West Virginia Code of State Rules
Agency 114 - Insurance Commission
Title 114 - LEGISLATIVE RULE INSURANCE COMMISSIONER
Series 114-25 - Insurance Adjusters
Section 114-25-20 - Revocation, Suspension, Refusal to Renew or Issue License; Penalty in Lieu Thereof

Universal Citation: 114 WV Code of State Rules 114-25-20

Current through Register Vol. XLI, No. 38, September 20, 2024

20.1. The Commissioner may examine and investigate the business affairs or conduct of persons applying for or holding an adjuster license to determine whether such person is trustworthy and competent or has been engaged in any violation of the insurance laws or rules of this state or in any unfair or deceptive acts or practices. In the event that the action by the Commissioner is to deny an application for or not renew a license, the Commissioner shall notify the applicant or licensee and advise, in writing, the applicant or licensee of the reason for the non-renewal or denial of the applicant's or licensee's license. The applicant or licensee may make written demand upon the Commissioner within ten days for a hearing before the Commissioner to determine the reasonableness of the commissioner's action. The hearing shall be held within forty-five days and shall be held pursuant to section thirteen, article two of chapter thirty-three of the West Virginia Code.

20.2. Whenever, after notice and hearing the Commissioner is satisfied that any adjuster has violated any provision of this rule, or is incompetent or untrustworthy, the Commissioner may place on probation, revoke, suspend, or refuse to issue or, if renewal of license is pending, refuse to renew the license of such adjuster. In addition to placing on probation, revoking, suspending, or refusing to renew such license, the Commissioner may in his or her discretion order such licensee to pay to the State of West Virginia an administrative penalty in a sum not to exceed $1,000 for each violation. Upon failure of the licensee to pay such penalty within 30 days, his or her license will be suspended or revoked by the Commissioner.

20.3. For the purposes of this rule, it is considered to demonstrate lack of trustworthiness or competency if the Commissioner determines such adjuster ha

20.3.a. Provided incorrect, misleading, incomplete, or materially untrue information in the license application;

20.3.b. Violated any insurance law or any lawful rule, regulation, subpoena or order of the Commissioner;

20.3.c. Improperly withheld, misappropriated, or converted to his own use any money received in the course of business and belonging to policyholders, insurers, beneficiaries, or others;

20.3.d. Intentionally misrepresented the terms or benefits of an actual or proposed insurance contract or the eligibility for claims under an insurance contract;

20.3.e. Admitted or been found to have committed any pattern of unfair methods of competition or unfair or deceptive acts or practices or fraud in the business of insurance as defined in W. Va. Code § 33-11-1 et seq;

20.3.f. Forged another person's name to any document or fraudulently procured a forged signature to any document, knowing such signature to be forged relating to an insurance transaction;

20.3.g. Knowingly and willfully made or permitted a false or fraudulent statement or misrepresentation in or relative to the adjustment of any claim or using fraudulent, coercive, or dishonest practices, or demonstrating incompetence, untrustworthiness, or financial irresponsibility, in the conduct of insurance business in this state or elsewhere;

20.3.h Been convicted of or pleaded nolo contendre to any felony;

20.3.i. Been convicted of or pleaded nolo contendre to a misdemeanor in connection with his activities relating to the business of insurance;

20.3.j. Had an insurance license or its equivalent suspended, revoked or refused in any other state, district or territory of the United States or any province of Canada;

20.3.k. Obtained a license as an agent, broker, or adjuster through misrepresentation, fraud, or any other act for which issuance of the license could have been refused had it been known to the Commissioner at the time of issuance.

20.3.l. Cheated, including improperly using notes, electronic devices or any other reference material, to complete an examination for an insurance license;

20.3.m. Knowingly accepting insurance business from an individual who is not licensed but who is required to be licensed by the Commissioner;

20.3.n. Failed to comply with an administrative or court order imposing a child support obligation;

20.3.o. Failed to pay state income tax or comply with any administrative or court order directing payment of state income tax; or

20.3.p. Committed any other act which inherently demonstrates untrustworthiness or lack of competence.

20.4. The Commissioner shall retain the authority to enforce the provisions of and impose any penalty or remedy authorized by this rule or W.Va. Code § 33-12B-1 et. seq. against any person who is under investigation for or charged with a violation of this rule or W.Va. Code § 33-12B-1 et. seq. even if the person's license or registration has been surrendered or has lapsed by operation of law.

20.5. Orders issued by the Commissioner pursuant to this section are subject to the judicial review provisions of W.Va. Code § 33-2-14.

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