H. B. 3040
(By Delegate Hall)
[Introduced March 10, 2009; referred to the
Committee on Government Organization then the Judiciary.]
A BILL to amend and reenact §33-41-8 of the Code of West Virginia,
1931, as amended, relating to expanding the insurance fraud
unit.
Be it enacted by the Legislature of West Virginia:
That §33-41-8 of the Code of West Virginia, 1931, as amended,
be amended and reenacted, to read as follows:
ARTICLE 41. INSURANCE FRAUD PREVENTION ACT.
§33-41-8. Creation of insurance fraud unit; purpose; duties;
personnel qualifications.
(a) There is established the West Virginia Insurance Fraud
Unit within the office of the Insurance Commissioner of West
Virginia. The commissioner may employ full-time supervisory, legal
and investigative personnel for the unit who shall be qualified by
training and experience in the areas of detection, investigation or
prosecution of fraud within and against the insurance industry to perform the duties of their positions. The director of the fraud
unit is a full-time position and shall be appointed by the
commissioner and serve at his or her will and pleasure. The
commissioner shall provide office space, equipment, supplies,
clerical and other staff that is necessary for the unit to carry
out its duties and responsibilities under this article.
(b) The fraud unit may in its discretion:
(1) Initiate inquiries and conduct investigations when the
unit has cause to believe violations of any of the following
provisions of this code relating to the business of insurance have
been or are being committed: This chapter; chapter twenty-three of
this code; article three, chapter sixty-one of this code; and
section five, article four of said chapter. Notwithstanding any
provision of this code to the contrary, the fraud unit may, with
the agreement of the Director of the Public Employees Insurance
Agency, conduct investigations related to possible fraud under
article sixteen, chapter five of this code;
(2) Review reports or complaints of alleged fraud related to
the business of insurance activities from federal, state and local
law-enforcement and regulatory agencies, persons engaged in the
business of insurance and the general public to determine whether
the reports require further investigation; and
(3) Conduct independent examinations of alleged fraudulent
activity related to the business of insurance and undertake independent studies to determine the extent of fraudulent insurance
acts.
(c) The insurance fraud unit may:
(1) Employ and train personnel to achieve the purposes of this
article and to employ legal counsel, investigators, Auditors and
clerical support personnel and other personnel as the commissioner
determines necessary from time to time to accomplish the purposes
of this article;
(2) Inspect, copy or collect records and evidence;
(3) Serve subpoenas issued by grand juries and trial courts in
criminal matters;
(4) Share records and evidence with federal, state or local
law-enforcement or regulatory agencies, and enter into interagency
agreements. For purposes of carrying out investigations under this
article, the unit shall be deemed a criminal justice agency under
all federal and state laws and regulations and as such shall have
access to any information that is available to other criminal
justice agencies concerning violations of the insurance laws of
West Virginia or related criminal laws;
(5) Make criminal referrals to the county prosecutors;
(6) Conduct investigations outside this state. If the
information the insurance fraud unit seeks to obtain is located
outside this state, the person from whom the information is sought
may make the information available to the insurance fraud unit to examine at the place where the information is located. The
insurance fraud unit may designate representatives, including
officials of the state in which the matter is located, to inspect
the information on behalf of the insurance fraud unit, and the
insurance fraud unit may respond to similar requests from officials
of other states;
(7) The insurance fraud unit may initiate investigations and
participate in the development of and, if necessary, the
prosecution of any health care provider, including a provider of
rehabilitation services, suspected of fraudulent activity related
to the business of insurance;
(8) Specific personnel, designated by the commissioner, shall
be permitted to operate vehicles owned or leased for the state
displaying Class A registration plates;
(9) Notwithstanding any provision of this code to the
contrary, specific personnel designated by the commissioner may
carry firearms in the course of their official duties after meeting
specialized qualifications established by the Governor's Committee
on Crime, Delinquency and Correction, which shall include the
successful completion of handgun training provided to law-
enforcement officers by the West Virginia State Police:
Provided,
That nothing in this subsection shall be construed to include any
person designated by the commissioner as a law-enforcement officer
as that term is defined by the provisions of section one, article twenty-nine, chapter thirty of this code; and
(10) The insurance fraud unit shall not be subject to the
provisions of article nine-a, chapter six of this code and the
investigations conducted by the insurance fraud unit and the
materials placed in the files of the unit as a result of any such
investigation are exempt from public disclosure under the
provisions of chapter twenty-nine-b of this code.
(d) The insurance fraud unit shall perform other duties as may
be assigned to it by the commissioner.
(e) Beginning July 1, 2009, the commissioner shall hire
additional supervisory, legal and investigative personnel. The
commissioner shall hire these employees to double the number of
such employees that worked for the insurance fraud unit during
2008, in order to better perform the duties of the insurance fraud
unit.
NOTE: The purpose of this bill is to expand the West Virginia
Insurance Fraud unit.
Strike-throughs indicate language that would be stricken from
the present law, and underscoring indicates new language that would
be added.
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