Underwriting

Department Personnel

Underwriting Manager

Melody Duke

ext 57618
Melody.A.Duke@wv.gov

Underwriter

Jeffrey Lawrentz

ext 57610

Jeff.P.Lawrentz@wv.gov

Underwriter

Tonya Pugh

ext. 57619

Tonya.J.Pugh@wv.gov

Insurance Assistant, Lead

Deanne Stevens

ext. 57621

Deanne.R.Stevens@wv.gov

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.