West Virginia Code of State Rules
Agency 114 - Insurance Commission
Title 114 - LEGISLATIVE RULE INSURANCE COMMISSIONER
Series 114-31 - Guaranteed Loss Ratios as Applied To Individual Sickness And Accident Insurance Policies
Section 114-31-5 - Rejection or Cancellation of Loss Ratio Guarantee

Universal Citation: 114 WV Code of State Rules 114-31-5

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

5.1. The Commissioner may reject a loss ratio guarantee or cancel an existing loss ratio guarantee for any of the following reasons which shall be a non-exclusive list:

a. The insurer has demonstrated an inability to adequately monitor its loss ratios;

b. The insurer has failed to take timely rate increases in accordance with sound actuarial principles during the three-year period prior to filing the loss ratio guarantee;

c. The insurer has not complied with the terms of a previously filed loss ratio guarantee;

d. The insurer has submitted false, misleading or fraudulent material or information to the Commissioner.

e. The insurer is impaired, insolvent, in hazardous financial condition or such other similar financial condition as defined in W. Va. Code §§ 33-10-1 et seq., 33-24-1 et seq., 33-34A-1 et seq., or any other article of this chapter;

f. The Commissioner determines that the insurer has not complied with the provisions of the guarantee or this article.

g. The insurer's data reflects a guaranteed loss ratio of less than sixty percent (60%);

h. The insurer has failed to comply with W. Va. Code § 33-6-34, form and rate filing fee requirement or other department filing procedure;

i. The insurer fails to provide information, data, or documentation reasonably requested by the Commissioner;

j. The insurer violates any provision of W. Va. Code § 33-1-1 et seq. or the rules promulgated thereunder;

k. The insurer refuses to permit the Commissioner to examine and copy such records as the Commissioner deems necessary to determine compliance with W. Va. Code § 33-6C-1 et seq.

l. The insurer fails or refuses to pay the reasonable costs of the Commissioner arising out of the Commissioner's examination of the insurer's records to determine compliance with W. Va. Code § 33-6C-1 et seq.

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