West Virginia · Insurance Adjuster Sample Interactive Mind Map
West Virginia Adjuster Regulations
A visual breakdown of the West Virginia rules an adjuster is tested on — including the three credentials and the license for company staff, the three examinations and the scaled 70, the claims rule that mixes working and calendar days and carries no frequency element, the third-party action that was created here and abolished here, and the workers' compensation minimum frozen since 2009.
West Virginia licenses three adjusters — company, independent and public — and unlike most states it licenses the insurer's own salaried staff. The article is W. Va. Code ch. 33, Article 12B, captioned simply “ADJUSTERS,” so unlike states that bury adjuster provisions in a shared producer chapter, everything in it was written about adjusters. Independent and company adjusters may hold property and casualty, workers' compensation and crop lines; a public adjuster is confined to property and casualty. There is no prelicensing education — but there are three separate Pearson VUE examinations, not one, and the 70 is a scaled score, which the candidate handbook states in terms while its own examination table prints “70%” anyway. No crop examination is published at all, because §33-12B-5(b)(1) accepts USDA Risk Management Agency certification in its place.
On the job West Virginia has what many states do not: a real claims-handling regulation. C.S.R. 114-14 carries roughly fifteen deadlines and mixes working days and calendar days inside the same rule — fifteen working days to acknowledge, thirty calendar days to complete an investigation, ten working days to affirm or deny after completing it, and status letters every forty-five calendar days. And here is the point most candidates miss: the statute carries a general business practice element and the regulation carries none, so a single missed clock on a single file violates the rule while leaving §33-11-4(9) unviolated. The rule creates no private cause of action, but its sanction reaches the individual licensee — and its definition of “person” names adjusters expressly.
Three more West Virginia answers run against the national grain. A first-party insured who merely substantially prevails recovers reasonable attorney's fees, net economic loss and damages for aggravation and inconvenience under Hayseeds — with no bad faith element in the formulation at all. The adjuster can be sued personally: Taylor, Docket No. 31154, decided 21 November 2003, holds in a syllabus point that a claims adjuster employed by an insurer is personally liable for Unfair Trade Practices Act violations, because both the statute and the rule use the noun “person.” And the third-party private action that Jenkins created in 1981 was abolished by §33-11-4a in 2005 — a genuine leading case whose statute moved underneath it, leaving an administrative complaint with a sixty-day cure as the sole remedy. Click through the clusters, then take the scenario quiz and see which numbers have stuck.
West Virginia licenses THREE adjusters — including the company’s own salaried staff.
The article is W. Va. Code ch. 33, Article 12B, captioned simply “ADJUSTERS.” That caption does real work: where other states bury adjuster provisions inside a shared producer chapter, West Virginia gives adjusters a dedicated article — so everything in it was written about you.
The article is W. Va. Code ch. 33, Article 12B, captioned simply “ADJUSTERS.” That caption does real work: where other states bury adjuster provisions inside a shared producer chapter, West Virginia gives adjusters a dedicated article — so everything in it was written about you.
§33-12B-2 — ALL THREE CREDENTIALS IN ONE SENTENCE“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.” ⚠ Many states exempt salaried staff adjusters entirely. West Virginia licenses them.
| Credential | Lines of authority | What is distinctive |
|---|---|---|
| Company adjuster | P&C · WC · Crop | The insurer’s own staff. Licensed here, unlike in most states. |
| Independent adjuster | P&C · WC · Crop | Contracts with insurers as an independent contractor. |
| Public adjuster | ⚠ P&C ONLY | §33-12B-7(b): “may only qualify for a license designating a property and casualty line.” |
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Eighteen entries in the article — and TWO are repealed and still printed with their catchlines
Article 12B runs §§1, 2, 3, 4, 4a, 5, 6, 7, 8, 9, 10, 10a, 11, 11a, 12, 13, 14, 15.
§33-12B-4a was a second exemptions section. §33-12B-11a was a second emergency-adjuster route. The 2020 Enrolled HB4502 repealed both, in the same act that amended and reenacted the rest.
⚠ The article index still lists them. Open the section — the section page correctly shows “[Repealed]”. The index and the section page disagree, on the same site, on the same day.
§33-12B-4a was a second exemptions section. §33-12B-11a was a second emergency-adjuster route. The 2020 Enrolled HB4502 repealed both, in the same act that amended and reenacted the rest.
⚠ The article index still lists them. Open the section — the section page correctly shows “[Repealed]”. The index and the section page disagree, on the same site, on the same day.
§33-12B-15 — A BARE EFFECTIVE-DATE SECTION THAT DATES EVERYTHING“The effective date of the amendments made to this article during the 2020 regular legislative session is July 1, 2021.” That one sentence explains why the workers’ compensation examination requirement, the reorganized exemptions and the collapsed emergency route all appear to arrive in mid-2021 rather than in 2020.
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FIFTEEN exemptions, not one — and the remote-adjusting carve-out is number fifteen
Most summaries mention a single escape hatch. §33-12B-3(a) has fifteen, and §33-12B-3(b) adds five more for public adjusters.
Attorneys acting professionally · fact-gatherers and technical assistants · fraud investigators who do not adjust or determine coverage · executive, administrative and clerical staff · healthcare providers · managed care employees · reinsurance and subrogation personnel · officers and directors · managers of US branches of foreign insurers · life, accident and health, annuity and disability claims · self-insured employers’ adjusters · producers and MGAs with claim authority · §33-46 entities · supervised claims data collectors · out-of-state company adjusters working remotely.
Attorneys acting professionally · fact-gatherers and technical assistants · fraud investigators who do not adjust or determine coverage · executive, administrative and clerical staff · healthcare providers · managed care employees · reinsurance and subrogation personnel · officers and directors · managers of US branches of foreign insurers · life, accident and health, annuity and disability claims · self-insured employers’ adjusters · producers and MGAs with claim authority · §33-46 entities · supervised claims data collectors · out-of-state company adjusters working remotely.
✅ TWO EXEMPTIONS WORTH MEMORIZING
THE SUPERVISION CAP IS 25. A supervisor may oversee no more than 25 unlicensed claims data collectors or entrants. Scale past it and the supervisor is outside the exemption.
LIFE, ACCIDENT AND HEALTH ARE OUTSIDE THE LICENSE ENTIRELY. So the WV adjuster license is, by construction, a property-casualty-side credential.
⚠ AND A RULE HIDING IN THE WRONG SECTION
THE CONFLICT RULE IS INSIDE §33-12B-2. Concurrent licenses are permitted; representing conflicting interests on the same claim is not.
Other states give that rule a section of its own. West Virginia buries it in the license-required section — which is why it is routinely missed.
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ONE emergency route — and the INSURER files, not you
§33-12B-11a is repealed; everything runs through the reenacted §33-12B-4.
§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.”
• 5 DAYS from the declared emergency — and the adjuster may work in the meantime if otherwise qualified
• 7 data elements required
• 90 DAYS, extendable — no stated outer limit
• $25, due at application
• §33-12B-5(d) switches off qualification and examination entirely
§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.”
• 5 DAYS from the declared emergency — and the adjuster may work in the meantime if otherwise qualified
• 7 data elements required
• 90 DAYS, extendable — no stated outer limit
• $25, due at application
• §33-12B-5(d) switches off qualification and examination entirely
⚠ TWO DEFINITIONS, TWO DIFFERENT TESTS§33-12B-1 defines an “insurance emergency” by ADJUSTER SCARCITY — “when the number of licensed adjusters in this state is inadequate to meet the demands.” But §33-2-10a keys the Commissioner’s declaration to CLAIM VOLUME — an event “reasonably likely to produce a volume of claims … that significantly exceeds the number of claims normally arising.” ⚠ Two conditions that must coincide — and neither you nor your firm can start the clock.
THREE examinations, a SCALED 70, and a term the statute and the agency state differently.
No prelicensing education. Three separate Pearson VUE instruments rather than one. A cut score the handbook describes two incompatible ways on the same document. And a license term where the statute says one year ending 31 May and your license actually runs two years to your birthday — both correct, for different reasons.
No prelicensing education. Three separate Pearson VUE instruments rather than one. A cut score the handbook describes two incompatible ways on the same document. And a license term where the statute says one year ending 31 May and your license actually runs two years to your birthday — both correct, for different reasons.
| Examination | Code | Time | Scored | Cut |
|---|---|---|---|---|
| WV Adjuster (company and independent) | InsWV-Adj14 | 90 min | 80 | 70 |
| WV Public Adjuster | InsWV-PubAdj17 | 45 min | 45 | 70 |
| WV Workers Compensation Adjuster | InsWV-WCAdj21 | 60 min | 45 | 70 |
$84 PER ATTEMPT · EIGHT ATTEMPTS PER LINE OF AUTHORITYNon-refundable, payable at reservation. The handbook’s “eight (8) attempts to pass each line of authority” matches §33-12B-5(b)(4)’s statutory phrasing of “seven additional attempts.” ⚠ Note the ratios — the public adjuster exam gives you ONE MINUTE PER QUESTION, the tightest of the three.
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The 70 is a SCALED score — and the handbook contradicts itself on the same document
The examination table prints “70%”, with a percent sign. The narrative says otherwise, and the narrative is right:
“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: “any score below 70 indicates how close the candidate came to passing.”
⚠ So there is no fixed number of questions you must get right. Forms are statistically equated and the conversion moves with the form. Teach the narrative, not the table.
“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: “any score below 70 indicates how close the candidate came to passing.”
⚠ So there is no fixed number of questions you must get right. Forms are statistically equated and the conversion moves with the form. Teach the narrative, not the table.
AND THE ITEM COUNT IS NOT THE SEAT COUNT“The examination will contain pretest questions, on which statistical information is being collected” and “Responses to pretest questions do not affect a candidate’s score.” ⚠ The 80 on InsWV-Adj14 is the scored count. You will sit more than 80 items. Budget the ninety minutes against what is in front of you. No WV statute or rule sets a passing score at all — and the only 80 cut score in the state is the bail bond exam.
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There is NO crop examination — and that is by statutory design
Enumerate the handbook’s whole examination table — Life, Accident and Health, Property and Casualty, Adjuster, Property, Surplus Lines, Casualty, Public Adjuster, Personal Lines, Viatical Settlement Broker, Workers Compensation Adjuster — and there is no crop instrument.
⚠ It is not an oversight. §33-12B-5(b)(1) lets the Commissioner accept USDA Risk Management Agency proficiency certification “in lieu of such an examination.”
The line of authority exists; the test does not, because a federal credential stands in its place. And §33-12B-10(d) lets the Commissioner require at renewal that the licensee “has maintained” that certification — so the substitute has to stay alive.
⚠ It is not an oversight. §33-12B-5(b)(1) lets the Commissioner accept USDA Risk Management Agency proficiency certification “in lieu of such an examination.”
The line of authority exists; the test does not, because a federal credential stands in its place. And §33-12B-10(d) lets the Commissioner require at renewal that the licensee “has maintained” that certification — so the substitute has to stay alive.
⚖ WHAT THE STATUTE SAYS
🏢 WHAT YOU ACTUALLY LIVE UNDER
§33-12B-10(a): “each license shall … expire at midnight on May 31 next following the date of issuance, and the commissioner shall renew annually.”
And §33-12B-8: “The annual fee for an individual adjuster license shall be $25.”
And §33-12B-8: “The annual fee for an individual adjuster license shall be $25.”
Last day of Birth Month, BIENNIALLY. The OIC fee schedule prices it “(Biennial DOB) $50.00.”
⚠ Two years at $25 is $50. Not a conflict — the same figure counted over different periods.
⚠ Two years at $25 is $50. Not a conflict — the same figure counted over different periods.
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The displacement power is in the SAME subsection — and it anticipates the transition both ways
§33-12B-10(a) continues: “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 of his or her office.”
If the reset shortens a paid period — “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 31 May default to stand would not have written the adjustment rules. Cite the biennial birth-month cycle to the Commissioner’s exercise of the power — never to §33-12B-10(a), which says one year and 31 May.
If the reset shortens a paid period — “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 31 May default to stand would not have written the adjustment rules. Cite the biennial birth-month cycle to the Commissioner’s exercise of the power — never to §33-12B-10(a), which says one year and 31 May.
LAPSE IS A REISSUE RIGHT, NOT A GRACE PERIOD§33-12B-10(b): an adjuster whose license expires may, on application “within one year of the expiration date, be reissued a license upon payment of twice the renewal fee.” ⚠ The license EXPIRED. Nothing tolls, nothing is suspended pending payment — and you were not licensed during that window. Adjusting in it is adjusting without a license. Renewal is waivable for “military service, long-term medical disability, or other extenuating circumstance.”
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CE is 24 hours with 3 in ethics — and both failure consequences are AUTOMATIC
Reported “on a biennial basis in conjunction with their license renewal cycle” — so the CE biennium and the license term are the SAME clock, and C.S.R. 114-42 defines the period as “coextensive with the … adjuster’s license period.”
• Carryover capped at 6 hours — overshooting by more is wasted
• Up to 2 hours from approved professional-organization membership
• Exempt if not licensed a full year before the biennium ends
• Nonresidents satisfy WV through home-state compliance
⚠ FAILURE BRINGS AUTOMATIC SUSPENSION. CONTINUED FAILURE THROUGH A SECOND BIENNIUM BRINGS AUTOMATIC TERMINATION — after which you reapply from the beginning under §33-12B-5, examination included. Neither step needs a hearing, an order, or a notice to fire.
• Carryover capped at 6 hours — overshooting by more is wasted
• Up to 2 hours from approved professional-organization membership
• Exempt if not licensed a full year before the biennium ends
• Nonresidents satisfy WV through home-state compliance
⚠ FAILURE BRINGS AUTOMATIC SUSPENSION. CONTINUED FAILURE THROUGH A SECOND BIENNIUM BRINGS AUTOMATIC TERMINATION — after which you reapply from the beginning under §33-12B-5, examination included. Neither step needs a hearing, an order, or a notice to fire.
⚠ REPORTING — TWO THIRTY-DAY CLOCKS, STARTING AT OPPOSITE ENDS§33-12B-10a(a) — administrative actions: 30 days from FINAL DISPOSITION, reaching actions “in another jurisdiction or by another governmental agency in this state,” expressly including crop decertification. §33-12B-10a(b) — criminal matters: “Within thirty days of the initial pretrial hearing date.” ⚠ That is near the START of the case. Waiting to see how a prosecution resolves misses it by months — the duty is triggered by the prosecution itself, not by any outcome.
TWO instruments govern claim handling here — and they do NOT have the same threshold.
The statute is W. Va. Code §33-11-4(9): fifteen practices, (a) through (o), with a general business practice requirement in the chapeau reaching all fifteen. The regulation is C.S.R. 114-14: roughly fifteen deadlines — and no frequency language anywhere in it.
The statute is W. Va. Code §33-11-4(9): fifteen practices, (a) through (o), with a general business practice requirement in the chapeau reaching all fifteen. The regulation is C.S.R. 114-14: roughly fifteen deadlines — and no frequency language anywhere in it.
⚠ THE MOST-MISSED POINT IN THE STATE§33-11-4(9) chapeau: “No person shall commit or perform with such frequency as to indicate a general business practice any of the following.” 114 C.S.R. 14 contains no such language. ⚠ So a single missed clock on a single file 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 difference is worth more than any single deadline in either instrument.
CALENDAR DAYS WORKING DAYS
| Duty | Clock | Instrument |
|---|---|---|
| ACKNOWLEDGE a claim notice | 15 WORKING | 114-14-5.1 |
| RESPOND to a Commissioner inquiry — “a complete written response” | 15 WORKING | 114-14-5.2 |
| REPLY to other pertinent communications | 15 WORKING | 114-14-5.3 |
| COMMENCE investigation | 15 WORKING | 114-14-6.2(a) |
| COMPLETE investigation | 30 CALENDAR | 114-14-6.7 |
| DELAY LETTER, once that period expires | 15 WORKING | 114-14-6.7 |
| STATUS LETTERS thereafter | every 45 CALENDAR | 114-14-6.7 |
| ⚠ AFFIRM OR DENY — after completing the investigation | 10 WORKING | 114-14-6.3 |
| PAY an agreed settlement | 15 WORKING | 114-14-6.11 |
| LIMITATIONS WARNING — first party | ≥ 30 CALENDAR | 114-14-6.12 |
| LIMITATIONS WARNING — third party | ≥ 60 CALENDAR | 114-14-6.12 |
| Auto — INSPECT a partial loss | 7 WORKING | 114-14-7.3 |
| Auto — PAY after acceptance | 10 WORKING | 114-14-7.3 |
| Auto — TOTAL LOSS | +5 WORKING | 114-14-7.4 |
| Auto — UNREASONABLE DELAY trigger | 15 WORKING, then 30 CALENDAR | 114-14-7.5 |
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The affirm-or-deny clock starts from a DIFFERENT event than every other one
§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, not from notice of claim.
Which means the 30-calendar-day investigation clock in §6.7 is what actually paces the file, and the ten-working-day clock is what happens at the end of it. Get those two the wrong way round and every date on the diary is wrong.
⚠ It runs from completion of the investigation — not from proof of loss, not from notice of claim.
Which means the 30-calendar-day investigation clock in §6.7 is what actually paces the file, and the ten-working-day clock is what happens at the end of it. Get those two the wrong way round and every date on the diary is wrong.
ONE SUSPENSION — WITH A GAG ATTACHEDThe §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. ⚠ You get the extra time and you may not explain why you are taking it.
✅ WHAT THE RULE DOES
REACHES YOU PERSONALLY. §114-14-10: a violator is “transacting insurance in an illegal, improper or unjust manner,” and the Commissioner may “revoke or suspend the license of any such person.”
NAMES YOUR JOB. §114-14-2 defines “person” to include “agents, adjusters and brokers.”
IS NOT A COMPLETE LIST. §1.1.d: “This rule is not exclusive.”
⚠ WHAT IT DOES NOT DO
CREATE A PRIVATE ACTION. §1.1.e: “Nothing in this rule creates or recognizes … any new or different cause of action not otherwise recognized by law.”
SET A RECORD RETENTION PERIOD. §114-14-3 imposes a reconstructability standard instead — files detailed enough that “pertinent events and the dates of such events can be reconstructed.”
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The only numeric retention period is FIVE YEARS — and it is in the LICENSING rule, for PUBLIC adjusters only
§114-25-8.2 requires records “maintained for at least five years after the termination of the transaction with an insured.”
⚠ §114-25-8 is captioned “Public Adjuster Records Maintenance” and §8.1 opens “A public adjuster shall maintain…”
A company or independent adjuster has NO numeric retention period anywhere in West Virginia. Ask where the answer lives before you ask what it is.
⚠ §114-25-8 is captioned “Public Adjuster Records Maintenance” and §8.1 opens “A public adjuster shall maintain…”
A company or independent adjuster has NO numeric retention period anywhere in West Virginia. Ask where the answer lives before you ask what it is.
West Virginia created the most claimant-friendly third-party action in the country — and then abolished it.
What survives is a first-party remedy that does not require bad faith at all, and a Supreme Court holding — in a syllabus point — that the adjuster can be sued personally.
What survives is a first-party remedy that does not require bad faith at all, and a Supreme Court holding — in a syllabus point — that the adjuster can be sued personally.
JENKINS — NO. 14607, SUPREME COURT OF APPEALS OF WEST VIRGINIA, 14 JULY 1981Created an implied private cause of action for violation of §33-11-4(9), holding that “third-party claimants are covered as a protected class under the act.” For twenty-four years it was the high-water mark of claimant-side insurance litigation in the United States.
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§33-11-4a abolished it in 2005 — and the bar reaches into the underlying tort suit
2005 Enrolled Committee Substitute for Senate Bill 418, captioned “Complaints by third-party claimants; elimination of private cause of action.”
§33-11-4a(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 same subsection bars a third-party claimant from “includ[ing] 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 so outright — State Auto v. Stucky, No. 15-1178, 14 June 2016: “Statutory third-party bad faith claims were abolished by the Legislature in W. Va. Code § 33-11-4a (2005).”
§33-11-4a(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 same subsection bars a third-party claimant from “includ[ing] 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 so outright — State Auto v. Stucky, No. 15-1178, 14 June 2016: “Statutory third-party bad faith claims were abolished by the Legislature in W. Va. Code § 33-11-4a (2005).”
⚠ A GENUINE LEADING CASE WHOSE STATUTE MOVED UNDERNEATH ITJenkins is real, famous, and still cited. The citation checks out, the reasoning is intact, and the door is shut. That shape is more dangerous than a fabricated case, because everything about it verifies. ⚠ First-party Jenkins-line claims survive. Third-party ones do not. Check the CLAIMANT’S STATUS before you check the case.
| Third-party route today | Clock | Source |
|---|---|---|
| File the administrative complaint — the sole remedy | 1 YEAR | From “actual or implied discovery” — §33-11-4a(b) |
| Commissioner contacts a deficient complainant | 15 DAYS | §33-11-4a(b)(2) |
| ⚠ CURE SAFE HARBOR — complaint closed, no further remedy | 60 DAYS | §33-11-4a(b)(4) |
| Notice of hearing | 10 DAYS | §33-11-4a(d) |
| Hearing held — in the complainant’s geographic region | 90 DAYS | §33-11-4a(d) · C.S.R. 114-76 |
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Read (e), (f) and (g) as ONE test — quoting any of them alone misstates it
(f) raises the bar. A finding “may only be based on the existence of substantially similar violations in a number of separate claims or causes of action.”
(g) removes a whole category. “A good faith disagreement over the value of an action or claim or the liability of any party … is not an unfair claims settlement practice.” Not a defense to be weighed — a statement that the conduct is outside the definition.
(e) puts a single-violation route back. Exposure survives for an “intentional violation” of §33-11-4(9), “even though it has not been established that the person engaged in a general business practice.”
(g) removes a whole category. “A good faith disagreement over the value of an action or claim or the liability of any party … is not an unfair claims settlement practice.” Not a defense to be weighed — a statement that the conduct is outside the definition.
(e) puts a single-violation route back. Exposure survives for an “intentional violation” of §33-11-4(9), “even though it has not been established that the person engaged in a general business practice.”
HAYSEEDS — NO. 16782, 12 DECEMBER 1986 — AND THE WORD THAT IS NOT IN ITThe opinion carries no numbered syllabus points, which is why the canonical formulation is the one restated 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; (2) the insured’s damages for net economic loss caused by the delay in settlement, and damages for aggravation and inconvenience.” ⚠ NOT bad faith. NOT unreasonableness. NOT a general business practice. An insurer that took a coverage position in complete good faith and lost is exposed to all three heads. And the aggravation head reaches “the entire claims collection process.”
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YOU can be sued personally — and it is a syllabus point
Taylor v. Nationwide Mutual Insurance Company and Scarlett Tarley, No. 31154, Supreme Court of Appeals of West Virginia, 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 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 rule goes further, naming adjusters expressly.
Taylor was a first-party insured’s case, which is why it survives the 2005 abolition. Do not carry another state’s answer across the border on this one.
“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 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 rule goes further, naming adjusters expressly.
Taylor was a first-party insured’s case, which is why it survives the 2005 abolition. Do not carry another state’s answer across the border on this one.
PUNITIVE DAMAGES ARE A DIFFERENT AND MUCH HIGHER BARMcCormick, No. 23261: “Punitive damages for failure to settle a property dispute shall not be awarded against an insurance company unless the policyholder can establish a high threshold of actual malice in the settlement process.” Plus §55-7-29’s statutory cap and clear and convincing standard, enacted 2015. ⚠ Substantially prevailing gets fees and aggravation damages. It does not get punitives.
| Limitation period | Length | The catch |
|---|---|---|
| Breach of an insurance contract | 10 YEARS | §55-2-6 — written contract signed by the party charged. A Hayseeds claim rides this. |
| Statutory UTPA claim | 1 YEAR | §55-2-12(c), per Klettner, No. 25436, 8 July 1999. ⚠ And it does not start until the appeal period expires on the underlying action. |
| Shortened suit clauses | FLOOR: 2 YRS | §33-6-14 voids anything shorter (1 year for marine), and voids clauses “preventing” suit for more than 6 months. |
| ⚠ The standard fire policy | 12 MONTHS | §33-6-14’s final sentence: “This section shall not apply to the standard fire insurance policy.” The NY 1943 form’s own clause governs. |
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The fire clock starts on WRITTEN DENIAL — and in the leading case that defeated the insureds
Sizemore v. State Farm General Insurance Company, No. 24436, decided 23 June 1998, applying Meadows v. Employers’ Fire Insurance Company (1982):
“the twelve-month time period for bringing suit commences to run when the insurance company notifies the insured in writing that it declines to pay the loss.”
⚠ Teach the OUTCOME alongside the rule. In Sizemore denial came 24 August 1993 and suit was filed 24 April 1995 — and the rule barred the claim.
A written denial starts the clock, and it starts it against the insured. A file that simply goes quiet never starts it at all.
“the twelve-month time period for bringing suit commences to run when the insurance company notifies the insured in writing that it declines to pay the loss.”
⚠ Teach the OUTCOME alongside the rule. In Sizemore denial came 24 August 1993 and suit was filed 24 April 1995 — and the rule barred the claim.
A written denial starts the clock, and it starts it against the insured. A file that simply goes quiet never starts it at all.
A fault state with no first-party benefits, a valued policy law nobody expects, and a comp minimum frozen since 2009.
Plus the two numbers most likely to be quoted wrong in the whole state: the total-loss sales tax, where a live rule and a live statute disagree — and the workers’ compensation minimum, where the statutory percentage overstates the published figure by about 98%.
Plus the two numbers most likely to be quoted wrong in the whole state: the total-loss sales tax, where a live rule and a live statute disagree — and the workers’ compensation minimum, where the statutory percentage overstates the published figure by about 98%.
FAULT STATE — AND THE NEGATIVES ARE PROVED BY ENUMERATIONNo no-fault. No PIP. No medical payments mandate. No mini-tort. No statutory first-party automobile benefits of any kind — established by walking Chapter 33’s 104 articles and Chapter 17D’s 7. What West Virginia has instead is compulsory third-party liability, compulsory UM, and a mandatory UIM offer.
| Automobile | Figure | The catch |
|---|---|---|
| Minimum liability limits | $25k / $50k / $25k | §17D-4-2(b), effective 1 January 2016. Unmoved since. |
| ⚠ Superseded limits, still printed | $20k / $40k / $10k | §17D-4-2(a) is still on the same page. Read the SUBSECTION, not the section. |
| Uninsured motorist | MANDATORY | Cannot be waived to zero. Limits “no less than” the §17D-4-2 figures. |
| Underinsured motorist | MANDATORY OFFER | “shall provide an option to the insured.” The insurer must offer; the insured may decline. |
| UM/UIM on umbrella and excess | OPTIONAL | §33-6-31f |
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Stacking SPLITS — and a premium discount is what decides it
INTER-POLICY: ANTI-STACKING LANGUAGE IS VOID.
State Automobile Mutual Insurance Company v. Youler, No. 19373, decided 20 July 1990: “so-called ‘antistacking’ language in automobile insurance policies is void under W.Va. Code, 33-6-31(b).”
INTRA-POLICY: ANTI-STACKING IS VALID — WITH A MULTI-CAR DISCOUNT.
Arbogast, No. 21022, decided 11 February 1993, quoting syllabus point 5 of Russell (1992); reaffirmed in GEICO v. Sayre, No. 16-0750, decided 31 May 2017, whose syllabus point 2 is the one you will actually use: not entitled to stack “where the insured received a multi-car premium discount.”
⚠ There is NO anti-stacking statute. The whole rule is judicial — and it turns on whether the insured paid separately for each car.
State Automobile Mutual Insurance Company v. Youler, No. 19373, decided 20 July 1990: “so-called ‘antistacking’ language in automobile insurance policies is void under W.Va. Code, 33-6-31(b).”
INTRA-POLICY: ANTI-STACKING IS VALID — WITH A MULTI-CAR DISCOUNT.
Arbogast, No. 21022, decided 11 February 1993, quoting syllabus point 5 of Russell (1992); reaffirmed in GEICO v. Sayre, No. 16-0750, decided 31 May 2017, whose syllabus point 2 is the one you will actually use: not entitled to stack “where the insured received a multi-car premium discount.”
⚠ There is NO anti-stacking statute. The whole rule is judicial — and it turns on whether the insured paid separately for each car.
⚠ SEVENTY-FIVE PERCENT IS REAL HERE — BUT IT DEFINES THE TERM, IT DOES NOT PULL THE TRIGGER§17A-4-10: “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 has two transactional limbs — the vehicle must be “determined to be a total loss or otherwise designated as totaled by an insurance company” AND there must be “payment of a total loss claim.” ⚠ Your own settlement decision plus your payment is what brands the vehicle — and the title must be surrendered to the DMV within 10 DAYS of payment.
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A LIVE CONFLICT on the total-loss sales tax — and the rule is the fossil
§114-14-7.4, adopted 2006: add FIVE percent for sales tax on a total loss.
§33-6-33, amended 2019: add the tax “set forth in §11-15-3c(b)” — which rose to SIX percent on 1 July 2017.
⚠ PAY SIX. The statute is later, more specific, and points at a live cross-reference; the rule’s figure was correct when written and was never updated.
This is the clearest instrument-conflict in West Virginia adjusting — and it sits on a number you touch on every total loss.
§33-6-33, amended 2019: add the tax “set forth in §11-15-3c(b)” — which rose to SIX percent on 1 July 2017.
⚠ PAY SIX. The statute is later, more specific, and points at a live cross-reference; the rule’s figure was correct when written and was never updated.
This is the clearest instrument-conflict in West Virginia adjusting — and it sits on a number you touch on every total loss.
VALUATION RUNS ON AN APPROVED GUIDE, AT BOTH LEVELS§33-6-33 and §114-14-7.4 both require the “most recent version of an ‘official used car guide’ approved by the Insurance Commissioner” — with downward deviations documented and itemized, dealer quotations where the vehicle is not in the guide, a special two-option rule for current-model-year total losses, and a duty, if you deduct salvage value, to name a dealer who will buy the salvage for that amount.
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The NY 1943 form by reference — PLUS a valued policy law that reaches PARTIAL losses
§33-17-2 adopts the New York standard fire policy, edition of 1943, by reference and re-designates it West Virginia’s. There is no state-drafted policy text in the code to read. Unamended since 1957.
§33-17-9, captioned “Total or partial fire loss”: “All insurers providing fire insurance on real property … shall be liable, in case of total loss … for the whole amount of insurance stated in the policy … and in case of partial loss … for the total amount of the partial loss.”
⚠ Real property only. Single insurer only — “does not apply where such insurance has been procured from two or more insurers.” But NOT total-loss only.
Screen for the FORMULA, not the vocabulary. §33-17-9 uses neither “conclusive” nor “prima facie” — the two phrases most valued policy statutes use — so a keyword search misses it entirely.
§33-17-9, captioned “Total or partial fire loss”: “All insurers providing fire insurance on real property … shall be liable, in case of total loss … for the whole amount of insurance stated in the policy … and in case of partial loss … for the total amount of the partial loss.”
⚠ Real property only. Single insurer only — “does not apply where such insurance has been procured from two or more insurers.” But NOT total-loss only.
Screen for the FORMULA, not the vocabulary. §33-17-9 uses neither “conclusive” nor “prima facie” — the two phrases most valued policy statutes use — so a keyword search misses it entirely.
GUARANTY — WORKERS’ COMPENSATION IS PAID IN FULL, WITH ONE PROVISO§33-26-8 pays “the full amount of a covered claim for benefits under a workers’ compensation insurance policy” — then adds: “any covered claim for deliberate intention … may not exceed $300,000 per claim.” Filing deadline is the EARLIER of 25 months after the final liquidation order or the court’s bar date; net worth bar $25,000,000; no claimant deductible; coverage continues 30 days after the FINAL ORDER OF LIQUIDATION — not from the receiver’s appointment. ⚠ And the ten exclusions live inside the §33-26-5 DEFINITION of “covered claim,” not in the limits section — so a claim fails because it was never covered, not because a cap cut it down.
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FRAUD: mandatory duty, FOURTEEN days — and the deadline is in a rule nothing points you to
§33-41-5(a) splits the verbs: “shall” for persons in the business of insurance, “may” for everyone else. Adjusters are in the mandatory group.
But the statute states no deadline. Enumerate all sixteen sections of Article 41 — nothing. Read the Commissioner’s own Informational Letter 206, which prescribes who reports and what the report contains — genuinely silent on timing.
⚠ §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.”
The clock starts on YOUR determination — not the loss, not the referral. And immunity is two-tier and INVERTED: the mandated reporter forfeits it only for malice or fraud; the volunteer forfeits it for reckless disregard. A fraud warning on claim forms is permissive.
But the statute states no deadline. Enumerate all sixteen sections of Article 41 — nothing. Read the Commissioner’s own Informational Letter 206, which prescribes who reports and what the report contains — genuinely silent on timing.
⚠ §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.”
The clock starts on YOUR determination — not the loss, not the referral. And immunity is two-tier and INVERTED: the mandated reporter forfeits it only for malice or fraud; the volunteer forfeits it for reckless disregard. A fraud warning on claim forms is permissive.
WORKERS’ COMPENSATION — A PRIVATIZED SYSTEM, WHICH IS WHY THERE IS A WC LINE AND A WC EXAM§23-4-6: TTD is “66 and two-thirds percent of the average weekly wage earnings … of the injured employee”; maximum “not to exceed 100 percent of the average weekly wage in West Virginia”; PPD “not to exceed 70 percent”; minimum “not be less than 33 and one-third percent.” ⚠ A 100%-of-wage maximum is unusually low as a multiple — most states use 105–133%. Application deadline 6 MONTHS (§23-4-15); late payment carries 6% simple interest (§23-4-16a) — no per-day penalty at all.
| FY2027 — effective 1 July 2026 | Weekly | Daily |
|---|---|---|
| State average weekly wage | $1,150.91 | — |
| Maximum — temporary total, permanent total, fatal | $1,150.91 | $164.42 |
| Maximum — permanent partial | $805.64 | $115.09 |
| ⚠ MINIMUM | $193.33 | $27.62 |
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The minimum is NOT 33⅓% of the state average weekly wage — and has not been for seventeen years
33⅓% of $1,150.91 = $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% of $290.00 is $193.33.
⚠ And 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.
NEVER derive a West Virginia minimum benefit from the statutory percentage. Read it off the table.
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% of $290.00 is $193.33.
⚠ And 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.
NEVER derive a West Virginia minimum benefit from the statutory percentage. Read it off the table.
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Top Exam Tips — West Virginia Adjuster Regulations
1. THREE CREDENTIALS — and West Virginia licenses company staff adjusters.
2. THREE EXAMINATIONS — Adj14 80/90, PubAdj17 45/45, WCAdj21 45/60. All $84, eight attempts per line.
3. THE 70 IS SCALED, and the handbook’s own table prints “70%” anyway. No crop exam — USDA RMA certification in lieu.
4. STATUTE: 1 YEAR ENDING 31 MAY. PRACTICE: 2 YEARS, BIRTH MONTH. Both true — §33-12B-10(a) contains the displacement power.
5. CE 24/3 BIENNIAL, carryover 6, membership 2 — and automatic suspension then automatic termination.
6. REPORTING: 30 DAYS FROM FINAL DISPOSITION (administrative) vs 30 DAYS FROM THE INITIAL PRETRIAL HEARING (criminal).
7. THE RULE HAS NO FREQUENCY ELEMENT; THE STATUTE DOES. A single missed clock violates the rule.
8. MIXED DAY CONVENTION — 15 working to acknowledge, 30 calendar to investigate, 10 working to affirm or deny AFTER completing it, 45 calendar between status letters.
9. NO RECORD RETENTION NUMBER in the claims rule; 5 years in the licensing rule, public adjusters only.
10. THIRD-PARTY ACTION ABOLISHED 2005 — Jenkins is real and its third-party half is gone. 60-day cure closes the complaint.
11. HAYSEEDS: SUBSTANTIALLY PREVAILS — fees + net economic loss + aggravation, no bad faith required.
12. THE ADJUSTER CAN BE SUED PERSONALLY — Taylor, No. 31154, syllabus point 1.
13. 10 YEARS on the contract, 1 YEAR on the statute; fire runs 12 months from WRITTEN DENIAL.
14. FRAUD: 14 DAYS, in §114-71-3.2 — not in the statute, not in the bulletin.
15. TOTAL LOSS SALES TAX IS 6%, not the rule’s 5%. WC MINIMUM IS $193.33, not $383.64.
2. THREE EXAMINATIONS — Adj14 80/90, PubAdj17 45/45, WCAdj21 45/60. All $84, eight attempts per line.
3. THE 70 IS SCALED, and the handbook’s own table prints “70%” anyway. No crop exam — USDA RMA certification in lieu.
4. STATUTE: 1 YEAR ENDING 31 MAY. PRACTICE: 2 YEARS, BIRTH MONTH. Both true — §33-12B-10(a) contains the displacement power.
5. CE 24/3 BIENNIAL, carryover 6, membership 2 — and automatic suspension then automatic termination.
6. REPORTING: 30 DAYS FROM FINAL DISPOSITION (administrative) vs 30 DAYS FROM THE INITIAL PRETRIAL HEARING (criminal).
7. THE RULE HAS NO FREQUENCY ELEMENT; THE STATUTE DOES. A single missed clock violates the rule.
8. MIXED DAY CONVENTION — 15 working to acknowledge, 30 calendar to investigate, 10 working to affirm or deny AFTER completing it, 45 calendar between status letters.
9. NO RECORD RETENTION NUMBER in the claims rule; 5 years in the licensing rule, public adjusters only.
10. THIRD-PARTY ACTION ABOLISHED 2005 — Jenkins is real and its third-party half is gone. 60-day cure closes the complaint.
11. HAYSEEDS: SUBSTANTIALLY PREVAILS — fees + net economic loss + aggravation, no bad faith required.
12. THE ADJUSTER CAN BE SUED PERSONALLY — Taylor, No. 31154, syllabus point 1.
13. 10 YEARS on the contract, 1 YEAR on the statute; fire runs 12 months from WRITTEN DENIAL.
14. FRAUD: 14 DAYS, in §114-71-3.2 — not in the statute, not in the bulletin.
15. TOTAL LOSS SALES TAX IS 6%, not the rule’s 5%. WC MINIMUM IS $193.33, not $383.64.
Ten West Virginia fact patterns — the traps, not the definitions.
Each turns on a place where West Virginia answers a national assumption backwards, or where the instrument that holds the answer is not the one the question names. Read the feedback even when you are right.
Each turns on a place where West Virginia answers a national assumption backwards, or where the instrument that holds the answer is not the one the question names. Read the feedback even when you are right.
Like learning this way? There's a whole library of them.
If the old manual you inherited from the office breakroom isn't cutting it and this format fits how your brain actually works, you'll want the rest. There are 56 Interactive Mind Maps like this one in the TESTivity Platinum Insurance Adjuster package — covering the full curriculum, right alongside the practice questions, exam simulators, and study guides.
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