West Virginia Code of State Rules
Agency 114 - Insurance Commission
Title 114 - LEGISLATIVE RULE INSURANCE COMMISSIONER
Series 114-76 - Rules Of Practice And Procedure For Administrative Proceedings Brought By Third Pary Claimants
Section 114-76-5 - Resolution Without Hearing

Universal Citation: 114 WV Code of State Rules 114-76-5

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

5.1. Closing of complaint. -- Except as provided in W. Va. Code § 33-11-4 a(i) and subsection 5.4 of this section, the commissioner shall close the complaint and no further action shall lie on the matter if he or she determines that the respondent:

a. Substantially corrected the circumstances that gave rise to the complaint within the sixty-day period;

b. Offered to resolve the complaint in a reasonable manner within the sixty-day period; or

c. Provided sufficient information to satisfy the commissioner that the complaint lacks merit.

5.2. When complaint may be closed. -- A determination to close the complaint pursuant to subsection 5.1 of this section may be made at any time after the expiration of the sixty-day period, including during or after a hearing conducted pursuant to section 7 of this rule.

5.3. Right to contest closure. -- This section shall not affect the right of a claimant to make a written demand for a hearing pursuant to the provisions of W. Va. Code § 33-2-13 on the issue of whether the commissioner properly decided to close the complaint pursuant to subsection 5.1 of this section. If the commissioner determines after such hearing that the closure was in error, the complaint shall be reopened and the matter shall proceed as if the commissioner had not made the determination to close the complaint pursuant to subsection 5.1 of this section. In the event of a reopening of the complaint pursuant to this subsection, all time periods in this rule shall be tolled pending the final determination of the proceedings instituted to contest the closure under subsection 5.1 of this section.

5.4. Effect of closure. -- The closure of a complaint pursuant to subsection 5.1 of this section does not limit the authority of the commissioner to consider evidence related to the factual allegations of the complaint in determining, in the context of a proceeding other than that involving the closed complaint itself, whether the alleged unfair settlement practice was, when considered in conjunction with other similar violations, part of a general business practice.

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