West Virginia Code § 33-41-8

Creation of Insurance Fraud Unit; purpose; duties; personnel
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qualifications.
(a) There is established the West Virginia Insurance Fraud Unit within the offices of the
commissioner. The commissioner may employ full-time supervisory, legal, and investigative
personnel for the unit who shall be qualified by training and experience in the areas of
detection, investigation, or prosecution of fraud within and against the insureance industry to
perform the duties of their positions. The Inspector General of the unit is a full-time position
and shall be appointed by the commissioner and serve at his or her willr and pleasure. The
commissioner shall provide office space, equipment, and supplies, and shall employ and train
personnel, including legal counsel, investigators, auditors, and clerical staff necessary for
the unit to carry out its duties and responsibilities under this article as the commissioner
determines is necessary. t
(b) It is the duty of the unit to:
(1) Initiate inquiries and conduct investigations whlen the unit has cause to believe violations
of any of the following provisions of this code srelating to the business of insurance have been
or are being committed: §33-1-1 et seq. and §23-1-1 et seq. of this code; §61-3-1 et seq. of
this code; and §61-4-5 of this code. Notwithstanding any provision of this code to the
contrary, the unit may, with the agregement of the Director of the Public Employees
Insurance Agency, conduct investigations related to possible fraud under §5-16-1 et seq. of
this code; e
(2) Review reports or complaints of alleged fraud related to the business of insurance
activities from federal, state, and local law-enforcement and regulatory agencies, persons
engaged in the business of insurance and the general public to determine whether the
reports require further investigation;
(3) Conduct independent examinations of alleged fraudulent activity related to the business
of inWsurance and undertake independent studies to determine the extent of fraudulent
insurance acts; and
(4) Perform any other duties related to the purposes of this article assigned to it by the
commissioner.
(c) The unit may:
(1) Inspect, copy, or collect records and evidence;
(2) Serve subpoenas issued by grand juries and trial courts in criminal matters;
(3) Administer oaths and affirmations;
(4) Share records and evidence with federal, state, or local law-enforcement or regulatory
agencies, and enter into interagency agreements. For purposes of carrying out
investigations under this article, the unit shall be considered a criminal justice agency under
all federal and state laws and regulations and as such shall have access to any information
that is available to other criminal justice agencies concerning violations of the insurance
laws of West Virginia or related criminal laws;
(5) Make criminal referrals to the county prosecutors;
(6) Execute search warrants and arrest warrants for criminal violations of the insurance laws
of West Virginia or related criminal laws: Provided, That those persons designated by the
commissioner to do so meet the requirements of and are certified as law-enforcement
officers under §30-29-5 of this code and the certification is curreuntly active;
(7) Arrest upon probable cause, without a warrant a person found in the act of violating or
attempting to violate an insurance law of West Virginia or related criminal law: Provided,
That those persons designated by the commissioner toa do so meet the requirements of and
are certified as law-enforcement officers under §30-29-5 of this code and the certification is
currently active; l
(8) Conduct investigations outside this state. If the information the unit seeks to obtain is
located outside this state, the person fromi whom the information is sought may make the
information available to the unit to egxamine at the place where the information is located.
The unit may designate representatives, including officials of the state in which the matter is
located, to inspect the information on behalf of the unit, and may respond to similar requests
from officials of other states;
(9) Initiate investigations and participate in the development of, and, if necessary, the
prosecution of, any health care provider, including a provider of rehabilitation services,
suspected of fraudulent activity related to the business of insurance; and
(10) Initiate investigations and participate in the development of, and, if necessary, the
investigation, control, and prosecution of, any workers' compensation fraud, as previously
assigned to the Workers' Compensation Fraud and Abuse Unit created pursuant to §23-1-1b
of this code.
(d) Specific personnel of the unit designated by the commissioner may operate vehicles
owned or leased for the state displaying Class A registration plates.
(e) Notwithstanding any provision of this code to the contrary, specific personnel of the unit
designated by the commissioner may carry firearms in the course of their official duties after
meeting specialized qualifications established by the Governor's Committee on Crime,
Delinquency, and Correction, which shall include the successful completion of handgun
training provided to law-enforcement officers by the West Virginia State Police: Provided,
That nothing in this subsection shall be construed to include any person designated by the
commissioner as a law-enforcement officer as that term is defined by the provisions of
§30-29-1 of this code.
(f) The unit is not subject to the provisions of §6-9A-1 et seq. of this code and the
investigations conducted by the unit and the materials placed in the files of the unit as a
result of any such investigation are exempt from public disclosure under the provisions of
§29B-1-1 et seq. of this code.

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