race, religion, national origin
P&C: cannot deny/limit solely for geographic location or physical/mental impairment (absent sound underwriting basis)
WV rule uses a same-class test without naming specific protected classes

Errors & Omissions (E&O)

Professional liability insurance for producers
Covers only honest mistakes causing financial damage to clients
No coverage for regulatory violations

Rebating

Prohibits refunds/discounts/favors/credits to induce purchase
P&C exception allowed if provided for in a Commissioner filing

Sharing Commission

Allowed only between producers licensed in the relevant line
WV bars sharing commission with anyone not licensed for that transaction
Unlicensed referral fee capped at $25, one-time, not sale-dependent

Suitability in Annuity Transactions

Must act in consumer’s best interest, not producer’s/insurer’s
Factors: age, income, objectives, tax status, risk tolerance, liquidity, existing assets
Must document if consumer refuses to provide information
Insurers responsible for supervising recommendations

Twisting

Misrepresentation made to induce lapse/forfeiture/exchange/conversion/surrender of a policy
True statements do not constitute twisting

Replacement of Life Insurance

Occurs when a new policy causes an existing policy to lapse/surrender/be reduced in value
Producer must: give replacement notice, list existing policies, submit required documentation
Replacing insurer must notify existing insurer and keep records
Non-compliance risks fines/license discipline

Unfair Marketing Practices

Commissioner sets standards for full/fair disclosure and standardized policy terms
Prohibits false claims of government/organization endorsement
Prohibits false statements about claims payment timeframes

Gramm-Leach-Bliley Act (GLBA)

Repealed Glass-Steagall; allows consolidation of banks, investment firms, and insurers
Establishes federal/state regulatory framework for combined financial services

McCarran-Ferguson Act

1945 law establishing state-level regulation of insurance
Grants limited antitrust exemption
Since 2021, exemption excludes health insurance except narrow historical loss-data sharing

NAIC

Standard-setting body governed by chief insurance regulators of states/territories
Supports peer review, model laws/standards, and coordinated regulatory oversight

Fair Credit Reporting Act (FCRA)

Governs consumer reporting agencies and use of consumer reports in underwriting
Investigative report request: must disclose to consumer within 3 days
Adverse action: must notify consumer and identify agency; consumer has 60 days to request free report/dispute inaccuracies

Privacy Act of 1974

Applies only to federal agencies, not private insurers
Insurer use of personal info governed by FCRA, GLBA, and state privacy law
WV: health information disclosure authorization valid max 24 months

Telemarketing

Do Not Call Registry restricts calls without permission or existing business relationship
Calls allowed only 8 a.m.–9 p.m. local time
Must disclose caller identity, represented company, and sales purpose

CAN-SPAM

Commercial email must be clearly identified as an ad
Requires accurate headers/subject line and valid physical postal address
Must offer opt-out; opt-out requests honored within 10 business days

West Virginia State Regulations & NAIC Insurance Law

Licensing

To apply for a West Virginia resident producer’s license, you must:

Be at least 18 years old
Be a resident of West Virginia before you submit your application

Pre-licensing course and exam

The passing score on a West Virginia producer examination is a scaled score of 70 (Pearson VUE, West Virginia Insurance Candidate Handbook).

Fingerprints/background check

Controlled business

Non-resident license

Is currently licensed as a resident, and in good standing, in the home state
Has applied (the home-state application or the Uniform Application) and paid the fees
Lives in a home state that grants nonresident licenses to residents of this state on the same basis (reciprocity)

Temporary license

Most states allow the insurance regulator to issue a temporary license, without an examination, when one is needed to keep an insurance business serviced. Typical cases are:

The surviving spouse or personal representative of a producer who dies or becomes disabled, to allow time to sell the business or train new people
A member or employee of a business entity producer, on the death or disability of its designated producer
The designee of a producer entering active military service

The regulator may limit what a temporary licensee may do and may require a licensed sponsor who takes responsibility for the temporary licensee’s acts.

Military service

Renewal and reinstatement

A producer license stays in effect only while the producer renews it on schedule: paying the renewal fee and completing continuing education by the due date.

West Virginia producer licenses expire on the last day of the licensee’s birth month, every two years (WV Offices of the Insurance Commissioner, Licensing and Education Division).

A producer who misses the deadline and lets the license lapse may be able to reinstate it without retaking the examination.

Continuing education

Notice of change of name or address

A West Virginia licensee must inform the Commissioner of a change of name, physical address, mailing address or email address within 30 days of the change (W. Va. Code § 33-12-9(f)).

Company regulations

Capital and surplus requirement

West Virginia Life and Health Insurance Guaranty Association

The West Virginia Life and Health Insurance Guaranty Association protects policyowners, insureds, beneficiaries, and annuitants if a licensed member insurer becomes financially impaired or insolvent.

Within this overall $300,000 limit, the association will not pay more than:

$300,000 in life insurance death benefits
$100,000 in life insurance cash surrender values
$250,000 in present value of annuity benefits

Special limits apply to certain unallocated annuity contracts:

For unallocated annuities funding governmental retirement plans under Internal Revenue Code §§ 401(k), 403(b), or 457, the limit is $250,000 in present value annuity benefits per participating individual.
For certain other covered unallocated annuity contracts, a limit of $5 million in benefits per contract owner or plan sponsor applies (W. Va. Code § 33-26A-3©(2)(E)).

In all cases, the association cannot pay more than the amount the insurer would have owed under the policy or contract.

The association does not provide coverage for:

Policies issued by insurers not authorized to transact insurance in West Virginia
Self-funded employer or association plans
Stop-loss or administrative-services-only contracts
Policies or portions of policies in which the policyholder assumed the investment risk
Interest rates or dividends that exceed statutory limits

Insurance companies and producers are prohibited from using the existence of the West Virginia Life and Health Insurance Guaranty Association as an inducement to purchase insurance.

Duties of the Insurance Commissioner

The Commissioner is responsible for establishing and enforcing regulations in the West Virginia insurance market in a manner that protects consumers and encourages economic development.

Duties of the Commissioner include:

Investigate all claims and complaints of legal violations relating to insurance.
If the Commissioner finds that laws have been violated, the findings and supporting documents may be referred for criminal prosecution.
Monitor transactions of all companies including domestic, foreign, and alien insurance companies.
Audit the books and records of any resident producer as frequently as necessary. In West Virginia this reaches any licensed agent, broker, excess lines broker or solicitor (W. Va. Code § 33-2-9(g)).
Collect all fees associated with producers and insurers.
Determine and administer fines associated with violations for insurers and producers.
Issue reports pertaining to the suspension and revocation of licenses of producers and certificates of authority for insurers.
Approve documentation used by insurance companies such as forms and rates.

Sidenote

Know this...

Suspend, revoke or non-renew

The Commissioner has the authority to suspend, revoke, or refuse to renew a license for:

Providing false information on the application for an insurance license.
Omitting any relevant information on an application that would have disqualified the individual from being eligible to receive a license.
Being found guilty of a violation or the noncompliance of insurance regulations and laws…
Committing fraud while attempting to obtain an insurance license.
Improperly withholding, misappropriating or converting any money or property received in the course of doing insurance business.
Providing false information in reference to the terms and conditions of an insurance contract.
Having been convicted of or pleaded nolo contendere to any felony, or to a misdemeanor in connection with activities as an agent, solicitor or excess line broker (W. Va. Code § 33-12-24(b)(6)-(7)).
Having admitted or been found to have committed any insurance unfair trade practice or fraud.
Having engaged in activities of a fraudulent nature which allowed the person to involve themselves in dishonest, coercive, untrustworthy, and financially irresponsible practices.
Having had a prior insurance license revoked or suspended in a state other than West Virginia.
Using another person’s identity and forging their name on an insurance application.
Being found guilty of using unethical practices or cheating on an examination for an insurance license.

Cease and desist

Hearing and penalties

An applicant or licensee whose license is refused or not renewed may demand a hearing in writing within 10 days, and the hearing is held within 45 days (W. Va. Code § 33-12-24©).

Unfair claims settlement practices

The intentional obstruction and delay of claims payment or the delay of a claims investigation is a violation of regulation.
Neglecting to provide a prompt response and written explanation of insurance policy terms, conditions, and laws related to the contract are examples of unfair claims settlement practices.
Failure to provide claims without launching a thorough investigation is a violation of regulation.
Making settlement claims based on information contained on an application that has been altered without the insured’s consent is a violation of regulation.
Denying a claim without conducting a thorough investigation.
Attempting to settle a claim for less than fair market value.

Policy forms

Insurers file their policy forms with the Commissioner.

If a policy provision conflicts with West Virginia law, the policy is read as amended to conform to the law.

The interest rate an insurer may charge on a life insurance policy loan is also limited by state law.

Record maintenance

A producer keeps records of each transaction (the policies placed, the insureds, the premiums received and any changes) and makes them available for the Commissioner’s inspection.

Fraudulent producer representation

A producer found guilty of conducting business in West Virginia in any line of insurance for which they are not properly licensed may have any other insurance license suspended or revoked.

Misrepresentation

Misrepresentation involving the creation or distribution of policies, quotes, and illustrations designed to provide inaccurate information about the terms and conditions of a policy is prohibited.
Providing inaccurate or incomplete information or comparisons regarding the benefits of a policy is an example of misrepresentation.
Providing inaccurate or incomplete information for the purpose of inducing, or tending to induce, the lapse, exchange, conversion, forfeiture, or surrender of a policy is a violation as well (twisting).

False advertising

Defamation

Boycott, coercion and intimidation

False financial statements

Illegal inducements

Unfair discrimination

Unfair discrimination is treating people or risks that present the same hazard differently. The NAIC’s model act, on which state unfair trade practices laws are based, prohibits:

Unfair discrimination between individuals of the same class and equal expectation of life in life insurance and annuity rates, dividends, benefits or terms
Unfair discrimination between individuals of the same class and essentially the same hazard in health insurance premiums, benefits or terms
Refusing, limiting or canceling coverage because of a person’s sex, marital status, race, religion or national origin
In property and casualty insurance, refusing or limiting coverage solely because of a risk’s geographic location, unless sound underwriting and actuarial principles justify it, or solely because the applicant or insured is physically or mentally impaired

Errors & omissions

Rebating

Sidenote

Know this...

To “solicit” or “negotiate” insurance implies that the person is licensed.

Sharing commission

Suitability in annuity transactions

Suitability is based on factors such as:

Age
Income and financial status
Financial objectives
Tax status
Risk tolerance
Liquidity needs
Existing assets

Producers must make reasonable efforts to obtain relevant financial information before making a recommendation.

If a consumer refuses to provide information, the refusal must be documented.

Insurers are responsible for supervising annuity recommendations.

Twisting

Replacement of life insurance

Replacement occurs when a new life insurance policy is purchased and, as a result, an existing life policy is lapsed, surrendered, forfeited, assigned, or otherwise reduced in value.

When replacement is involved, the producer must:

Provide the applicant with a notice regarding replacement
Obtain a list of existing life insurance policies to be replaced
Submit required replacement documentation to the insurer

The replacing insurer must notify the existing insurer and maintain required replacement records.

Failure to comply with replacement requirements may result in fines or license discipline.

Unfair marketing practices

Any statement or implication that policies are approved, or that the financial condition of a company is endorsed, by any government agency or by any independent group, individual, organization or society, unless that is the fact.
Any statements regarding advertising that are false or untrue in reference to the time frame in which claims are paid.

Gramm-Leach Bliley Act (GLBA)

McCarran-Ferguson Act

National Association of Insurance Commissioners (NAIC)

Fair Credit Reporting Act

When an insurer requests an investigative consumer report, it must disclose that to the consumer within 3 days of the request
When an insurer takes adverse action based on a consumer report, it must notify the consumer and identify the reporting agency. The consumer then has 60 days to request a free copy of the report and may dispute inaccurate information

Privacy Act of 1974

Telemarketing

May be made only between 8 a.m. and 9 p.m. in the recipient’s local time
Must disclose the caller’s identity, the company the caller represents and that the purpose is a sale

CAN-SPAM

A commercial email must:

Be identified clearly as an advertisement
Carry accurate header information and a subject line that is not deceptive
Include the sender’s valid physical postal address
Offer a way to opt out, and the sender must honor an opt-out within 10 business days

West Virginia State Regulations & NAIC Insurance Law

Licensing

To apply for a West Virginia resident producer’s license, you must:

Be at least 18 years old
Be a resident of West Virginia before you submit your application

Pre-licensing course and exam

The passing score on a West Virginia producer examination is a scaled score of 70 (Pearson VUE, West Virginia Insurance Candidate Handbook).

Fingerprints/background check

Controlled business

Non-resident license

Is currently licensed as a resident, and in good standing, in the home state
Has applied (the home-state application or the Uniform Application) and paid the fees
Lives in a home state that grants nonresident licenses to residents of this state on the same basis (reciprocity)

Temporary license

Most states allow the insurance regulator to issue a temporary license, without an examination, when one is needed to keep an insurance business serviced. Typical cases are:

The surviving spouse or personal representative of a producer who dies or becomes disabled, to allow time to sell the business or train new people
A member or employee of a business entity producer, on the death or disability of its designated producer
The designee of a producer entering active military service

The regulator may limit what a temporary licensee may do and may require a licensed sponsor who takes responsibility for the temporary licensee’s acts.

Military service

Renewal and reinstatement

A producer license stays in effect only while the producer renews it on schedule: paying the renewal fee and completing continuing education by the due date.

West Virginia producer licenses expire on the last day of the licensee’s birth month, every two years (WV Offices of the Insurance Commissioner, Licensing and Education Division).

A producer who misses the deadline and lets the license lapse may be able to reinstate it without retaking the examination.

Continuing education

Notice of change of name or address

A West Virginia licensee must inform the Commissioner of a change of name, physical address, mailing address or email address within 30 days of the change (W. Va. Code § 33-12-9(f)).

Company regulations

Capital and surplus requirement

West Virginia Life and Health Insurance Guaranty Association

The West Virginia Life and Health Insurance Guaranty Association protects policyowners, insureds, beneficiaries, and annuitants if a licensed member insurer becomes financially impaired or insolvent.

Within this overall $300,000 limit, the association will not pay more than:

$300,000 in life insurance death benefits
$100,000 in life insurance cash surrender values
$250,000 in present value of annuity benefits

Special limits apply to certain unallocated annuity contracts:

For unallocated annuities funding governmental retirement plans under Internal Revenue Code §§ 401(k), 403(b), or 457, the limit is $250,000 in present value annuity benefits per participating individual.
For certain other covered unallocated annuity contracts, a limit of $5 million in benefits per contract owner or plan sponsor applies (W. Va. Code § 33-26A-3©(2)(E)).

In all cases, the association cannot pay more than the amount the insurer would have owed under the policy or contract.

The association does not provide coverage for:

Policies issued by insurers not authorized to transact insurance in West Virginia
Self-funded employer or association plans
Stop-loss or administrative-services-only contracts
Policies or portions of policies in which the policyholder assumed the investment risk
Interest rates or dividends that exceed statutory limits

Insurance companies and producers are prohibited from using the existence of the West Virginia Life and Health Insurance Guaranty Association as an inducement to purchase insurance.

Duties of the Insurance Commissioner

The Commissioner is responsible for establishing and enforcing regulations in the West Virginia insurance market in a manner that protects consumers and encourages economic development.

Duties of the Commissioner include:

Investigate all claims and complaints of legal violations relating to insurance.
If the Commissioner finds that laws have been violated, the findings and supporting documents may be referred for criminal prosecution.
Monitor transactions of all companies including domestic, foreign, and alien insurance companies.
Audit the books and records of any resident producer as frequently as necessary. In West Virginia this reaches any licensed agent, broker, excess lines broker or solicitor (W. Va. Code § 33-2-9(g)).
Collect all fees associated with producers and insurers.
Determine and administer fines associated with violations for insurers and producers.
Issue reports pertaining to the suspension and revocation of licenses of producers and certificates of authority for insurers.
Approve documentation used by insurance companies such as forms and rates.

Sidenote

Know this...

Suspend, revoke or non-renew

The Commissioner has the authority to suspend, revoke, or refuse to renew a license for:

Providing false information on the application for an insurance license.
Omitting any relevant information on an application that would have disqualified the individual from being eligible to receive a license.
Being found guilty of a violation or the noncompliance of insurance regulations and laws…
Committing fraud while attempting to obtain an insurance license.
Improperly withholding, misappropriating or converting any money or property received in the course of doing insurance business.
Providing false information in reference to the terms and conditions of an insurance contract.
Having been convicted of or pleaded nolo contendere to any felony, or to a misdemeanor in connection with activities as an agent, solicitor or excess line broker (W. Va. Code § 33-12-24(b)(6)-(7)).
Having admitted or been found to have committed any insurance unfair trade practice or fraud.
Having engaged in activities of a fraudulent nature which allowed the person to involve themselves in dishonest, coercive, untrustworthy, and financially irresponsible practices.
Having had a prior insurance license revoked or suspended in a state other than West Virginia.
Using another person’s identity and forging their name on an insurance application.
Being found guilty of using unethical practices or cheating on an examination for an insurance license.

Cease and desist

Hearing and penalties

An applicant or licensee whose license is refused or not renewed may demand a hearing in writing within 10 days, and the hearing is held within 45 days (W. Va. Code § 33-12-24©).

Unfair claims settlement practices

The intentional obstruction and delay of claims payment or the delay of a claims investigation is a violation of regulation.
Neglecting to provide a prompt response and written explanation of insurance policy terms, conditions, and laws related to the contract are examples of unfair claims settlement practices.
Failure to provide claims without launching a thorough investigation is a violation of regulation.
Making settlement claims based on information contained on an application that has been altered without the insured’s consent is a violation of regulation.
Denying a claim without conducting a thorough investigation.
Attempting to settle a claim for less than fair market value.

Policy forms

Insurers file their policy forms with the Commissioner.

If a policy provision conflicts with West Virginia law, the policy is read as amended to conform to the law.

The interest rate an insurer may charge on a life insurance policy loan is also limited by state law.

Record maintenance

A producer keeps records of each transaction (the policies placed, the insureds, the premiums received and any changes) and makes them available for the Commissioner’s inspection.

Fraudulent producer representation

A producer found guilty of conducting business in West Virginia in any line of insurance for which they are not properly licensed may have any other insurance license suspended or revoked.

Misrepresentation

Misrepresentation involving the creation or distribution of policies, quotes, and illustrations designed to provide inaccurate information about the terms and conditions of a policy is prohibited.
Providing inaccurate or incomplete information or comparisons regarding the benefits of a policy is an example of misrepresentation.
Providing inaccurate or incomplete information for the purpose of inducing, or tending to induce, the lapse, exchange, conversion, forfeiture, or surrender of a policy is a violation as well (twisting).

False advertising

Defamation

Boycott, coercion and intimidation

False financial statements

Illegal inducements

Unfair discrimination

Unfair discrimination is treating people or risks that present the same hazard differently. The NAIC’s model act, on which state unfair trade practices laws are based, prohibits:

Unfair discrimination between individuals of the same class and equal expectation of life in life insurance and annuity rates, dividends, benefits or terms
Unfair discrimination between individuals of the same class and essentially the same hazard in health insurance premiums, benefits or terms
Refusing, limiting or canceling coverage because of a person’s sex, marital status, race, religion or national origin
In property and casualty insurance, refusing or limiting coverage solely because of a risk’s geographic location, unless sound underwriting and actuarial principles justify it, or solely because the applicant or insured is physically or mentally impaired

Errors & omissions

Rebating

Sidenote

Know this...

To “solicit” or “negotiate” insurance implies that the person is licensed.

Sharing commission

Suitability in annuity transactions

Suitability is based on factors such as:

Age
Income and financial status
Financial objectives
Tax status
Risk tolerance
Liquidity needs
Existing assets

Producers must make reasonable efforts to obtain relevant financial information before making a recommendation.

If a consumer refuses to provide information, the refusal must be documented.

Insurers are responsible for supervising annuity recommendations.

Twisting

Replacement of life insurance

Replacement occurs when a new life insurance policy is purchased and, as a result, an existing life policy is lapsed, surrendered, forfeited, assigned, or otherwise reduced in value.

When replacement is involved, the producer must:

Provide the applicant with a notice regarding replacement
Obtain a list of existing life insurance policies to be replaced
Submit required replacement documentation to the insurer

The replacing insurer must notify the existing insurer and maintain required replacement records.

Failure to comply with replacement requirements may result in fines or license discipline.

Unfair marketing practices

Any statement or implication that policies are approved, or that the financial condition of a company is endorsed, by any government agency or by any independent group, individual, organization or society, unless that is the fact.
Any statements regarding advertising that are false or untrue in reference to the time frame in which claims are paid.

Gramm-Leach Bliley Act (GLBA)

McCarran-Ferguson Act

National Association of Insurance Commissioners (NAIC)

Fair Credit Reporting Act

When an insurer requests an investigative consumer report, it must disclose that to the consumer within 3 days of the request
When an insurer takes adverse action based on a consumer report, it must notify the consumer and identify the reporting agency. The consumer then has 60 days to request a free copy of the report and may dispute inaccurate information

Privacy Act of 1974

Telemarketing

May be made only between 8 a.m. and 9 p.m. in the recipient’s local time
Must disclose the caller’s identity, the company the caller represents and that the purpose is a sale

CAN-SPAM

A commercial email must:

Be identified clearly as an advertisement
Carry accurate header information and a subject line that is not deceptive
Include the sender’s valid physical postal address
Offer a way to opt out, and the sender must honor an opt-out within 10 business days

Licensing (Resident Producer)

Minimum age: 18; must be WV resident before applying
Requires 20 hours prelicensing education per line of authority
Passing exam score: scaled score of 70

Fingerprints/Background Check

Criminal history record check required for resident license applicants
Full set of fingerprints submitted for FBI check

Controlled Business

Insurance on producer’s own life/property/family/employer interests
License cannot be used principally to write controlled business
Commissioner must confirm this intent before issuing license

Non-resident License

No WV exam needed if licensed elsewhere in good standing
Requires reciprocity, application (home-state or Uniform Application), and fee payment
Address change: within 30 days; new resident license after move: within 90 days (no repeat of exam/prelicensing education)

Temporary License

Issued without exam to keep business serviced (e.g., death/disability of producer, military deployment)
WV allows up to 180 days
Regulator may limit activities and require a licensed sponsor

Military Service

Waiver available for renewal procedures, exams, fines/sanctions if unable to comply due to military service or long-term medical disability

Renewal and Reinstatement

WV licenses expire last day of birth month, every 2 years
Lapsed license: reinstate within 12 months without exam
Penalty: double the unpaid renewal fee

Continuing Education

Required for all major lines before renewal
Hours set by state law, published by insurance department

Notice of Change of Name/Address

Must notify Commissioner within 30 days of name/address change
Also 30 days to report administrative actions (from final disposition) or criminal prosecutions (from initial pretrial hearing) in other jurisdictions
Must notify before doing business under any assumed name

Company Regulations

Must obtain certificate of authority from WV Commissioner
Requires filing charter/articles, financial statements, meeting capital/surplus rules, and fees

Capital and Surplus Requirement

Stock insurer: minimum $1 million fully paid capital
Mutual insurer: minimum $1 million surplus
Both must maintain additional surplus of at least $1 million
Commissioner must refuse renewal or suspend/revoke license for asset deficiency

WV Life and Health Insurance Guaranty Association

Protects policyowners, insureds, beneficiaries, and annuitants if a licensed member insurer becomes financially impaired or insolvent
Applies only to member insurers (currently or formerly licensed in WV) when impaired or insolvent
Aggregate cap per insured life: $300,000 (health benefit plans: $500,000)
Sub-limits within the $300,000 cap: $300,000 life death benefits, $100,000 life cash surrender values, $250,000 present value annuity benefits
Special unallocated annuity limits: $250,000 per participant (governmental retirement plans under IRC §§401(k)/403(b)/457); $5 million per contract owner/plan sponsor (certain other unallocated contracts)
Payment never exceeds what the insurer itself would have owed
Excludes: unauthorized insurers, self-funded employer/association plans, stop-loss/ASO contracts, investment-risk-assumed policies, excess interest/dividends
Cannot be used by insurers/producers as a sales inducement

Duties of the Insurance Commissioner

Appointed by governor, confirmed by Senate; 6-year term
Investigates violations/complaints, audits producers, collects fees, imposes fines, approves forms/rates
Cannot arrest, issue injunctions, or sentence jail time (refers matters for prosecution)
WV Insurance Fraud Unit certified officers may execute warrants/arrests and refer cases to prosecutors

Suspend, Revoke or Non-renew License

Grounds include: false/omitted application info, fraud, felony/certain misdemeanor convictions, unfair trade practices, prior license revocation elsewhere, exam cheating, forging signatures, misappropriating funds

Cease and Desist

Issued when a violation is found; does not suspend/revoke license but stops/limits the activity

Hearing and Penalties

Right to notice and hearing before adverse action
Written hearing request: within 10 days; hearing held within 45 days
Civil penalties (unfair trade practice): up to $1,000/violation ($10,000 total) if unknowing; up to $5,000/violation ($100,000 per six months) if knowing
License-related civil penalty: up to $5,000

Unfair Claims Settlement Practices

Violation when frequent enough to indicate a general business practice
Includes: delaying claims/investigation, failing to explain policy terms, using altered applications without consent, denying without investigation, settling below fair value

Policy Forms

Noncommercial lines: filed 60 days before use, deemed approved if no Commissioner action
Commercial P&C forms: take effect unless disapproved within 30 days
Conflicting policy provisions read as amended to conform to law

Record Maintenance

Producers keep transaction records available for Commissioner inspection
Retain policy files: current calendar year plus up to 5 additional years

Fraudulent Producer Representation

Illegal to represent licensure without passing required exam
Applies to all public communications (ads, cards, letterhead)
May result in suspension/revocation of other licenses held

Misrepresentation

Prohibits inaccurate policies, quotes, illustrations, or comparisons
Includes inducing lapse/surrender via inaccurate information (twisting)

False Advertising

Untrue, deceptive, or misleading statements about insurance business prohibited
Applies across all media; intent to deceive not required

Defamation

False or maliciously critical statements about financial condition (of insurer, or in WV, any person) prohibited
Must be calculated to injure the target

Boycott, Coercion, Intimidation

Prohibited when resulting in unreasonable restraint or monopoly of insurance business

False Financial Statements

Prohibits knowingly false statements about financial condition or false book entries
Also prohibits false statements on applications to obtain fee/commission/benefit

Illegal Inducements

Cannot offer unlisted value to induce insurance purchase
WV prohibits rebating unless expressly allowed
Educational/promotional items ≤$25 exempt from rebating rule

Unfair Discrimination

Prohibits differing treatment for same-class/same-hazard risks
Model act bars discrimination by sex, marital status, race, religion, national origin
P&C: cannot deny/limit solely for geographic location or physical/mental impairment (absent sound underwriting basis)
WV rule uses a same-class test without naming specific protected classes

Errors & Omissions (E&O)

Professional liability insurance for producers
Covers only honest mistakes causing financial damage to clients
No coverage for regulatory violations

Rebating

Prohibits refunds/discounts/favors/credits to induce purchase
P&C exception allowed if provided for in a Commissioner filing

Sharing Commission

Allowed only between producers licensed in the relevant line
WV bars sharing commission with anyone not licensed for that transaction
Unlicensed referral fee capped at $25, one-time, not sale-dependent

Suitability in Annuity Transactions

Must act in consumer’s best interest, not producer’s/insurer’s
Factors: age, income, objectives, tax status, risk tolerance, liquidity, existing assets
Must document if consumer refuses to provide information
Insurers responsible for supervising recommendations

Twisting

Misrepresentation made to induce lapse/forfeiture/exchange/conversion/surrender of a policy
True statements do not constitute twisting

Replacement of Life Insurance

Occurs when a new policy causes an existing policy to lapse/surrender/be reduced in value
Producer must: give replacement notice, list existing policies, submit required documentation
Replacing insurer must notify existing insurer and keep records
Non-compliance risks fines/license discipline

Unfair Marketing Practices

Commissioner sets standards for full/fair disclosure and standardized policy terms
Prohibits false claims of government/organization endorsement
Prohibits false statements about claims payment timeframes

Gramm-Leach-Bliley Act (GLBA)

Repealed Glass-Steagall; allows consolidation of banks, investment firms, and insurers
Establishes federal/state regulatory framework for combined financial services

McCarran-Ferguson Act

1945 law establishing state-level regulation of insurance
Grants limited antitrust exemption
Since 2021, exemption excludes health insurance except narrow historical loss-data sharing

NAIC

Standard-setting body governed by chief insurance regulators of states/territories
Supports peer review, model laws/standards, and coordinated regulatory oversight

Fair Credit Reporting Act (FCRA)

Governs consumer reporting agencies and use of consumer reports in underwriting
Investigative report request: must disclose to consumer within 3 days
Adverse action: must notify consumer and identify agency; consumer has 60 days to request free report/dispute inaccuracies

Privacy Act of 1974

Applies only to federal agencies, not private insurers
Insurer use of personal info governed by FCRA, GLBA, and state privacy law
WV: health information disclosure authorization valid max 24 months

Telemarketing

Do Not Call Registry restricts calls without permission or existing business relationship
Calls allowed only 8 a.m.–9 p.m. local time
Must disclose caller identity, represented company, and sales purpose

CAN-SPAM

Commercial email must be clearly identified as an ad
Requires accurate headers/subject line and valid physical postal address
Must offer opt-out; opt-out requests honored within 10 business days

West Virginia State Regulations & NAIC Insurance Law

Licensing

To apply for a West Virginia resident producer’s license, you must:

Be at least 18 years old
Be a resident of West Virginia before you submit your application

Pre-licensing course and exam

The passing score on a West Virginia producer examination is a scaled score of 70 (Pearson VUE, West Virginia Insurance Candidate Handbook).

Fingerprints/background check

Controlled business

Non-resident license

Is currently licensed as a resident, and in good standing, in the home state
Has applied (the home-state application or the Uniform Application) and paid the fees
Lives in a home state that grants nonresident licenses to residents of this state on the same basis (reciprocity)

Temporary license

Most states allow the insurance regulator to issue a temporary license, without an examination, when one is needed to keep an insurance business serviced. Typical cases are:

The surviving spouse or personal representative of a producer who dies or becomes disabled, to allow time to sell the business or train new people
A member or employee of a business entity producer, on the death or disability of its designated producer
The designee of a producer entering active military service

The regulator may limit what a temporary licensee may do and may require a licensed sponsor who takes responsibility for the temporary licensee’s acts.

Military service

Renewal and reinstatement

A producer license stays in effect only while the producer renews it on schedule: paying the renewal fee and completing continuing education by the due date.

West Virginia producer licenses expire on the last day of the licensee’s birth month, every two years (WV Offices of the Insurance Commissioner, Licensing and Education Division).

A producer who misses the deadline and lets the license lapse may be able to reinstate it without retaking the examination.

Continuing education

Notice of change of name or address

A West Virginia licensee must inform the Commissioner of a change of name, physical address, mailing address or email address within 30 days of the change (W. Va. Code § 33-12-9(f)).

Company regulations

Capital and surplus requirement

West Virginia Life and Health Insurance Guaranty Association

The West Virginia Life and Health Insurance Guaranty Association protects policyowners, insureds, beneficiaries, and annuitants if a licensed member insurer becomes financially impaired or insolvent.

Within this overall $300,000 limit, the association will not pay more than:

$300,000 in life insurance death benefits
$100,000 in life insurance cash surrender values
$250,000 in present value of annuity benefits

Special limits apply to certain unallocated annuity contracts:

For unallocated annuities funding governmental retirement plans under Internal Revenue Code §§ 401(k), 403(b), or 457, the limit is $250,000 in present value annuity benefits per participating individual.
For certain other covered unallocated annuity contracts, a limit of $5 million in benefits per contract owner or plan sponsor applies (W. Va. Code § 33-26A-3©(2)(E)).

In all cases, the association cannot pay more than the amount the insurer would have owed under the policy or contract.

The association does not provide coverage for:

Policies issued by insurers not authorized to transact insurance in West Virginia
Self-funded employer or association plans
Stop-loss or administrative-services-only contracts
Policies or portions of policies in which the policyholder assumed the investment risk
Interest rates or dividends that exceed statutory limits

Insurance companies and producers are prohibited from using the existence of the West Virginia Life and Health Insurance Guaranty Association as an inducement to purchase insurance.

Duties of the Insurance Commissioner

The Commissioner is responsible for establishing and enforcing regulations in the West Virginia insurance market in a manner that protects consumers and encourages economic development.

Duties of the Commissioner include:

Investigate all claims and complaints of legal violations relating to insurance.
If the Commissioner finds that laws have been violated, the findings and supporting documents may be referred for criminal prosecution.
Monitor transactions of all companies including domestic, foreign, and alien insurance companies.
Audit the books and records of any resident producer as frequently as necessary. In West Virginia this reaches any licensed agent, broker, excess lines broker or solicitor (W. Va. Code § 33-2-9(g)).
Collect all fees associated with producers and insurers.
Determine and administer fines associated with violations for insurers and producers.
Issue reports pertaining to the suspension and revocation of licenses of producers and certificates of authority for insurers.
Approve documentation used by insurance companies such as forms and rates.

Sidenote

Know this...

Suspend, revoke or non-renew

The Commissioner has the authority to suspend, revoke, or refuse to renew a license for:

Providing false information on the application for an insurance license.
Omitting any relevant information on an application that would have disqualified the individual from being eligible to receive a license.
Being found guilty of a violation or the noncompliance of insurance regulations and laws…
Committing fraud while attempting to obtain an insurance license.
Improperly withholding, misappropriating or converting any money or property received in the course of doing insurance business.
Providing false information in reference to the terms and conditions of an insurance contract.
Having been convicted of or pleaded nolo contendere to any felony, or to a misdemeanor in connection with activities as an agent, solicitor or excess line broker (W. Va. Code § 33-12-24(b)(6)-(7)).
Having admitted or been found to have committed any insurance unfair trade practice or fraud.
Having engaged in activities of a fraudulent nature which allowed the person to involve themselves in dishonest, coercive, untrustworthy, and financially irresponsible practices.
Having had a prior insurance license revoked or suspended in a state other than West Virginia.
Using another person’s identity and forging their name on an insurance application.
Being found guilty of using unethical practices or cheating on an examination for an insurance license.

Cease and desist

Hearing and penalties

An applicant or licensee whose license is refused or not renewed may demand a hearing in writing within 10 days, and the hearing is held within 45 days (W. Va. Code § 33-12-24©).

Unfair claims settlement practices

The intentional obstruction and delay of claims payment or the delay of a claims investigation is a violation of regulation.
Neglecting to provide a prompt response and written explanation of insurance policy terms, conditions, and laws related to the contract are examples of unfair claims settlement practices.
Failure to provide claims without launching a thorough investigation is a violation of regulation.
Making settlement claims based on information contained on an application that has been altered without the insured’s consent is a violation of regulation.
Denying a claim without conducting a thorough investigation.
Attempting to settle a claim for less than fair market value.

Policy forms

Insurers file their policy forms with the Commissioner.

If a policy provision conflicts with West Virginia law, the policy is read as amended to conform to the law.

The interest rate an insurer may charge on a life insurance policy loan is also limited by state law.

Record maintenance

A producer keeps records of each transaction (the policies placed, the insureds, the premiums received and any changes) and makes them available for the Commissioner’s inspection.

Fraudulent producer representation

A producer found guilty of conducting business in West Virginia in any line of insurance for which they are not properly licensed may have any other insurance license suspended or revoked.

Misrepresentation

Misrepresentation involving the creation or distribution of policies, quotes, and illustrations designed to provide inaccurate information about the terms and conditions of a policy is prohibited.
Providing inaccurate or incomplete information or comparisons regarding the benefits of a policy is an example of misrepresentation.
Providing inaccurate or incomplete information for the purpose of inducing, or tending to induce, the lapse, exchange, conversion, forfeiture, or surrender of a policy is a violation as well (twisting).

False advertising

Defamation

Boycott, coercion and intimidation

False financial statements

Illegal inducements

Unfair discrimination

Unfair discrimination is treating people or risks that present the same hazard differently. The NAIC’s model act, on which state unfair trade practices laws are based, prohibits:

Unfair discrimination between individuals of the same class and equal expectation of life in life insurance and annuity rates, dividends, benefits or terms
Unfair discrimination between individuals of the same class and essentially the same hazard in health insurance premiums, benefits or terms
Refusing, limiting or canceling coverage because of a person’s sex, marital status, race, religion or national origin
In property and casualty insurance, refusing or limiting coverage solely because of a risk’s geographic location, unless sound underwriting and actuarial principles justify it, or solely because the applicant or insured is physically or mentally impaired

Errors & omissions

Rebating

Sidenote

Know this...

To “solicit” or “negotiate” insurance implies that the person is licensed.

Sharing commission

Suitability in annuity transactions

Suitability is based on factors such as:

Age
Income and financial status
Financial objectives
Tax status
Risk tolerance
Liquidity needs
Existing assets

Producers must make reasonable efforts to obtain relevant financial information before making a recommendation.

If a consumer refuses to provide information, the refusal must be documented.

Insurers are responsible for supervising annuity recommendations.

Twisting

Replacement of life insurance

Replacement occurs when a new life insurance policy is purchased and, as a result, an existing life policy is lapsed, surrendered, forfeited, assigned, or otherwise reduced in value.

When replacement is involved, the producer must:

Provide the applicant with a notice regarding replacement
Obtain a list of existing life insurance policies to be replaced
Submit required replacement documentation to the insurer

The replacing insurer must notify the existing insurer and maintain required replacement records.

Failure to comply with replacement requirements may result in fines or license discipline.

Unfair marketing practices

Any statement or implication that policies are approved, or that the financial condition of a company is endorsed, by any government agency or by any independent group, individual, organization or society, unless that is the fact.
Any statements regarding advertising that are false or untrue in reference to the time frame in which claims are paid.

Gramm-Leach Bliley Act (GLBA)

McCarran-Ferguson Act

National Association of Insurance Commissioners (NAIC)

Fair Credit Reporting Act

When an insurer requests an investigative consumer report, it must disclose that to the consumer within 3 days of the request
When an insurer takes adverse action based on a consumer report, it must notify the consumer and identify the reporting agency. The consumer then has 60 days to request a free copy of the report and may dispute inaccurate information

Privacy Act of 1974

Telemarketing

May be made only between 8 a.m. and 9 p.m. in the recipient’s local time
Must disclose the caller’s identity, the company the caller represents and that the purpose is a sale

CAN-SPAM

A commercial email must:

Be identified clearly as an advertisement
Carry accurate header information and a subject line that is not deceptive
Include the sender’s valid physical postal address
Offer a way to opt out, and the sender must honor an opt-out within 10 business days

Licensing (Resident Producer)

Minimum age: 18; must be WV resident before applying
Requires 20 hours prelicensing education per line of authority
Passing exam score: scaled score of 70

Fingerprints/Background Check

Criminal history record check required for resident license applicants
Full set of fingerprints submitted for FBI check

Controlled Business

Insurance on producer’s own life/property/family/employer interests
License cannot be used principally to write controlled business
Commissioner must confirm this intent before issuing license

Non-resident License

No WV exam needed if licensed elsewhere in good standing
Requires reciprocity, application (home-state or Uniform Application), and fee payment
Address change: within 30 days; new resident license after move: within 90 days (no repeat of exam/prelicensing education)

Temporary License

Issued without exam to keep business serviced (e.g., death/disability of producer, military deployment)
WV allows up to 180 days
Regulator may limit activities and require a licensed sponsor

Military Service

Waiver available for renewal procedures, exams, fines/sanctions if unable to comply due to military service or long-term medical disability

Renewal and Reinstatement

WV licenses expire last day of birth month, every 2 years
Lapsed license: reinstate within 12 months without exam
Penalty: double the unpaid renewal fee

Continuing Education

Required for all major lines before renewal
Hours set by state law, published by insurance department

Notice of Change of Name/Address

Must notify Commissioner within 30 days of name/address change
Also 30 days to report administrative actions (from final disposition) or criminal prosecutions (from initial pretrial hearing) in other jurisdictions
Must notify before doing business under any assumed name

Company Regulations

Must obtain certificate of authority from WV Commissioner
Requires filing charter/articles, financial statements, meeting capital/surplus rules, and fees

Capital and Surplus Requirement

Stock insurer: minimum $1 million fully paid capital
Mutual insurer: minimum $1 million surplus
Both must maintain additional surplus of at least $1 million
Commissioner must refuse renewal or suspend/revoke license for asset deficiency

WV Life and Health Insurance Guaranty Association

Protects policyowners, insureds, beneficiaries, and annuitants if a licensed member insurer becomes financially impaired or insolvent
Applies only to member insurers (currently or formerly licensed in WV) when impaired or insolvent
Aggregate cap per insured life: $300,000 (health benefit plans: $500,000)
Sub-limits within the $300,000 cap: $300,000 life death benefits, $100,000 life cash surrender values, $250,000 present value annuity benefits
Special unallocated annuity limits: $250,000 per participant (governmental retirement plans under IRC §§401(k)/403(b)/457); $5 million per contract owner/plan sponsor (certain other unallocated contracts)
Payment never exceeds what the insurer itself would have owed
Excludes: unauthorized insurers, self-funded employer/association plans, stop-loss/ASO contracts, investment-risk-assumed policies, excess interest/dividends
Cannot be used by insurers/producers as a sales inducement

Duties of the Insurance Commissioner

Appointed by governor, confirmed by Senate; 6-year term
Investigates violations/complaints, audits producers, collects fees, imposes fines, approves forms/rates
Cannot arrest, issue injunctions, or sentence jail time (refers matters for prosecution)
WV Insurance Fraud Unit certified officers may execute warrants/arrests and refer cases to prosecutors

Suspend, Revoke or Non-renew License

Grounds include: false/omitted application info, fraud, felony/certain misdemeanor convictions, unfair trade practices, prior license revocation elsewhere, exam cheating, forging signatures, misappropriating funds

Cease and Desist

Issued when a violation is found; does not suspend/revoke license but stops/limits the activity

Hearing and Penalties

Right to notice and hearing before adverse action
Written hearing request: within 10 days; hearing held within 45 days
Civil penalties (unfair trade practice): up to $1,000/violation ($10,000 total) if unknowing; up to $5,000/violation ($100,000 per six months) if knowing
License-related civil penalty: up to $5,000

Unfair Claims Settlement Practices

Violation when frequent enough to indicate a general business practice
Includes: delaying claims/investigation, failing to explain policy terms, using altered applications without consent, denying without investigation, settling below fair value

Policy Forms

Noncommercial lines: filed 60 days before use, deemed approved if no Commissioner action
Commercial P&C forms: take effect unless disapproved within 30 days
Conflicting policy provisions read as amended to conform to law

Record Maintenance

Producers keep transaction records available for Commissioner inspection
Retain policy files: current calendar year plus up to 5 additional years

Fraudulent Producer Representation

Illegal to represent licensure without passing required exam
Applies to all public communications (ads, cards, letterhead)
May result in suspension/revocation of other licenses held

Misrepresentation

Prohibits inaccurate policies, quotes, illustrations, or comparisons
Includes inducing lapse/surrender via inaccurate information (twisting)

False Advertising

Untrue, deceptive, or misleading statements about insurance business prohibited
Applies across all media; intent to deceive not required

Defamation

False or maliciously critical statements about financial condition (of insurer, or in WV, any person) prohibited
Must be calculated to injure the target

Boycott, Coercion, Intimidation

Prohibited when resulting in unreasonable restraint or monopoly of insurance business

False Financial Statements

Prohibits knowingly false statements about financial condition or false book entries
Also prohibits false statements on applications to obtain fee/commission/benefit

Illegal Inducements

Cannot offer unlisted value to induce insurance purchase
WV prohibits rebating unless expressly allowed
Educational/promotional items ≤$25 exempt from rebating rule

Unfair Discrimination

Prohibits differing treatment for same-class/same-hazard risks
Model act bars discrimination by sex, marital status, race, religion, national origin
P&C: cannot deny/limit solely for geographic location or physical/mental impairment (absent sound underwriting basis)
WV rule uses a same-class test without naming specific protected classes

Errors & Omissions (E&O)

Professional liability insurance for producers
Covers only honest mistakes causing financial damage to clients
No coverage for regulatory violations

Rebating

Prohibits refunds/discounts/favors/credits to induce purchase
P&C exception allowed if provided for in a Commissioner filing

Sharing Commission

Allowed only between producers licensed in the relevant line
WV bars sharing commission with anyone not licensed for that transaction
Unlicensed referral fee capped at $25, one-time, not sale-dependent

Suitability in Annuity Transactions

Must act in consumer’s best interest, not producer’s/insurer’s
Factors: age, income, objectives, tax status, risk tolerance, liquidity, existing assets
Must document if consumer refuses to provide information
Insurers responsible for supervising recommendations

Twisting

Misrepresentation made to induce lapse/forfeiture/exchange/conversion/surrender of a policy
True statements do not constitute twisting

Replacement of Life Insurance

Occurs when a new policy causes an existing policy to lapse/surrender/be reduced in value
Producer must: give replacement notice, list existing policies, submit required documentation
Replacing insurer must notify existing insurer and keep records
Non-compliance risks fines/license discipline

Unfair Marketing Practices

Commissioner sets standards for full/fair disclosure and standardized policy terms
Prohibits false claims of government/organization endorsement
Prohibits false statements about claims payment timeframes

Gramm-Leach-Bliley Act (GLBA)

Repealed Glass-Steagall; allows consolidation of banks, investment firms, and insurers
Establishes federal/state regulatory framework for combined financial services

McCarran-Ferguson Act

1945 law establishing state-level regulation of insurance
Grants limited antitrust exemption
Since 2021, exemption excludes health insurance except narrow historical loss-data sharing

NAIC

Standard-setting body governed by chief insurance regulators of states/territories
Supports peer review, model laws/standards, and coordinated regulatory oversight

Fair Credit Reporting Act (FCRA)

Governs consumer reporting agencies and use of consumer reports in underwriting
Investigative report request: must disclose to consumer within 3 days
Adverse action: must notify consumer and identify agency; consumer has 60 days to request free report/dispute inaccuracies

Privacy Act of 1974

Applies only to federal agencies, not private insurers
Insurer use of personal info governed by FCRA, GLBA, and state privacy law
WV: health information disclosure authorization valid max 24 months

Telemarketing

Do Not Call Registry restricts calls without permission or existing business relationship
Calls allowed only 8 a.m.–9 p.m. local time
Must disclose caller identity, represented company, and sales purpose

CAN-SPAM

Commercial email must be clearly identified as an ad
Requires accurate headers/subject line and valid physical postal address
Must offer opt-out; opt-out requests honored within 10 business days