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

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FIRST PARTY COMPLAINTS HANDLED BY THE OFFICE OF THE CONSUMER ADVOCATE IN 2009 RESPONDENT FIRST PARTY COMPLAINTANT RESOLUTION Nationwide Mutual Ins. Co. Ms. Betty Maynard Settlement - $2,823.90 State Farm Mutual Auto Ins. Andre Portee Pursued in circuit court State Farm Insurance Co. Gerald Carpenter Obtained private council Ronald & Mary Settlement – $1100.00 Encompass Insurance Co. Breault Encompass Insurance Co. Dale Petrucci Settlement - $1750.00 Allstate Insurance Co. Harold Kirk $15,000 by private council AIG Centennial Ins. Co. Darryl Palmer Settlement - $5000.00 Allstate Insurance Co. Elaine Green Settled – consumer demand met Western Southern Life Ins. Larry Clendenin Settlement - $5200.00 $40.00/mo. Life benefits Farmers & Mechanics Mutual Freda Bradley Complaint dismissed - appealed Safe Insurance Company Margaret Nabridge Settlement - $4000.00 American National P & C Co. Glenda Hedrick Settlement - $3,771.57 Hartford Insurance Co. Sandra Kelly Settlement - $15,000 State Farm Insurance Co. Charles Weatherford Settlement - $719.58 State Farm Insurance Co. Carolyn Callopi Cancelled by legal div. Erie Insurance Company Michael Nasuto Settlement - $3800.00 Motorist Mutual Ins. Co. James & Terry Riggs Pending Titan Indemnity Insurance Co. Melinda Halvorson Pending Standard Insurance Company Bernice Tennant Pending Genworth Financial Assurance Connie Runyon Pending State Farm Insurance Co. Leonard Nester Pending 38
Certificate of Need Review The Office of the Consumer Advocate participated in the review of Certificate of Need (CON) applications before the Health Care Authority. All health care providers must obtain a CON from the West Virginia Health Care Authority to develop, add, or acquire new health care facilities and equipment. The Office of the Consumer Advocate reviews all CON applications and may intervene for the interests of West Virginia residents in the Health Care Authority's CON review process. The Office of the Consumer Advocate carefully reviewed and considered the following thirty-five (35) CON applications: (total capitol expenditure $197,504,633.12). CERTIFICATE OF NEED - January 2009 FACILITY CON NO. REQUEST CAPITOL EXPENDITURE Medi Home Health Agency 09-5-9014-Y hospice services in Wood County $35,000.00 Huntington Regional Gamma Knife 08-2-8857-E development of gamma knife services $4,600,000.00 Covenant Home Health Care 08-3-8897-Z home health services $0.00 Weirton Medical Center 08-9-8820-H therapeutic cardiac catheterization $0.00 Professional Sleep Lab 07-5-8606-PV Sleep laboratory $44,700.00 CERTIFICATE OF NEED – February 2009 FACILITY CON NO. REQUEST CAPITOL EXPENDITURE New River Health Association. 08-4-8828-X geriatric ambulatory care center $73,500.00 United Hospital Center 09-6-8902-H medical office building condo project $8,000,000.00 Springfield Center 09-1-8929-A acquisition of Springfield Center $2,950,000.00 Wheeling Hospital 09-10-8924-P pediatric outpatient rehab relocation $200,000.00 39
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 34 and 35: January 2009 February 2009 March 20
Page 36 and 37: Representing Consumers in First and
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
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FINANCIAL CONDITIONS DIVISION Risk
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National Health Club Purchasing Gro
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FINANCIAL CONDITIONS DIVISION Name
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ADA Risk Purchasing Group, Inc. (Am
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FINANCIAL CONDITIONS DIVISION Liqui
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Office of Inspector General—Fraud
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The following chart depicts statist
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James R. Hiroskey Jr., age 25 of Lo
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Ramona Mack, age 40 of Winfield, pl
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Jennifer Jo & Matthew Nichols, ages
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Senate Bill 284 - Relating to Viati
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Senate Bill 537 - Relating to Worke
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Senate Bill 537 -continued §33-2-2
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House Bill 3047 - Clarifying that t
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114 CSR 42 - Continuing Education f
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09-EO-03 - Emergency Order entered
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DISCIPLINARY ACTIONS Individual Ins
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Market Conduct Unit Four (4) “Agr
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Employer Violator System (EVS) The
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MANAGED HEALTH CARE PLANS: The West
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A Client Reporting process was deve
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Non-Workers’ Compensation Matters
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Rates and Forms Division The Rates
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2009 Filings by Product Commercial
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Approved Rate Change History of Top
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Private Passenger Auto Market Share
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2009 West Virginia Market Share Rep
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Total for Top 10 Insurers 76.87% $4
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Admitted Assets, Liabilities, Net W
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Admitted Assets, Liabilities, Commo
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Domestic Property Insurers Common P
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Admitted Assets, Liabilities, Capit
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Admitted Assets, Liabilities, Capit
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West Virginia Offices of the Insurance Commissioner 2009 Annual ...

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