W. Va. Code R. § 114-20-4 - Placement of Surplus Lines Coverages
4.1. Diligent Search -- Except as provided in
section 4A of this rule, insurance coverage written by a surplus lines insurer
and placed by a surplus lines licensee for an insured whose home state is West
Virginia may not be procured until a diligent search has been made by the
individual insurance producer to place the risk with an admitted insurer. The
surplus lines licensee shall submit to the commissioner a sworn notarized
affidavit that a diligent search has been made by the individual insurance
producer to place the risk with licensed insurers authorized to write and
actually writing the particular risk sought to be placed in the excess lines
market. This affidavit shall be maintained, as required by W. Va. Code §
33-12C-16,
as part of the full and true record of each surplus lines contract
procured.
4.2. The following
minimum requirements and conditions apply to the conduct of a diligent search
to place a risk with licensed insurers:
4.2.a.
The individual insurance producer shall execute and forward to the licensed
surplus lines licensee a written statement, in a form prescribed by the
commissioner, declaring that a diligent effort to procure the desired coverage
from admitted insurers was made. The form shall contain an affidavit that the
individual insurance producer complied with the due diligence requirements of
this rule. The affidavit shall affirm that the insured was expressly advised
prior to the placement of the insurance that:
4.2.a.1. The surplus lines insurer with which
the insurance is to be placed is not an admitted authorized insurer in this
state and is not subject to the commissioner's supervision; and,
4.2.a.2. In the event the surplus lines
insurance becomes insolvent, claims will not be paid nor will unearned premiums
be returned by any West Virginia insurance guaranty fund.
4.2.b. No individual insurance producer may
solicit, procure, place, or renew any insurance with a nonadmitted insurer
unless the producer has been unable to procure the requested insurance from an
authorized insurer after conducting a diligent search. A diligent search
requires the individual insurance producer to contact as many insurers as the
individual insurance producer represents, that customarily write the kind of
insurance requested by the insured. A diligent search is presumed if
declinations are received from each authorized insurer contacted.
4.2.c. An individual insurance producer shall
obtain a declination in writing from the licensed insurer or create a written
record of an oral declination by the licensed insurer. A written record of an
oral declination shall be made by the person who initially received the
declination or by another employee of the individual insurance producer from
information transmitted by the person who received the declination. A
declination shall be obtained from the licensed insurer or recorded by or on
behalf of the individual insurance producer at or near the time of receipt of
the declination, and the records shall be maintained in the regular course of
business.
4.2.d. A written record
documenting an oral declination shall include:
4.2.d.1. The name, office location and phone
number of the licensed insurer or firm acting in the capacity of underwriting
manager for the licensed insurer.
4.2.d.2. The name and position of the person
contacted.
4.2.d.3. The date of
contact.
4.2.d.4. A detailed
explanation of the licensed insurer's reasons for declining to insure the
risk.
4.2.e. If a
licensed insurer fails to respond within 5 business days after first being
contacted by the individual insurance producer, the individual insurance
producer may assume that the insurer has declined to write the risk. The
individual insurance producer shall create a written record of the contact,
including the manner in which contact was made and the information required
under subdivision d of this subsection.
4.2.f. A declination of coverage by a
licensed insurer shall be made by a full time employee of the licensed insurer
who has underwriting responsibility or by a full time employee of a firm acting
in the capacity of underwriting manager for the licensed insurer.
4.2.g. Affiliates.
4.2.g.1. A declination may not be obtained
from a licensed insurer which is an affiliate of a licensed insurer from which
a declination has already been obtained.
4.2.g.2. Surplus lines insurance may not be
placed with an unlicensed insurer that is an affiliate of a licensed insurer
from which a declination has been obtained.
4.2.g.3. The restrictions in paragraphs 1 and
2 of this subdivision do not apply if the affiliated insurers write coverage
independently of each other using separate and independently developed
underwriting criteria and marketing plans and, for underwriting purposes,
compete with each other for the same type of coverage or class of
insurance.
4.3. Notification. -- Each surplus lines
insurance policy or evidence of insurance shall have printed or stamped in
contrasting color on the front page the following statement:
THIS COMPANY IS NOT LICENSED TO DO BUSINESS IN WEST VIRGINIA
AND IS NOT SUBJECT TO THE WEST VIRGINIA INSURANCE GUARANTY ACT.
4.4.
Records of surplus lines licensee. -- Each surplus lines licensee shall keep in
his or her office a full and true record of each surplus lines contract
procured by him or her on behalf of any insured whose home state is West
Virginia, and the records may be examined at any time thereafter by the
commissioner. The records shall include the following items as they are
applicable:
4.4.a. The name and address of the
surplus lines insurer;
4.4.b. The
names and addresses of the insureds;
4.4.c. The amount of insurance;
4.4.d. The gross premium charged;
4.4.e. The return premium paid, if
any;
4.4.f. The rate of premium
charged on the several items of coverages;
4.4.g. The effective date of the contract and
the terms of the contract;
4.4.h. A
brief general description of the risks insured against and the property
insured;
4.4.i. The policy
number;
4.4.j. The written due
diligence declaration of the individual insurance producer required in
subsection 4.2 of this section unless the due diligence requirement is not
applicable; and
4.4.k. Any
additional information the commissioner may require to effectuate the
provisions of The Nonadmitted Insurance Act, W. Va. Code §
33-12C-1et
seq. and, if executed, NIMA.
4.5. Responsibilities of the surplus lines
licensee. -- Each licensed surplus lines licensee who participates directly or
indirectly in effecting any insurance contract on a surplus lines basis on
behalf of any insured whose home state is West Virginia:
4.5.a. Shall, in no instance, knowingly place
any coverage in an insolvent insurer, in accordance with the provisions of W.
Va. Code §
33-12C-26;
4.5.b. May accept and place authorized
surplus lines business from any individual insurance producer licensed in this
state for the kind of insurance involved, and may compensate the individual
insurance producer. The surplus lines licensee has the right to receive from
the surplus lines insurer the customary commission, in accordance with the
provisions of W. Va. Code §
33-12C-15;
and
4.6. Surplus lines
insurance valid. -- In accordance with the provisions of W. Va. Code §
33-12C-5,
any insurance contract procured as surplus lines coverage from a surplus lines
insurer shall be fully valid and enforceable as to all parties, and shall be
given recognition in all matters and respects to the same effect as like
contracts issued by licensed insurers.
Notes
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