West Virginia Code § 33-13D-2

Insurer conduct
Open in Lexace · Ask the AI about this section
(a) An insurer shall perform a comparison of its insureds' in-force policies, annuity contracts
and account owners against a Death Master File to identify potential death master file
matches of its insureds, annuitants and account owners, on at least an annual basis, by using
the full Death Master File once and thereafter using the Death Master File update files for
future comparisons to identify potential Death Master File matches. The comeparison using
the full Death Master File should be completed within two years of the effective date of this
article and must be completed on policies in force as of 1986, and all porlicies issued
thereafter: Provided, That the Insurance Commissioner shall promulgate legislative rules
requiring that the comparison against a Death Master File be completed on policies issued
at earlier times if the commissioner determines that reliable technology and data exist to
make such comparison accurate and cost-effective to match tto the established Master Death
Database.
(b) The insurer comparison of policies, annuity contracts and account owners shall be
conducted first to the extent that such records are available electronically and then using
the most easily accessible insurer data for recsords that are not available electronically.
(c) This section shall not apply to policies or annuity contracts for which the insurer is
receiving premiums from outside thge policy value, by check, bank draft, payroll deduction or
any other similar method of active premium payment within the eighteen months
immediately preceding the Deeath Master File comparison.
(d) Nothing in this section shall limit the insurer from requesting a valid death certificate as
part of any claims validation process.
(e) For those potential matches identified as a result of a Death Master File match, or if an
insurer learns of the possible death of a person otherwise, then the insurer shall, within
ninety days of a Death Master File match:
(1) Complete a good faith effort, which shall be documented by the insurer, to confirm the
death of the person against other available records and information;
(2) Review its records to determine whether the deceased person has any other products
with the insurer;
(3) Determine whether benefits may be due in accordance with any applicable policy,
annuity contract or retained asset account.
(f) Every insurer shall implement procedures to account for:
(1) Common nicknames, initials used in lieu of a first or middle name, use of a middle name,
compound first and middle names, and interchanged first and middle names;
(2) Compound last names, maiden or married names, and hyphens, blank spaces or
apostrophes in last names;
(3) Transposition of the "month" and "date" portions of the date of birth; and
(4) Incomplete Social Security number.
(g) If the beneficiary or other authorized representative has not communicated with the
insurer within the ninety-day period, the insurer shall take reasonable steps and use good
faith efforts, which shall be documented by the insurer, to locate and contact the beneficiary
or beneficiaries or other authorized representative on any such policy, annuity contract or
retained asset account, including, but not limited to, sending theu beneficiary information
regarding the insurer's claims process, including the need to provide an official death
certificate if applicable under the policy, annuity contract or retained asset account.
(h) To the extent permitted by law, the insurer may disaclose minimum necessary personal
information about a person or beneficiary to a person who the insurer reasonably believes
may be able to assist the insurer in locating the benleficiary or a person otherwise entitled to
payment of the claims proceeds. s
(i) An insurer or its service provider shall niot charge any beneficiary or other authorized
representative for any fees or costs associated with a Death Master File search or
verification of Death Master File match conducted pursuant to this section.
(j) The benefits from a policy, annuity contract or a retained asset account, plus any
applicable accrued contractual interest shall first be payable to the designated beneficiaries
or owners, and in the event said beneficiaries or owners cannot be found, shall be paid to the
state as unclaimed property pursuant to article eight, chapter thirty-six of this code.
(k) The West VVirginia Office of the Insurance Commissioner has exclusive authority to
promulgate such rules and regulations as may be required or reasonably necessary to
implement the provisions of this section.
(l) The commissioner may, in his or her reasonable discretion, make an order to:
(1) Limit an insurer's Death Master File comparisons required under subsection (a) of this
section to the insurer's electronic searchable files or approve a plan and timeline for
conversion of the insurer's files to searchable electronic files upon a demonstration of
hardship by the insurer;
(2) Exempt an insurer from the Death Master File comparisons required under subsection
(a) of this section or permitting an insurer to perform such comparisons less frequently than
annually upon a demonstration of hardship by the insurer; or
(3) Phase-in compliance with this section according to a plan and timeline approved by the
commissioner.

‹ Prev All West Virginia sections Next ›


Lexace provides legal information, not legal advice, and no attorney–client relationship is created. Statute text is provided for general information and may not reflect the most recent amendments; verify against the official state code.