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

Representing Consumers in First and Third Party Administrative Hearings
In 2009, the Office of the Consumer Advocate assisted insurance consumers in forty-seven (47)
complaints before the West Virginia Insurance Commission. Twenty-six (26) of these complaints
were third party complaints and the remaining twenty-one (21) complaints were first party matters.
First party complaints are complaints filed by a consumer against their own insurer, while third party
complaints are complaints filed by a consumer against another person's insurer.
A total of One hundred-thirty two thousand, fifty three dollars, eighty six cents ($132,053.86) was
awarded directly to West Virginia Consumers in the form of settlements in sixteen (16) of the twentysix
(26) third party complaints. A market conduct exam was ordered against State Farm as a result of
one consumer complaint decision. One (1) case went to hearing and the Hearing Examiner made a
finding that no violation of the unfair trade practices act occurred. One (1) case was settled between
the insurance company and consumer after our involvement was made known. Two (2) consumers
obtained private council. Three (3) consumers did not request representation from this office. Three
(3) consumer complaint cases are either awaiting hearing or are awaiting final order.
A total of Fifty Eight Thousand One Hundred Sixty-five Dollars and Five Cents ($58,165.05) was
awarded directly to West Virginia consumers in the form of settlements in eleven (11) of the twentyone
(21) first party matters that the Office of the Consumer Advocate worked on in 2009. One (1)
consumer withdrew their consumer complaint and pursued a settlement in circuit court. One (1)
consumer had their non-monetary demands met by the insurance company. One (1) consumer
obtained private council and the outcome of the case is not known. One (1) consumer, in addition to a
monetary settlement, received a $40.00/month settlement. One (1) consumer complaint hearing was
cancelled by the legal division for administrative reasons. Five (5) consumer complaint cases are either
awaiting hearing or a final order.
Three (3) third party consumers declined to request representation when contacted by the Office of the
Consumer Advocate.
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