W. Va. Code R. § 114-36-2

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 114-36-2 - Definitions

2.1. "Commissioner" means the Insurance Commissioner of the State of West Virginia.

2.2. "Disclaimer" means the written notice required to be placed on the face of the Summary Document pursuant to W. Va. Code § 33-26A-19(c).

2.3. "Member Insurer" means any insurer licensed or which holds a certificate of authority to transact in this state any kind of insurance for which coverage is provided under W. Va. Code § 33-29A-3, and includes any insurer whose license or certificate of authority in this state may have been suspended, revoked, not renewed or voluntarily withdrawn, and includes nonprofit service corporations as defined in article twenty-four of this chapter and health care corporations as defined in W. Va. Code § 33-25-1 et seq.: Provided, That the term "member insurer" does not include a health maintenance organization, a fraternal benefit society, a mandatory state pooling plan, a mutual assessment company, any entity that operates on an assessment basis, an insurance exchange, an organization that has a certificate or license limited to the issuance of charitable gift annuities pursuant to W. Va. Code § 33-13B-1 et seq., or any other similar entity.

2.4. "Notice" means the document set forth in Appendix B of this rule entitled "NOTICE OF NON-COVERAGE." The Notice comprises the non-coverage notice required by W. Va. Code § 33-26A-19(d).

2.5. "Policy or Contract" means the following types of policies or contracts issued by a Member Insurer to persons described in W. Va. Code § 33-26A-3(a):

2.5.a. Direct nongroup life insurance, health insurance, annuities and supplemental policies or contracts;

2.5.b. Certificates under direct group life insurance policies, health insurance policies, or annuity contracts; or

2.5.c. Unallocated annuity contracts.

2.6. "Summary Document" means the document describing the general purposes, limitations and exclusions under the West Virginia Life and Health Insurance Guaranty Association Act, W. Va. Code § 33-26A-1 et seq., as adopted by the West Virginia Life and Health Insurance Guaranty Association and approved by the Commissioner and required to be given to Policy or Contract Holders by Member Insurers or their agents pursuant to W. Va. Code § 33-26A-19(b). An approved summary document containing the disclaimer required by W. Va. Code § 33-26A-19(c) can be found in the attached Appendix A of this rule.

W. Va. Code R. § 114-36-2