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

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CONSUMER SERVICE COMPLAINTS CALENDAR YEAR 2009 WORKERS’ COMPENSATION COMPANIES AND THIRD PARTY ADMINISTRATORS WITH TEN OR MORE COMPLAINTS COMPANY NAME # COMPLAINTS SEDGWICK CLAIMS MANAGEMENT SERVICES, INC. 297 BRICKSTREET MUTUAL INSURANCE COMPANY 236 WELLS FARGO INSURANCE SERVICES OF WEST VIRGINIA, INC. 48 FRANK GATES SERVICE COMPANY (THE) 16 GALLAGHER BASSETT SERVICES 16 BROADSPIRE SERVICES, INC. 10 48
TOP FIVE INSURANCE COVERAGE TYPE AND REASONS FOR COMPLAINTS CALENDER YEAR 2009 COVERAGE TYPES # COMPLAINTS Private Passenger Auto 456 Workers’ Compensation 387 Workers’ Compensation Old Fund 367 Group Accident & Health 286 Liability Auto 225 Private Passenger Auto Workers’ Compensation Workers’ Compensation Old Fund Group Accident & Health Liability Auto COMPLAINT REASONS # COMPLAINTS Denial of Claim – Workers’ Compensation 309 Delays – Workers’ Compensation 281 Denial of Claim – Group Accident & Health 126 Denial of Claim – Auto Private Passenger 117 Unsatisfactory Settlement/Offer – Auto Private Passenger 87 Denial of Claim – Workers’ Compensation Delays – Workers’ Compensation Denial of Claim – Group Accident & Health Denial of Claim – Auto Private Passenger 49 Unsatisfactory Settlement/Offer – Auto Private Passenger
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 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 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 92 and 93: National Health Club Purchasing Gro
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FINANCIAL CONDITIONS DIVISION Risk
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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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