West Virginia Adjuster Insurance Exam 2026

Three Credentials, Three Lines — and West Virginia Licenses Staff Adjusters Too

West Virginia licenses three kinds of adjuster, and one of them is the company's own salaried staff. W. Va. Code §33-12B-2: "No person may act or hold himself, herself, or itself out as a company adjuster, an independent adjuster, or a public adjuster in this state unless the person is licensed."

The article is Chapter 33, Article 12B, captioned simply "ADJUSTERS." It runs eighteen entries — §§1, 2, 3, 4, 4a, 5, 6, 7, 8, 9, 10, 10a, 11, 11a, 12, 13, 14 and 15 — and unlike most states this is a dedicated adjuster article rather than a shared producer chapter. Everything in it was written about you.

Two of those eighteen are repealed and still indexed. §33-12B-4a (a second exemptions section) and §33-12B-11a (a second emergency-adjuster route) were both repealed by the 2020 Enrolled HB4502, which amended and reenacted the rest of the article in the same act. The index still prints their catchlines. Open the section before relying on it.

Three lines of authority — §33-12B-7. An independent or company adjuster may hold "(1) Property and casualty; (2) Workers' compensation; or (3) Crop." A public adjuster "may only qualify for a license designating a property and casualty line of authority."

And there is a conflict rule inside the licensing section itself. §33-12B-2 permits an individual to hold concurrent licenses but forbids representing conflicting interests on the same claim. Several states carry that rule; West Virginia puts it in the license-required section rather than giving it one of its own, which is why it is easy to miss.

The Official Code Site Prints Two Bill Lists, and Only One of Them Means Anything

This is the first thing to learn about West Virginia, because it governs every other claim you will make about the state. The official code site at `code.wvlegislature.gov` prints two separate bill lists at the foot of every section page, a few lines apart, in near-identical formatting.

One is headed "Bill History For §X." The other is headed "Signed Bills For §X." The first includes bills that were introduced and never enacted. The second is the enacted list.

The live example is a 2026 bill about adjusters. HB5521, "Relating to public adjusters," passed the House 86–3 on 4 March 2026, was referred to Senate Banking and Insurance the next day, and was never reported out before the session ended. It appears in the "Bill History" list for §§33-12B-1, -2 and -3. It is not law. Read that list as a history line and you would credit a 2026 amendment to sections last amended in 2020.

You can prove it structurally without leaving the code. HB5521 would have created §§33-12B-5A through -5G and §§33-12B-16 through -21. The article index runs 1 to 15 and contains none of them.

It is not a one-off. The same divergence appears at §33-12B-13 (2021 SB493), §33-12B-9 (2012 SB330), §23-4-6 (2003 HB2120) and §21A-6-10 (three separate bills). Every divergence runs the same direction — a bill in the history list that never reached the signed list.

And the site never explains the distinction. There is no legend, no help text and no disclaimer. The only currency statement anywhere is generic: "These West Virginia Code sections are updated regularly as new legislation takes effect."

Fifteen Exemptions for Company and Independent Adjusters, Five More for Public Adjusters

§33-12B-3 is the live exemptions section, and it is far larger than the one carve-out most summaries mention. Subsection (a) exempts fifteen categories from the company or independent adjuster license; subsection (b) exempts five more from the public adjuster license.

The fifteen, in outline: attorneys admitted in West Virginia "when acting in their professional capacity"; persons hired solely to gather facts or give technical help to a licensed adjuster; fraud investigators who do not adjust losses or determine coverage; executive, administrative, managerial or clerical staff who do not settle claims; licensed healthcare providers and their employees who do not determine compensability; managed care organization employees on the same terms; personnel settling reinsurance or subrogation between insurers; officers and directors of authorized insurers; managers of United States branches of foreign insurers; persons handling life, accident and health, annuity or disability claims; self-insured employers' own adjusters; licensed producers and managing general agents with claim authority; business entities licensed under §33-46; claims data collectors and entrants under supervision; and out-of-state company adjusters working West Virginia claims remotely.

Two of the fifteen carry numbers or consequences worth memorizing. The supervision exemption caps a supervisor at 25 unlicensed persons. And the life-and-health exemption means the adjuster license in West Virginia is, by construction, a property-casualty-side credential — a claims person who handles only health or disability work does not need one.

The remote exemption is real but it is not the headline. Out-of-state company adjusters who handle West Virginia claims without physically entering the state are exempt — subject to the Commissioner's regulation. It is (a)(15) of fifteen, not the single narrow escape hatch it is usually described as.

The public adjuster carve-outs are narrower: in-state attorneys practicing law; persons handling "life or health insurance policy or annuity contract" claims; fact-gatherers assisting a licensed public adjuster; healthcare providers filing health claims for patients; and subrogation settlements between insurers.

Eighteen, Trustworthy, and a Home-State Test That Is Not a Residency Test

§33-12B-5(a) sets the findings the Commissioner must make before issuing a resident license. The age requirement is plain: "Is 18 years of age or more."

Residency is satisfied two ways, not one. "Is a resident of West Virginia, or eligible to designate West Virginia as his or her home state." "Home state" is a defined term in §33-12B-1, and it is what carries the nonresident and reciprocal machinery later in the article. A person who lives elsewhere but designates West Virginia is treated as a resident applicant for this purpose.

There is no prelicensing education requirement for any adjuster credential in West Virginia. No classroom hours, no certificate to present at the test center, no course provider to choose. The examination is the gate.

The criminal history record check sits in its own section — §33-12B-6 — which authorizes it and prices it separately from the license fee. Read it alongside §33-12B-8 rather than assuming the license fee covers it.

West Virginia Publishes Three Adjuster Examinations, Not One

The single most common error about West Virginia adjuster licensing is treating the examination as one test. The Candidate Handbook's own examination table lists three separate adjuster instruments, each with its own code, length and item count.

WV Adjuster — `InsWV-Adj14`. 80 scored questions, 90 minutes. This is the company and independent adjuster examination and it is the one most candidates sit.

WV Public Adjuster — `InsWV-PubAdj17`. 45 scored questions, 45 minutes. Note the ratio: one minute per question, the tightest of the three.

WV Workers Compensation Adjuster — `InsWV-WCAdj21`. 45 scored questions, 60 minutes. A standalone examination for a standalone line of authority — a combination almost no other state has, and it exists because West Virginia privatized its workers' compensation system.

All three cost $84 per attempt, non-refundable, payable at reservation. All three carry a cut score of 70.

The attempt limit is eight per line of authority — "A candidate is limited to eight (8) attempts to pass each line of authority" — which matches §33-12B-5(b)(4)'s statutory phrasing of "seven additional attempts" after the first.

The 70 Is a Scaled Score — and the Handbook Contradicts Itself on the Same Document

The Candidate Handbook's examination table prints the passing score as "70%", with a percent sign. Its narrative says something different, and the narrative is the one that is correct.

"Raw scores are converted into scaled scores that can range from 0 to 100."

"The scaled score that is reported to you is neither the number of questions you answered correctly nor the percentage of questions you answered correctly."

A failing score is a distance-to-pass metric, not a count. The handbook is explicit that with a passing score of 70, "any score below 70 indicates how close the candidate came to passing, rather than the actual number or percentage of questions the candidates answered correctly."

So there is no fixed number of questions you must answer correctly. Forms are statistically equated, and the raw-to-scaled conversion moves with the form. A candidate who sits a slightly harder form needs fewer raw points for the same scaled 70.

No West Virginia statute or rule sets a passing score at all. The number is vendor policy, published in the handbook, and it can move without any legislative or rulemaking act.

The Examination Is Discretionary in Its Own Terms — and That Verb Does Real Work

§33-12B-5 does not command an examination in every case. It frames the requirement so that the Commissioner may accept substitutes, and the same section carries the waiver machinery that governs both the crop line and the nonresident route.

The crop substitute is express — §33-12B-5(b)(1): to qualify for the crop line of authority "the commissioner may accept, in lieu of such an examination, certification" of proficiency issued or approved by the USDA Risk Management Agency.

The emergency route switches the section off entirely — §33-12B-5(d): "The requirements of this section do not apply to temporary licenses issued to emergency company" or independent adjusters.

Reading the waiver power is how the rest of the article makes sense. Reinstatement inside the lapse window and nonresident equivalence are not separate schemes with their own rules — they are this section's discretion being exercised. Find the verb before you look for a separate statute.

The Statute Prices the License at $25 a Year. The Agency Charges $50.

§33-12B-8 is the fee section, and it is short and specific: "The annual fee for an individual adjuster license shall be $25." Business entities are priced separately at $200.

The agency's published schedule shows a different figure on a different cycle. The OIC fee schedule lists "Resident/Non Resident license (Biennial DOB) $50.00."

Those two reconcile cleanly, and it is worth seeing why. The statute prices one year. The agency bills on a two-year cycle. Two years at $25 is $50. Unlike Michigan — where a statute said $10 while the agency charged $15 with nothing to bridge them — West Virginia's figures are the same number counted over different periods.

The examination is $84 per attempt, non-refundable and payable at reservation, and it is charged by the vendor rather than set by the statute.

All in on a first try: about $134 — $84 for the examination plus the $50 the agency collects at application. Add the criminal history record check, which §33-12B-6 authorizes and prices separately from the license fee.

Emergency temporary licensure is priced at $25 under §33-12B-4(d), "due and payable at the time of application for licensure."

The Statute Says One Year Ending 31 May. Your License Runs Two Years to Your Birthday.

Both of those statements are true, and only one of them is in the statute. This is the cleanest example in the build of why you read the statute and the agency, and say which one you are quoting.

§33-12B-10(a) sets the default: "If another date is not so fixed by the commissioner, each license shall … expire at midnight on May 31 next following the date of issuance, and the commissioner shall renew annually the license of all such licensees who qualify."

And the same subsection hands the Commissioner an open-ended power to displace it: "The commissioner may, in his or her discretion, fix the dates of expiration of respective licenses for all adjusters in any manner as is considered by him or her to be advisable for an efficient distribution of the workload."

The Commissioner has exercised that power, and the exercise is what you actually live under. NIPR states the resident adjuster renewal cycle as "Last day of Birth Month Biennially," and the OIC's own fee schedule prices the license as "Resident/Non Resident license (Biennial DOB)."

The subsection even anticipates the transition, in both directions. If the reset shortens a period you have already paid for, "no refund of the unearned fee shall be made." If it lengthens one, "the commissioner shall charge no additional fee for the lengthened period." A legislature that expected the default to stand would not have written the adjustment rules.

The license term and the continuing education biennium are the same clock. §33-12B-13(e) requires CE "reported to the commissioner on a biennial basis in conjunction with their license renewal cycle," and C.S.R. 114-42 defines the reporting period as "coextensive with the producer's license or adjuster's license period." One cycle, not two.

Twelve Months to Get It Back — and It Is a Reissue Right, Not a Grace Period

§33-12B-10(b): "An adjuster whose license expires may, if application is made within one year of the expiration date, be reissued a license upon payment of twice the renewal fee."

Read the words carefully, because the distinction matters. The license expires. Nothing tolls, nothing extends, nothing is suspended pending payment. What the subsection gives you is a right to be reissued during the following twelve months. That is not a grace period, and you were not licensed during it. Adjusting during that window is adjusting without a license.

The implementing rule uses the same window and states the money differently. §114-25-19.2: reinstatement "if he or she makes application within twelve months of the expiration date and pays a penalty in the amount of $25 in addition to any other fees." Twelve months and one year are the same period; $25 plus the $25 renewal is the statute's "twice the renewal fee."

Renewal requirements are waivable for cause. §33-12B-10(c) reaches a licensee "unable to comply due to military service, long-term medical disability, or other extenuating circumstance." The third limb is open-ended and is the one worth remembering.

Crop is the one line with a continuing condition. §33-12B-10(d) lets the Commissioner require, at renewal, that the licensee "demonstrate that he or she has maintained certification of proficiency issued or approved by the United States Department of Agriculture Risk Management Agency." The federal credential that substituted for the examination has to stay alive.

Twenty-Four Hours, Three in Ethics — and Two Automatic Consequences Most Summaries Omit

§33-12B-13 applies to all three credentials — company, independent and public adjusters licensed under §33-12B-2 — and requires "a minimum of 24 hours of continuing education courses, of which three hours must be in ethics, reported to the commissioner on a biennial basis."

Two exemptions. A licensee not licensed for one full year before the biennium ends is exempt for that period. And a nonresident adjuster who meets substantially similar requirements in the home state satisfies West Virginia through home-state compliance.

Carryover is capped at six hours. An adjuster who exceeds the minimum may carry forward "a maximum of six credit hours" into the next reporting period. Overshooting by more than six is wasted.

Up to two hours may come from membership rather than coursework — active membership in an approved professional organization earns credit, "limited to two hours per biennium."

And the enforcement is automatic on both steps, which is what most summaries leave out. Failure to comply brings automatic suspension of the license. Failure to demonstrate compliance by the end of the following biennium brings automatic termination — at which point the person must reapply from the beginning under §33-12B-5, examination included.

The biennium provisions took effect from the reporting period beginning 1 July 2021, which is the same §33-12B-15 date that governs the rest of the 2020 amendment package.

Two Thirty-Day Clocks — and the Criminal One Starts Near the Beginning of the Case

§33-12B-10a was added in 2010 and has never been amended. Its Bill History and Signed Bills lists are identical single entries — which is, incidentally, what a section with a clean history actually looks like on this site.

Subsection (a) — administrative actions. Thirty days from FINAL DISPOSITION. An adjuster "shall report to the commissioner any administrative action taken against the adjuster in another jurisdiction or by another governmental agency in this state within thirty days of the final disposition." Note the reach: it is not confined to insurance regulators, and it expressly includes crop decertification.

Subsection (b) — criminal matters. Thirty days from the INITIAL PRETRIAL HEARING DATE. "Within thirty days of the initial pretrial hearing date, an adjuster shall report to the commissioner any criminal prosecution of the adjuster in any jurisdiction."

Both limbs require documents, not just notice. The administrative report must include "a copy of the order, consent to order and any other relevant legal documents"; the criminal report must include "a copy of the initial complaint filed, the order resulting from the hearing" and related papers.

The Insurer Files, Not You — Five Days, Ninety Days, Twenty-Five Dollars

There is one emergency route in West Virginia today, and there used to be two. §33-12B-11a — "Emergency adjusters and insurance emergencies" — was repealed by the 2020 Enrolled HB4502, which collapsed a two-track scheme into the single reenacted §33-12B-4.

The defined term outlived its own section. "Insurance emergency" is still defined in §33-12B-1 and now feeds §33-12B-4. And the definition is about adjuster supply, not disaster severity: a temporary situation declared by the Commissioner "when the number of licensed adjusters in this state is inadequate to meet the demands."

But the Commissioner's declaration power turns on a different test. §33-2-10a keys the declaration to an event "reasonably likely to produce a volume of claims … that significantly exceeds the number of claims normally arising." Claim volume triggers the declaration; adjuster scarcity defines the emergency. Two conditions that must effectively coincide.

The filing duty sits on the insurer, not on the adjuster. §33-12B-4(a): "an insurer shall notify the commissioner with an application for temporary emergency licensure for each individual who will act as an emergency company adjuster or emergency independent adjuster on behalf of the insurer."

Five days — and you may work in the meantime. §33-12B-4(b): an individual may act "if, within five days of the declared insurance emergency, the insurer notifies the commissioner." Seven data elements are required, including the individual's National Producer Number if any, the insurer represented, and the emergency or loss control number.

Ninety days, extendable with no stated outer limit. §33-12B-4(c): the temporary licensure "shall remain in force for a period not to exceed 90 days, unless extended for an additional period by the commissioner." The fee is $25, due at application.

Home State Is the Hinge, Not Residency

§33-12B-9 governs nonresident licensing, and it runs on the defined term "home state" rather than on where you live. §33-12B-1 defines it, §33-12B-5(a)(2) accepts eligibility to designate West Virginia as a home state in place of residency, and §33-12B-9 handles the reverse case.

The practical consequence is that West Virginia has two doors into a resident-style license. You may qualify because you live here, or because you are eligible to designate West Virginia as your home state — and a person licensed in another state may hold a West Virginia nonresident license on the strength of that home-state license.

The rule adds a ninety-day conversion window. §114-25-18.4 gives a licensee "ninety (90) days to obtain a resident license" — the mechanism for someone whose home state changes.

Continuing education is the place where nonresident status pays off. §33-12B-13 exempts a nonresident adjuster who meets substantially similar continuing education requirements in the home state. Comply at home and West Virginia is satisfied.

Your Conduct Standards Are in a Rule the Legislature Just Renewed for Ten Years

Article 12B contains no conduct standards. Not one. It licenses, examines, prices, renews and disciplines — and says nothing about how you behave on a claim. The conduct standards are in C.S.R. 114-25, "Insurance Adjusters," and that rule moved on 8 April 2026.

The 2026 version is in force today. The Secretary of State's version table shows 8 April 2026 — Active, Legislative, with the three earlier versions (2021, 2011, 1990) marked Historical. The rule's own text prints "1.3. Filing Date. -- April 8, 2026" and "1.4. Effective Date. -- April 8, 2026" — filed and effective the same day.

The vehicle was 2026 HB4245, "Authorizing Certain Agencies of the Department of Revenue to Promulgate Legislative Rules," approved by the Governor on 1 April 2026 and codified at §64-7-3(e), which authorizes the adjuster rule "without modification."

But read the diff, not the date: it is a sunset extension, not a rewrite. The substantive change is §1.5 — the rule now "shall terminate and have no further force or effect upon August 1, 2036," replacing 2026. OIC Informational Bulletin 26-02 says so in terms: HB4245 "approved the following four Insurance Commissioner rules to extend their sunset dates." No new duty, no new prohibition, no new number. An adjuster compliant on 7 April 2026 was compliant on 9 April 2026.

Two things did change, and both break citations rather than conduct. The §9 catchline was corrected from "Company and Crop Adjusters" to "Company and Independent Adjusters" — the 2021 heading had always been wrong on its own terms, since its body governed company and independent adjusters and said nothing about crop. And subdivisions were re-designated from letters to numbers: what was `114-25-9.1.a` is now `114-25-9.1.1`.

Four Duties for Company and Independent Adjusters — and the Fourth Is About Salvage

§114-25-9 is the whole of the conduct code for company and independent adjusters, and it has four provisions. They are short enough to carry verbatim.

No legal advice, and no going around counsel. A company or independent adjuster "shall not give legal advice, and shall not deal directly with any policyholder or claimant who is represented by legal counsel, without the consent of the legal counsel involved."

Identify what you are. The adjuster "shall identify himself or herself as an independent contractor and, if applicable, identify his or her employer when dealing with any policyholder or claimant" — and the following provision repeats the employer-identification duty on its own. The redundancy is in the rule as adopted and survived the 2026 refiling.

No financial interest, and no salvage without written authority. The adjuster "shall not have any financial interest in any adjustment or acquire for himself or herself any interest or title in salvage, without first receiving written authority from the principal."

The last one is the one that catches people, because it is not an absolute bar. Salvage interest is permitted — with prior written authority from the principal. An adjuster who buys salvage off a file without that authority has violated the rule; one who obtains it in writing first has not.

No Bond, a Ten Percent Catastrophe Cap, and a Seventy-Two-Hour Switch

West Virginia has no public adjuster bond. That negative is provable rather than assumed: walking all twenty sections of C.S.R. 114-25 and all eighteen of Article 12B turns up no bond or financial-security section. The nearest thing is a records obligation — §114-25-8.1.10 requires the public adjuster to keep "evidence of financial responsibility in a format prescribed by the Commissioner," and the rule does not say what that evidence is or in what amount.

Fees run on a reasonableness standard with one hard number. §114-25-12.1: "Any fee charged by a public adjuster must be reasonable." No percentage. But §114-25-12.4 adds a cap that bites when it matters most: "In the event of a catastrophe, no public adjuster shall charge, agree to or accept as compensation … more than ten percent of any insurance settlement or proceeds," and shall not take any fee, retainer or deposit "prior to settlement of a claim."

The seventy-two-hour rule is the most unusual provision in the state. §114-25-11.3: if the insurer pays or commits in writing to pay policy limits within seventy-two hours of the loss being reported, the public adjuster may take no percentage commission and is "entitled only to reasonable compensation … based on the time spent on a claim and expenses incurred."

The contract regime is detailed. §114-25-11 requires a document titled "Public Adjuster Contract" carrying the adjuster's name, permanent home state business address, license number, the insured's details, "a description of the loss and its location," the services, both signatures with dates, and the full compensation. Prohibited terms include percentage fees on amounts the insurer has already committed to pay, checks payable to the adjuster alone, collection costs or late fees, and any term restricting the insured's civil remedies.

Two separate escape hatches for the insured, and they run on different clocks. §114-25-11.6.8 gives a three-business-day right to rescind, with anything of value returned "within fifteen business days." And §114-25-15.4 makes a contract "executed within forty-eight hours after conclusion of the loss producing occurrence" voidable at the insured's option for ten days after execution.

Records: five years, and only for public adjusters. §114-25-8.2 requires records "maintained for at least five years after the termination of the transaction with an insured." Ten categories of content are prescribed.

A 2026 Bill Would Have Rewritten All of This. It Died in Committee.

2026 HB5521, "Relating to public adjusters," would have put public adjuster application, licensure, examination and conduct standards into the statute — creating §§33-12B-5A through -5G and §§33-12B-16 through -21.

It passed the House 86–3 on 4 March 2026, was referred to Senate Banking and Insurance on 5 March 2026, and was never reported out of that committee before the session ended. A bill sitting in committee at adjournment dies there.

West Virginia's bill-status pages print no "died" line, which is why secondary summaries describe it as pending. It is not pending; the 2026 regular session is over.

So the rule remains the only source of public adjuster conduct standards in West Virginia, and any source describing new statutory public-adjuster standards of conduct, examination requirements or sections in the 5A–5G range is describing a bill that failed.

And this is why the two-list problem on the code site matters so much in this particular state. HB5521 appears in the "Bill History" list for §§33-12B-1, -2 and -3 — the three sections it would have amended. It appears in no "Signed Bills" list anywhere in the article.

West Virginia Has a Real Claims Regulation — and It Has No Frequency Element

Two instruments govern claim handling in West Virginia and they do not have the same threshold. The statute is W. Va. Code §33-11-4(9). The regulation is C.S.R. 114-14, effective 24 April 2006. You need both, and the difference between them is the most-missed point in the state.

The statute has a frequency element, and it reaches every practice. §33-11-4(9)'s chapeau: "No person shall commit or perform with such frequency as to indicate a general business practice any of the following." By its own words that requirement attaches to all fifteen enumerated practices, (a) through (o).

The regulation has no frequency element at all. Searching 114-14 end to end turns up no "frequency" and no "general business practice" language anywhere in it.

So a single missed deadline violates the rule, while the identical conduct would not by itself violate the statute. One file, handled badly once, is a rule violation and is not a statutory one. That is the practical difference between the two instruments and it is worth more than any single deadline in either.

But the rule creates no private action, and says so. §114-14-1.1.e: "Nothing in this rule creates or recognizes, either explicitly or impliedly, any new or different cause of action not otherwise recognized by law."

Its sanction is administrative — and it reaches you personally. §114-14-10: a person who fails to comply "shall, after notice and hearing, be found to be transacting insurance in an illegal, improper or unjust manner," and the Commissioner may "refuse to renew, or may revoke or suspend the license of any such person."

And the rule is expressly not a complete list. §114-14-1.1.d: "This rule is not exclusive, and other acts, not herein specified, may also constitute unfair claims settlement practices."

Roughly Fifteen Clocks — and West Virginia Mixes Working Days and Calendar Days

This is an unusually dense set of claim deadlines, and the day convention changes inside the same rule. Read the units on every clock; they are not uniform and the pattern is not intuitive.

The working-day clocks — fifteen days each. Acknowledge a claim notice (§114-14-5.1). Respond to a Commissioner inquiry, and it must be "a complete written response" addressing all issues raised (§114-14-5.2). Reply to other pertinent communications (§114-14-5.3). Commence an investigation (§114-14-6.2(a)). Pay an agreed settlement, running from receipt of the agreement or the claimant's performance of conditions, whichever is later (§114-14-6.11).

Affirm or deny: ten working days — and the clock starts from a different event. §114-14-6.3: "Within ten (10) working days of completing its investigation, the insurer shall deny the claim in writing or make a written offer, subject to policy limits." It runs from completion of the investigation, not from proof of loss.

The investigation clock is calendar, and it starts the delay-letter machinery. §114-14-6.7: if the insurer needs more than thirty (30) calendar days from receipt of a first-party proof of loss or a third-party notice of claim, it must send a delay letter — due fifteen working days after that period expires — and then status letters every forty-five (45) calendar days thereafter.

Limitations warnings run on calendar days and split by claimant type. §114-14-6.12 requires written notice to unrepresented claimants not less than thirty (30) days before a first-party limitation period expires, and not less than sixty (60) days for a third-party claimant.

Automobile physical damage has its own working-day set. Inspect a partial loss within seven (7) working days of notice of loss; pay within ten (10) working days after the insured accepts the offer; total losses get five additional working days on those clocks. The unreasonable-delay trigger is fifteen working days from receipt of proofs of loss, then explanations every thirty (30) calendar days.

One suspension, with a condition attached. The §6.7 clocks are relieved where claimant fraud is suspected — but the rule forbids disclosing anything "that could reasonably be expected to alert a claimant to the fact that the subject claim is being investigated as a suspected fraudulent" claim.

The Third-Party Private Action Was Abolished in 2005 — and the Case That Created It Is Still Cited

West Virginia once had the most claimant-friendly third-party rule in the country, and the legislature took it away.

Jenkins v. J. C. Penney Casualty Insurance Company, No. 14607, Supreme Court of Appeals of West Virginia, 14 July 1981 created an implied private cause of action for violation of §33-11-4(9) and held that "third-party claimants are covered as a protected class under the act." It reached that result through a four-factor implied-right test.

W. Va. Code §33-11-4a, enacted by the 2005 Enrolled Committee Substitute for SB418, abolished it. Subsection (a): "A third-party claimant may not bring a private cause of action or any other action against any person for an unfair claims settlement practice." Note the breadth — any person, not merely an insurer.

And the bar reaches into the underlying tort suit. The same subsection provides that a third-party claimant "may not include allegations of unfair claims settlement practices in any underlying litigation." You cannot plead around it by folding the allegations into the liability case.

The Court has said outright what happened. State ex rel. State Auto Property Insurance v. Hon. James C. Stucky, No. 15-1178 (W. Va., 14 June 2016): "Statutory third-party bad faith claims were abolished by the Legislature in W. Va. Code § 33-11-4a (2005)."

What is left is an administrative complaint, and it has its own machinery. The sole remedy is "the filing of an administrative complaint with the Commissioner," filed "as soon as practicable but in no event later than one year following the actual or implied discovery." The Commissioner contacts the claimant within fifteen days; a hearing is set on ten days' written notice, held within ninety days of filing, and conducted "in the geographical region of the state where the complainant" resides. C.S.R. 114-76 is the procedural rule for it.

A Sixty-Day Cure and a Good-Faith-Disagreement Rule — Both in §33-11-4a

§33-11-4a did more than abolish a cause of action. It wrote two safe harbors into the administrative route, and both are worth knowing on a live file.

The sixty-day cure closes the complaint entirely. §33-11-4a(b)(4): where the respondent "substantially corrects the circumstances that gave rise to the violation or offers to resolve the complaint in a manner found reasonable by the Commissioner within sixty days," the Commissioner "shall close the complaint" — and no further remedy follows.

The good-faith-disagreement rule is categorical. §33-11-4a(g): "A good faith disagreement over the value of an action or claim or the liability of any party to any action or claim is not an unfair claims settlement practice." Not a defense to be weighed — a statement that the conduct is outside the definition.

The frequency element is statutorily defined for this route. §33-11-4a(f): a finding "may only be based on the existence of substantially similar violations in a number of separate claims or causes of action." One file is not enough, and the violations must resemble each other.

But a single INTENTIONAL violation still bites. §33-11-4a(e) preserves exposure where a person "engaged in any method of competition, act or practice that involves an intentional violation" of §33-11-4(9), "even though it has not been established that the person engaged in a general business practice."

Two more procedural clocks sit inside the section. The Commissioner has fifteen days to contact a claimant about a deficient complaint; the respondent reports "within fifteen days of the disposition but no later than sixty days from notice."

Hayseeds — Fees, Net Economic Loss, and Aggravation, With No Bad Faith Required

West Virginia's first-party remedy is generous and it does not require proving bad faith. It requires only that the policyholder substantially prevail.

Hayseeds, Inc. v. State Farm Fire & Casualty, No. 16782, Supreme Court of Appeals of West Virginia, 12 December 1986 is the source. The opinion carries no numbered syllabus points, which is why the canonical statement of the rule is the one restated as a syllabus point in McCormick v. Allstate, No. 23261, 18 July 1996:

"Whenever a policyholder substantially prevails in a property damage suit against its insurer, the insurer is liable for: (1) the insured's reasonable attorneys' fees in vindicating its claim; (2) the insured's damages for net economic loss caused by the delay in settlement, and damages for aggravation and inconvenience."

Read the trigger again. It is "substantially prevails" — not bad faith, not unreasonableness, not a general business practice. An insurer that takes a coverage position in complete good faith and loses is exposed to all three heads.

And the aggravation head is wider than it sounds. McCormick holds those damages are "not limited to damages associated with loss of use of the personal property but relate as well to the aggravation and inconvenience shown in the entire claims collection process."

The statutory first-party action survives §33-11-4a, and was reaffirmed in State Auto v. Stucky, No. 15-1178 (14 June 2016): as the insured under the policy, the claimant "is a first-party claimant and has a cause of action." But that was a 3–2 memorandum decision, a weaker vehicle than its billing suggests, and a follow-on decision in October 2017 cut back its practical reach.

The statutory route carries a judicial frequency threshold that the Hayseeds route does not. Dodrill, syllabus point 4, quoted in Holloman v. Nationwide, No. 32286 (21 June 2005), requires more than a single violation — separate discrete acts reflecting a habit, custom or business policy. So the contract-derived remedy is the easier one to reach.

West Virginia Holds That an Adjuster Can Be Sued Personally — In a Syllabus Point

Most states either foreclose this or leave it unresolved. West Virginia answered it directly, and the answer is yes.

Thomas W. Taylor v. Nationwide Mutual Insurance Company and Scarlett Tarley, No. 31154, Supreme Court of Appeals of West Virginia, submitted 24 September 2003, decided 21 November 2003. Syllabus point 1: "A cause of action exists in West Virginia to hold a claims adjuster employed by an insurance company personally liable for violations of the West Virginia Unfair Trade Practices Act."

The certified question was framed in exactly those terms — whether a cause of action exists to hold an insurance company's employee claims adjuster personally liable for UTPA violations. The Court said it does.

The reasoning rests entirely on a noun. §33-11-4(9) prohibits conduct by "no person," and §33-11-2(a) defines "person" to include "any individual … including agents and brokers." The prohibition was never written to run only against insurers.

And the regulation's noun is broader still — it names your job. §114-14-2 defines "person" to include "agents, adjusters and brokers." The claims rule you work under identifies you by role.

Taylor was a first-party insured's case, which is why it survives the 2005 abolition of the third-party action — §33-11-4a(a) removed the third-party route, not the first-party one. A search for overruling or narrowing authority found none. The first-party limitation is a sound reading of §33-11-4a against §33-11-2(a) rather than a holding, and is reported here as a reading.

A federal court applied Taylor the following year and declined to extend it to a non-insurance investigator — so the holding is about claims adjusters employed by insurers, not about anyone touching a claim file.

Ten Years on the Contract, One Year on the Statute — and Fire Is Carved Out of Both

West Virginia's periods are unusually far apart, and which one applies turns on how the claim is pleaded.

Breach of an insurance contract: TEN years. §55-2-6 gives ten years for an action "upon a contract in writing, signed by the party to be charged thereby, or by his agent, but not under seal." A Hayseeds claim, being contract-derived, rides that period.

A statutory UTPA claim: ONE year. Klettner v. State Farm, No. 25436 (8 July 1999) adopts the rule that unfair settlement practice claims "are governed by the one-year statute of limitations set forth" in §55-2-12(c) — the catch-all subsection, not the two-year property or personal-injury ones.

And that year does not start when you think. Under Klettner, the period "does not begin to run until the appeal period has expired on the underlying cause of action."

Contractually shortened suit clauses have a statutory floor — §33-6-14. A policy may not limit the time to sue to "a period of less than two years from the time the cause of action accrues in connection with all insurances other than marine," and the section separately voids a clause "preventing the bringing of an action … for more than six months after the cause of action accrues."

Then the final sentence takes the fire policy back out: "This section shall not apply to the standard fire insurance policy." So the two-year floor does not protect a fire claimant. The fire policy runs on the New York 1943 form's twelve months — a fixed contractual period, not a statutory minimum.

Fourteen Days — and the Deadline Is in a Rule Neither the Statute nor the Bulletin Names

The duty is mandatory, the deadline is fourteen days, and finding it requires going one instrument further than most research stops.

§33-41-5(a) creates the duty and splits the verbs. It uses "shall" for persons in the business of insurance and "may" for everyone else. Adjusters are in the mandatory group — the Commissioner's own Informational Letter 206 (November 2019) confirms it and adds: "There are no exceptions nor reasons to refrain from reporting."

But the statute does not state a deadline. It delegates the manner — the report is made "in a manner prescribed by, the commissioner." Enumerating all sixteen sections of Article 41 turns up no period, and Informational Letter 206, which prescribes who reports and what the report contains, is genuinely silent on timing.

The Commissioner prescribed it in a rule. §114-71-3.2: "The report shall be filed with the Insurance Fraud Unit within fourteen (14) days of the determination by the reporter that a suspected fraudulent insurance act has been committed."

C.S.R. 114-71 was filed and effective 6 May 2005 under the authority of §§33-2-10 and 33-41-10, and the Secretary of State shows it Active on a single row — no later versions. §114-71-3.1 sweeps adjusters in by incorporating §33-41-5(a), and the report must be signed, dated, on a prescribed form, with eight content categories. §114-71-3.3(e) requires each party's date of birth, social security number, taxpayer identification number and driver's license number "if known."

Note when the clock starts: on YOUR determination, not on the event. The fourteen days run from "the determination by the reporter that a suspected fraudulent insurance act has been committed" — so documenting when you formed that view is what makes the deadline auditable.

A Fault State With No First-Party Benefits At All

West Virginia is a fault (tort) state. No no-fault, no personal injury protection, no medical payments mandate, no mini-tort, and no statutory first-party automobile benefits of any kind — proved by enumerating Chapter 33's 104 articles and Chapter 17D's 7. What West Virginia has instead is compulsory third-party liability, compulsory uninsured motorist coverage, and a mandatory underinsured motorist offer.

Minimum limits: $25,000 / $50,000 / $25,000. §17D-4-2(b), effective 1 January 2016 by the 2015 Enrolled Committee Substitute for HB2790. They have not moved since.

And the old limits are still printed on the same page. §17D-4-2(a) still carries $20,000 / $40,000 / $10,000. Read the subsection, not the section — a search that lands in (a) returns a real, current, superseded figure.

Uninsured motorist coverage is mandatory and cannot be waived to zero. §33-6-31(b): no policy may be issued or delivered "unless it contains an endorsement or provisions undertaking to pay the insured all sums which he or she is legally entitled to recover" — at limits "no less than the requirements of section two, article four, chapter seventeen-d."

Underinsured motorist coverage is mandatory-OFFER, not mandatory. The same subsection requires that the policy "shall provide an option to the insured with appropriately adjusted premiums." The insurer must offer; the insured may decline. And UM/UIM is optional altogether on umbrella and excess policies (§33-6-31f).

Seventy-Five Percent Is Real Here — but It Defines the Term, It Does Not Pull the Trigger

Several states carry an invented total-loss percentage attached to a real-looking citation. West Virginia's percentage is genuine — and it still is not the trigger.

§17A-4-10 defines the term: "The term 'total loss' means a motor vehicle which has sustained damages equivalent to seventy-five percent or more of the market value as determined by a nationally accepted used car value guide."

But the operative trigger for a salvage certificate is transactional, and it has two limbs. The vehicle must be "determined to be a total loss or otherwise designated as totaled by an insurance company or insurer" and there must be "payment of a total loss claim." Your own settlement decision plus your payment is what brands the vehicle.

And there is a hard ten-day duty attached. "Within 10 days of payment of the total loss claim, the insurance company or insurer shall surrender the certificate of title" to the Division of Motor Vehicles, with a copy of the claim settlement and a prescribed application form.

Valuation runs on an approved guide, at both statutory and regulatory level. §33-6-33 requires insurers to "use the most recent version of an 'official used car guide' approved by the Insurance Commissioner," and §114-14-7.4 requires the same, with downward deviations documented and itemized and dealer quotations where the vehicle is not in the guide.

Two more provisions in §114-14-7.4 worth carrying. A current-model-year total loss gets a special two-option rule. And if the insurer deducts salvage value, it must furnish the insured with the name of a salvage dealer who will buy the salvage for that amount.

The New York 1943 Form by Reference — Plus a Valued Policy Law That Reaches Partial Losses

West Virginia does not draft its own fire policy. §33-17-2 adopts the New York standard fire policy, 1943 edition, by reference and re-designates it the West Virginia standard fire policy. There is no state-drafted policy text in the code to read. Non-conforming language is permitted only if it is "at least as favorable to the insured." §33-17-2 has not been amended since 1957.

And West Virginia has a valued policy law, at §33-17-9, captioned "Total or partial fire loss." "All insurers providing fire insurance on real property in West Virginia shall be liable, in case of total loss by fire or otherwise, as stated in the policy, for the whole amount of insurance stated in the policy."

Its scope has three limits and one of them is usually stated wrong. It reaches real property only. It applies to a single insurer only — "This section does not apply where such insurance has been procured from two or more insurers covering the same interest." But it is not confined to total losses. The same section continues: "in case of partial loss … the liability shall be for the total amount of the partial loss, not to exceed the whole amount of insurance."

There is no statutory replacement-cost provision, no statutory definition of actual cash value, no matching rule and no depreciation-of-labor rule — proved by walking §114-14-2's thirteen defined terms and the Commissioner's bulletin and informational-letter indexes.

One property provision that is easy to miss: §33-17-9b conditions payment of debris removal proceeds on certification that the debris was actually cleared.

Workers' Compensation Is Paid in Full — Except One Species, Capped at $300,000

W. Va. Code Article 33-26 is the property and casualty guaranty association, and its most useful provision is a limit that is not a limit.

§33-26-8 pays "the full amount of a covered claim for benefits under a workers' compensation insurance policy" — uncapped. Then it adds one proviso: "any covered claim for deliberate intention … may not exceed $300,000 per claim." Ordinary comp is uncapped; the deliberate-intent claim under §23-4-2 is capped.

The filing deadline is the earlier of two dates, not a single number. Claims are barred "after the earlier of: (i) Twenty-five months after the date of the final order of liquidation; or (ii) the final date set by the court." Two clocks, and the shorter one governs.

The net-worth exclusion is $25,000,000 and it bars the claim from both directions — first-party and third-party. ⚠️ But it carries two exceptions: it does not apply to workers' compensation claims, and it does not apply to third-party claims where the insured is in bankruptcy or liquidation.

There is no claimant deductible in West Virginia, and that negative can be proved by enumerating all ten exclusions in the §33-26-5 definition of "covered claim": punitive and exemplary damages; retrospective premium return; reinsurer, insurer and pool subrogation; first-party claims of $25 million net-worth insureds; third-party claims against them; claims above another state's threshold; first-party claims by an affiliate of the insolvent insurer; provider fees from pre-insolvency retention; claimant-side provider fees for prosecuting the claim; and "any claims for interest." None is a minimum-claim threshold.

Coverage continues thirty days after the FINAL ORDER OF LIQUIDATION — or the policy's expiration date if that is sooner. Not from the receiver's appointment; §33-26-5 defines "receiver" separately as "receiver, liquidator, rehabilitator or conservator."

A Privatized System, Its Own License Line, and a Minimum Frozen Since 2009

West Virginia privatized its workers' compensation system, and that single fact explains the licensing structure. It is why the state has a workers' compensation line of authority on the adjuster license and a standalone examination for it — `InsWV-WCAdj21`, 45 questions in 60 minutes — a combination almost no other state has.

The benefit percentages are in §23-4-6. Temporary total disability is "66 and two-thirds percent of the average weekly wage earnings, wherever earned, of the injured employee." The maximum is "not to exceed 100 percent of the average weekly wage in West Virginia." Permanent partial is "not to exceed 70 percent." The minimum is "not be less than 33 and one-third percent."

The FY2027 figures, from the Commissioner's own table, effective 1 July 2026: state average weekly wage $1,150.91; maximum weekly for temporary total, permanent total and fatal awards $1,150.91; permanent partial $805.64; minimum $193.33. Daily equivalents are $164.42, $115.09 and $27.62.

A 100 percent-of-wage maximum is unusually low as a multiple. Most states set the ceiling at 105 to 133 percent of the state average weekly wage. West Virginia's maximum IS the state average weekly wage.

And the minimum is not what the percentage would give you. 33⅓ percent of $1,150.91 is $383.64. The published minimum is $193.33 — roughly half. The reason is a parenthetical in the Commissioner's own rule statement: "Minimum rate is 33 1/3% of SAWW (Effective 7/1/94, cannot exceed Federal Minimum)." The federal minimum wage has been $7.25 since 24 July 2009; a forty-hour week at that rate is $290.00; and 66⅔ percent of $290.00 is $193.33.

The Commissioner labels that whole block "Effective 7/24/09 and after" — stating on the face of the table that the minimum has been frozen at the 2009 federal minimum wage while the wage-derived figure drifted to nearly double it. The gap widens every year the federal minimum does not move.

Six Months to Apply, Six Percent on Late Payment — and No Percentage Penalty

The workers' compensation deadlines sit in Chapter 23 and they are not the Chapter 33 clocks. Keep the two chapters apart: 23 is the compensation act, 33 is the insurance code.

The application deadline is six months. §23-4-15 requires application "within six months from and after the injury or death," with longer periods — three years, two years and one year — attaching to particular categories.

Late payment carries interest, not a percentage penalty. §23-4-16a provides interest "at the simple rate of six percent per annum." There is no per-day penalty and no percentage add-on — that is a structural difference from states like Michigan, which layers a $50-per-day penalty on top.

None of those figures moved in 2026, despite a very large act. 2026 Enrolled Committee Substitute for HB5515 was approved by the Governor on 1 April 2026 and took effect 12 June 2026 — ninety days from passage — as Chapter 292 of the 2026 Acts.

Its enrolled title amends 36 sections and repeals 15, but its true reach is 51, because the code site places the repealing bill into the repealed section's "Signed Bills" list as well. What it changed was housekeeping: obsolete Commission references deleted, spelled-out numbers converted to numerals, twelve "effective until June 30, 2022" twin sections repealed, cross-references repointed. No benefit percentage moved. No deadline moved. No penalty or interest rate moved. OIC Bulletin 26-02 describes it as revising "outdated and/or unnecessary provisions."

Read the Signed List, Open the Section, and Check What Kind of File You Just Downloaded

West Virginia's official publisher is reachable and generally excellent — and it has three habits that will mislead you if you do not know them.

One: take currency from "Signed Bills," never from "Bill History." The two lists sit a few lines apart at the foot of every section page and only the second is enacted law. And then open the section, because a repealed section carries its repealing bill in the signed list and both article indexes for Chapter 23 still print repealed catchlines as though live.

Two: the free reproductions are behind, and one of them hides it. Justia's West Virginia rules carry a "current through" stamp of 19 June 2025 — nine and a half months before C.S.R. 114-25's current version took effect — and serve the 2021 rule under it. Cornell carries no edition date at all, only a note that state regulations are updated quarterly. Both show the old catchlines and the old lettering.

Three: check what kind of file the agency actually served you. The Commissioner's workers' compensation benefit rates sit behind a link captioned only "Benefit Rates FY2027" — and the file is a spreadsheet, not a PDF, delivered through a generic handler. Tools that assume a PDF fail on it silently and in a way that looks exactly like an unreadable scan.

Four things move on their own schedule and none of them is in the statute you would naturally read. The workers' compensation benefit table resets each fiscal year on 1 July. The examination fee and cut scores are vendor policy. The guaranty association's exclusions turn on figures inside a definition rather than a limits section. And the legislative rules carry sunset dates — C.S.R. 114-25 now runs to 1 August 2036.

And there is one live loose end worth knowing about. §23-4-14 names two different officers as the determiner of the state average weekly wage — subsection (c) points to an agency that no longer exists under that name, and to two sections neither of which contains a wage computation, while subsection (a), as rewritten in 2026, names the Insurance Commissioner. Operationally the Commissioner publishes it. The statute has not caught up.

Quick Reference

Official Links