90 MacCorkle Avenue S.W.
Suite 203
South Charleston, WV 25303
Toll Free WV:  1-800-345-4669
Phone: (304) 766-2646
Fax: (304) 744-7120


Underwriting Department

Underwriting Manager
Underwriter Jeffrey Lawrentz ext 57610 jeff.p.lawrentz@wv.gov
Insurance Program Specialist Tonya Pugh ext. 57619 Tonya.J.Pugh@wv.gov
Insurance  Assistant Deanne Stevens ext. 57621 Deanne.R.Stevens@wv.gov
Office Assistant I Lori Bailey ext. 57601 Lori.D.Bailey@wv.gov

State of West Virginia Auto Insurance


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2014 Policies

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Underwriting Information

Renewal Questionnaire
(Authorized Agents Only)


Certificate Request Form       word.gif (167 bytes)

Certificates of Insurance

(Authorized Agents Only)


Supplemental Forms


Physician/Hospital Professional Liability Supplemental Questionnaire           word.gif (167 bytes)

Workbased Learning Program
(Work-Based Coordinators Only)



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