West Virginia Code § 33-16A-5

Persons for whom coverage not required
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The insurer shall not be required to issue a converted policy covering any person if such
person is or could be covered by Medicare (Title XVIII of the United State Social Security
Act as supplemented by the Social Security Amendments of 1965 or as later amended or
superseded). Furthermore, the insurer shall not be required to issue a converted policy
covering any person if: e
(a) (1) Such person is covered for similar benefits by another hospital, surgical, medical or
major medical expense insurance policy or hospital or medical service subscriber contract or
medical practice or other prepayment plan or by any other plan uor program; or
(2) Similar benefits are provided to such person, pursuant to or in accordance with the
requirements of any state or federal law; and
(b) The benefits provided under the sources referred to in (1) above for such person or
benefits provided under the sources referred to in l(2) above for such person, together with
the benefits provided by the converted policy,s would result in overinsurance according to the
insurer's standards. The insurer's standards must bear some reasonable relationship to
actual health care costs in the area in whicih the insured lives at the time of conversion and
must be filed with the commissionerg prior to their use in denying coverage.

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