Offices of the Insurance Commissioner

State of West Virginia

Official Website: https://www.wvinsurance.gov/

Forms & Documents

Browse all Offices of the Insurance Commissioner government forms

1 - 20 of 96 forms

Form Title Topics
Accredited/Trusteed Reinsurer Renewal Instructions
Affidavit of Filing and Annual Statement Attestation
Agent Request Form
Application for 104 Weeks Dependents' Benefits [OIC-WC-202]
Application for Fatal Dependents' Benefits [OIC-WC-201]
Application for PTD Benefits
Application to Reopen Partial Disability Claim
Appointment/Termination Form
Attending Physician Benefits Form
Captive Insurance Company - Application for License (Form A-10)
Carrier Request For Occupational Lung Center Examination
Carrier/Self-Insured/TPA Request for Permanent Total Disability Review
C.E. Reinstatement Form
Certificate of Assuming Insurer (Form AR-1)
CGA Notification Gift Instructions
Company App for CPA (CAP-4)
Company Application Guidelines
Company App to Certify Loss Reserves (CAP-5)
Company Biographical Affidavit
Company Compliance Statement (CAP-2)

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