West Virginia Offices of the Insurance Commissioner 2009 Annual ...

More documents

Recommendations

Info

January 2009 February 2009 March 2009 Claims benefits paid: Medical (4,311,559.34) (3,824,287.37) (3,525,583.66) Permanent Total Disability (12,528,584.44) (12,747,399.01) (12,358,925.75) Permanent Partial Disability (602,557.01) (639,888.35) (650,510.98) Temporary Total Disability (119,238.22) (166,436.36) (201,815.65) Temporary Partial Disability (882.28) (882.28) (7,233.28) Settlement Agreements (366,131.30) (317,845.71) (200,012.07) Fatals (2,645,088.86) (2,708,862.89) (2,750,202.80) 104 weeks (714,848.44) (620,275.08) (562,433.43) Non-Awarded Partials 0.00 0.00 0.00 Total (21,288,889.89) (21,025,877.05) (20,256,717.62) Claims credits and overpayments 220,455.94 136,419.17 167,970.40 Total claims paid (21,068,433.95) (20,889,457.88) (20,088,747.22) April 2009 May 2009 June 2009 Claims benefits paid: Medical (4,890,935.10) (3,891,543.66) (3,990,028.82) Permanent Total Disability (12,567,880.38) (12,835,184.47) (12,184,904.79) Permanent Partial Disability (654,030.48) (548,575.78) (529,912.59) Temporary Total Disability (100,718.93) (103,982.47) (152,567.40) Temporary Partial Disability (882.28) (1,186.71) (798.17) Settlement Agreements (172,534.99) (340,287.29) (342,141.81) Fatals (2,648,279.98) (2,707,301.72) (2,676,374.22) 104 weeks (469,725.58) (495,265.81) (514,210.34) Non-Awarded Partials 0.00 0.00 0.00 Total (21,504,987.72) (20,923,327.91) (20,390,938.14) Claims credits and overpayments 85,996.91 87,215.74 192,188.22 Total claims paid (21,418,990.81) (20,836,112.17) (20,198,749.92) 34
West Virginia Office of Consumer Advocate In 2009, the Office of Consumer Advocate served the interests of the West Virginia insurance consumer and fulfilled the expanded duties conferred upon the Office in the tort reform measures passed in 2005 in Senate Bill 418. A large portion of the Office of the Consumer Advocate’s time and resources was devoted to first and third party administrative hearings. The efforts of the Office of the Consumer Advocate on behalf of West Virginia insurance consumers yielded financial awards totaling $190,218.91 as well as a number of other important settlements and regulatory orders directly benefiting the West Virginia insurance consumer. Also in the health care arena, the Office of the Consumer Advocate reviewed thirty-five (35) Certificate of Need Applications and thirty-four (34) Rate Review Applications before the West Virginia Health Care Authority. Furthermore, the Office of the Consumer Advocate is currently investigating matters related to the cost of health insurance, including the practice of hospital discount rate contracts and other methods to foster competition among health insurance companies to facilitate a reduction in costs for consumers. The Office of the Consumer Advocate attended many State conferences and State festivals as a means of interacting with and disseminating information to West Virginia insurance consumers. State festivals attended include the West Virginia State Fair, the Friends of Coal Auto Fair in Beckley, the Arts and Crafts Fair in Ripley and the Pumpkin Festival in Milton. Further, the Office of the Consumer Advocate participated in several telephonic conferences with over thirty (30) state insurance consumer advocates from across the nation in an effort to network and gather information that can be used to provide better representation to West Virginia insurance consumers. The Office of the Consumer Advocate participated in mandatory continuing legal education with a focus on insurance and consumer related education. In January 2009, the Attorney II for the Office of the Consumer Advocate attended the very prestigious 28 th Annual National Trial Advocacy College on the campus of the University Virginia in Charlottesville, Virginia. The Attorney II position is now vacant in the Consumer Advocate’s Office and the Director hopes that it is filled soon and to be able to send the newly hired Attorney II to this fine program in the future. The Office of the Consumer Advocate kept abreast of any legislation that would affect West Virginia Consumers. Representatives from the Office of the Consumer Advocate reviewed legislation and attended legislative hearings in both the House of Representatives and the Senate. Finally, the Office of the Consumer Advocate maintains a long term goal of consumer outreach and education. Said goal will be achieved by media outreach to consumers and by setting up information booths across the state at fairs and festivals such as: The West Virginia State Fair, the Friends of Coal Auto Fair in Beckley, the Arts and Crafts Fair in Ripley and the Pumpkin Festival in Milton. 35
Page 1 and 2: West Virginia Offices of the Insura
Page 3 and 4: Executive Summary This report to th
Page 5 and 6: TABLE OF CONTENTS SECTION 1 GENERAL
Page 7 and 8: Admitted Assets, Liabilities, Commo
Page 9 and 10: Organizational Chart Virgil Helton,
Page 11 and 12: FEES AND TAXES COLLECTED DURING THE
Page 13 and 14: WEST VIRGINIA OFFICES OF THE INSURA
Page 15 and 16: APPROPRIATED APPROPRIATED EXPENDITU
Page 17 and 18: SECTION 2 DIVISIONAL REPORTS 17
Page 19 and 20: An applicant must be a resident of
Page 21 and 22: Major Activities in 2009 The Plan
Page 23 and 24: Agents Licensing and Education Divi
Page 25: Workers’ Compensation Board of Re
Page 28 and 29: The focused settlement initiative h
Page 30 and 31: October 2008 November 2008 December
Page 32 and 33: Offices of the Insurance Commission
Page 36 and 37: Representing Consumers in First and
Page 38 and 39: FIRST PARTY COMPLAINTS HANDLED BY T
Page 40 and 41: CERTIFICATE OF NEED - March 2009 FA
Page 42 and 43: Hospital Rate Review The Office of
Page 44 and 45: Consumer Service Division The Consu
Page 46 and 47: CONSUMER SERVICE COMPLAINTS CALENDA
Page 48 and 49: CONSUMER SERVICE COMPLAINTS CALENDA
Page 50 and 51: Employer Coverage Unit The Employer
Page 52 and 53: Financial Accounting Unit The Finan
Page 54 and 55: Financial Conditions Division The p
Page 56 and 57: FINANCIAL CONDITIONS DIVISION West
Page 58 and 59: FINANCIAL CONDITIONS DIVISION West
Page 60 and 61: WEST VIRGINIA ESSENTIAL PROPERTY IN
Page 62 and 63: 2009 Summary of West Virginia Opera
Page 64 and 65: American Retirement Life Insurance
Page 66 and 67: ADP Totalsource, Inc. d/b/a ADP Tot
Page 68 and 69: FINANCIAL CONDITIONS DIVISION Merit
Page 70 and 71: FINANCIAL CONDITIONS DIVISION Compa
Page 78 and 79: FINANCIAL CONDITIONS DIVISION Risk
Page 84 and 85:
FINANCIAL CONDITIONS DIVISION Risk
Page 86 and 87:
Page 88 and 89:
Page 90 and 91:
Page 92 and 93:
National Health Club Purchasing Gro
Page 94 and 95:
Page 96 and 97:
Page 98 and 99:
Page 100 and 101:
FINANCIAL CONDITIONS DIVISION Name
Page 102 and 103:
Page 104 and 105:
Page 106 and 107:
ADA Risk Purchasing Group, Inc. (Am
Page 108 and 109:
FINANCIAL CONDITIONS DIVISION Liqui
Page 110 and 111:
Office of Inspector General—Fraud
Page 112 and 113:
The following chart depicts statist
Page 114 and 115:
James R. Hiroskey Jr., age 25 of Lo
Page 116 and 117:
Ramona Mack, age 40 of Winfield, pl
Page 118 and 119:
Jennifer Jo & Matthew Nichols, ages
Page 120 and 121:
Senate Bill 284 - Relating to Viati
Page 122 and 123:
Senate Bill 537 - Relating to Worke
Page 124 and 125:
Senate Bill 537 -continued §33-2-2
Page 126 and 127:
House Bill 3047 - Clarifying that t
Page 128 and 129:
114 CSR 42 - Continuing Education f
Page 130 and 131:
09-EO-03 - Emergency Order entered
Page 132 and 133:
DISCIPLINARY ACTIONS Individual Ins
Page 134 and 135:
Market Conduct Unit Four (4) “Agr
Page 136 and 137:
Employer Violator System (EVS) The
Page 138 and 139:
MANAGED HEALTH CARE PLANS: The West
Page 140 and 141:
A Client Reporting process was deve
Page 142 and 143:
Non-Workers’ Compensation Matters
Page 144 and 145:
Rates and Forms Division The Rates
Page 146 and 147:
2009 Filings by Product Commercial
Page 148 and 149:
Approved Rate Change History of Top
Page 150 and 151:
Private Passenger Auto Market Share
Page 152 and 153:
2009 West Virginia Market Share Rep
Page 154 and 155:
Page 156 and 157:
Page 158 and 159:
Page 160 and 161:
Total for Top 10 Insurers 76.87% $4
Page 162 and 163:
Page 164 and 165:
Page 166 and 167:
Page 168 and 169:
Page 170 and 171:
Page 172 and 173:
Page 174 and 175:
Page 176 and 177:
Page 178 and 179:
Page 180 and 181:
Page 182 and 183:
Page 184 and 185:
Page 186 and 187:
Page 188 and 189:
Page 190 and 191:
Page 192 and 193:
Page 194 and 195:
Page 196 and 197:
Page 198 and 199:
Page 200 and 201:
Page 202 and 203:
Page 204 and 205:
Page 206 and 207:
Page 208 and 209:
Page 210 and 211:
Page 212 and 213:
Page 214 and 215:
Page 216 and 217:
Page 218 and 219:
Page 220 and 221:
Page 222 and 223:
Page 224 and 225:
Page 226 and 227:
Page 228 and 229:
Page 230 and 231:
Page 232 and 233:
Page 234 and 235:
Page 236 and 237:
Page 238 and 239:
Page 240 and 241:
Page 242 and 243:
Page 244 and 245:
Page 246 and 247:
Page 248 and 249:
Page 250 and 251:
Page 252 and 253:
Page 254 and 255:
Page 256 and 257:
Page 258 and 259:
Page 260 and 261:
Page 262 and 263:
Page 264 and 265:
Page 266 and 267:
Page 268 and 269:
Page 270 and 271:
Page 272 and 273:
Page 274 and 275:
Page 276 and 277:
Page 278 and 279:
Page 280 and 281:
Page 282 and 283:
Page 284 and 285:
Page 286 and 287:
Admitted Assets, Liabilities, Net W
Page 288 and 289:
Admitted Assets, Liabilities, Commo
Page 290 and 291:
Page 292 and 293:
Page 294 and 295:
Page 296 and 297:
Domestic Property Insurers Common P
Page 298 and 299:
Page 300 and 301:
Page 302 and 303:
Page 304 and 305:
Page 306 and 307:
Page 308 and 309:
Page 310 and 311:
Admitted Assets, Liabilities, Capit
Page 312 and 313:
Admitted Assets, Liabilities, Capit
show all

West Virginia Offices of the Insurance Commissioner 2009 Annual ...

Create successful ePaper yourself

Delete template?

Save as template?