Underwriting

Department Personnel

Underwriting Manager
Melody Duke
 
Underwriter
Jeffrey Lawrentz    
ext 57610    
 
Underwriter    
Tonya Pugh    
ext. 57619    
 
Insurance  Assistant, Lead    
Deanne Stevens    
ext. 57621    
 
Office Assistant II    
Lori Bailey    
ext. 57601    
Lori.D.Bailey@wv.gov

Online Forms

Renewal Questionnaire
(Authorized Agents Only)
Instructions

State of West Virginia Auto Insurance

Certificate Request Form (PDF)

(Please allow 48 hours)

 


Please print a duplicate copy of the certificate and submit to BRIM.

Workbased Learning Program
(Work-Based Coordinators Only)

 

Supplemental Forms

Click HERE to access supplemental forms.