West Virginia Code § 33-16A-6

Inquiries by insurer
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A converted policy may include a provision whereby the insurer may request information in
advance of any premium due date of such policy of any person covered thereunder as to
whether (i) he 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 or programe, (ii) he is
covered for similar benefits under any arrangement of coverage for individuals in a group,
whether on an insured or uninsured basis, or (iii) similar benefits are prrovided for or
available to such person, pursuant to or in accordance with the requirements of any state or
federal law. The converted policy may provide that the insurer may refuse to renew the
policy or the coverage of any person insured thereunder for the following reasons only:
(a) Either the benefits provided under the sources referred to in (i) and (ii) above for such
person or benefits provided or available under the sources referred to in (iii) above for such
person, together with the benefits provided by the converted policy, would result in
overinsurance according to the insurer's standards on file with the commissioner or the
converted policyholder fails to provide the reqsuested information;
(b) Fraud or material misrepresentation in applying for any benefits under the converted
policy; g
(c) Eligibility of the insured person for coverage under Medicare (Title XVIII of the United
States Social Security Act as supplemented by the Social Security Amendments of 1965 or as
later amended or superseded) or under any other state or federal law providing for benefits
similar to those provided by the converted policy;
(d) Other reasons approved by the commissioner.

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