West Virginia Code 33-41-3 – Fraud warning authorized; statement required of nonadmitted insurers
(a) Claims forms and applications for insurance, regardless of the form of transmission, may contain the following warning or a substantially similar caveat:
Terms Used In West Virginia Code 33-41-3
- Claim: means an application or request for payment or benefits provided under the terms of a policy of insurance. See West Virginia Code 33-41-2
- Insurance: means a contract or arrangement in which a person undertakes to:
(1) Pay or indemnify another person as to loss from certain contingencies called "risks" including through reinsurance. See West Virginia Code 33-41-2
- Insurer: means a person entering into arrangements or contracts of insurance or reinsurance. See West Virginia Code 33-41-2
- Person: means an individual, a corporation, a limited liability company, a partnership, an association, a joint stock company, a trust, trustees, an unincorporated organization, or any similar business entity, or any combination of the foregoing. See West Virginia Code 33-41-2
- Policy: means an individual or group policy, group certificate, contract or arrangement of insurance or reinsurance, coverage by a self-insured employer or employer group for its workers' compensation risk including its risk of catastrophic injuries or reinsurance, affecting the rights of a resident of this state or bearing a reasonable relation to this state, regardless of whether delivered or issued for delivery in this state. See West Virginia Code 33-41-2
- State: when applied to a part of the United States and not restricted by the context, includes the District of Columbia and the several territories, and the words "United States" also include the said district and territories. See West Virginia Code 2-2-10
- Statement: means any written or oral representation made to any person, insurer or authorized agency. See West Virginia Code 33-41-2
"Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison."
(b) The lack of a warning as authorized by the provisions of subsection (a) of this section does not constitute a defense in any prosecution for a fraudulent or illegal act nor shall it constitute the basis for any type of civil cause of action.
(c) Policies issued by nonadmitted insurers pursuant to article twelve-c of this chapter shall contain a statement disclosing the status of the insurer to do business in the state where the policy is delivered or issued for delivery or the state where coverage is in force. The requirement of this subsection may be satisfied by a disclosure specifically required by section five, article twelve-c of this chapter; section nine, article thirty-two of this chapter; and section eighteen, article thirty-two of this chapter.