Title 18, Insurance Code

§ 3305. Entire contract; changes. There shall be a provision as follows: “Entire Contract; Changes: This policy, including the endorsements and the attached papers, if any, constitutes the entire contract of insurance. No change in this policy shall be valid until approved by an …

§ 3306. Time limit on certain defenses. (a) There shall be a provision as follows: “Time Limit on Certain Defenses: (1) After 2 years from the date of issue of this policy, no misstatements, except fraudulent misstatements, made by the applicant in the application for such policy…

§ 3307. Grace period. There shall be a provision as follows: “A grace period of . . . (insert a number not less than “7” for weekly premium policies, “10” for monthly premium policies and “31” for all other policies) days will be granted for the payment of each premium falling du…

§ 3308. Reinstatement. (a) There shall be a provision as follows: “Reinstatement: If any renewal premium be not paid within the time granted the insured for payment, a subsequent acceptance of premium by the insurer or by any agent duly authorized by the company to accept such pr…

§ 3309. Notice of claim. (a) There shall be a provision as follows: “Notice of Claim: Written notice of claim must be given to the company within twenty days after the occurrence or commencement of any loss covered by the policy, or as soon thereafter as is reasonably possible. N…

§ 3310. Claim. There shall be a provision as follows: “Claim Forms: The company, upon receipt of a notice of claim, will furnish to the claimant such forms as are usually furnished by it for filing proofs of loss. If such forms are not furnished within fifteen days after the givi…

§ 3311. Proofs of loss. There shall be a provision as follows: “Proofs of Loss: Written proof of loss must be furnished to the company at its said office in case of claim for loss for which this policy provides any periodic payment contingent upon continuing loss within ninety da…

§ 3312. Time of payment of claims. There shall be a provision as follows: “Time of Payment of Claims: Indemnities payable under this policy for any loss other than loss for which this policy provides any periodic payment will be paid immediately upon receipt of due written proof …

§ 3313. Payment of claims. (a) There shall be a provision as follows: “Payment of Claims: Indemnity for loss of life will be payable in accordance with the beneficiary designation and the provisions respecting such payment which may be prescribed herein and effective at the time …

§ 3314. Physical examination; autopsy. There shall be a provision as follows: “Physical Examinations and Autopsy: The company at its own expense shall have the right and opportunity to examine the person of the insured when and as often as it may reasonably require during the pen…

§ 3315. Legal actions. There shall be a provision as follows: “Legal Actions: No action at law or in equity shall be brought to recover on this policy prior to the expiration of sixty days after written proof of loss has been furnished in accordance with the requirements of this …

§ 3316. Change of beneficiary. (a) There shall be a provision as follows: “Change of Beneficiary: Unless the insured make an irrevocable designation of beneficiary, the right to change the beneficiary is reserved to the insured and the consent of the beneficiary or beneficiaries …

§ 3317. Optional policy provisions. Except as provided in § 3304 of this title, no such policy delivered or issued for delivery to any person in this State shall contain provisions respecting the matters set forth in §§ 3318-3325, inclusive, of this title unless such provisions a…

§ 3318. Change of occupation. There may be a provision as follows: “Change of Occupation: If the insured be injured or contract sickness after having changed his/her occupation to one classified by the company as more hazardous than that stated in this policy or while doing for c…

§ 3319. Misstatement of age. There may be a provision as follows: “Misstatement of Age: If the age of the insured has been misstated, all amounts payable under this policy shall be such as the premium paid would have purchased at the correct age.”18 Del. C. 1953, § 3319; 56 Del. …

§ 3320. Overinsurance; all coverages. (a) There may be a provision as follows: “Overinsurance: If, with respect to a person covered under this policy, benefits for allowable expense incurred during a claim determination period under this policy together with benefits for allowabl…

§ 3321. Relation of earnings to insurance. (a) There may be a provision as follows: “After the loss-of-time benefit of this policy has been payable for 90 days, such benefit will be adjusted, as provided below, if the total amount of unadjusted loss-of-time benefits provided in a…

§ 3322. Unpaid premiums. There may be a provision as follows: “Unpaid Premium: Upon the payment of a claim under this policy, any premium then due and unpaid or covered by any note or written order may be deducted therefrom.”18 Del. C. 1953, § 3323; 56 Del. Laws, c. 380, § 1; 80 …

§ 3323. Conformity with state statutes. There may be a provision as follows: “Conformity with State Statutes: Any provision of this policy which, on its effective date is in conflict with the statutes of the state in which the insured resides on such date is hereby amended to con…

§ 3324. Illegal occupation. There may be a provision as follows: “Illegal Occupation: The company shall not be liable for any loss to which a contributing cause was the insured’s commission of or attempt to commit a felony or to which a contributing cause was the insured’s being …

§ 3325. Intoxicants and narcotics. There may be a provision as follows: “Intoxicants and Narcotics: The company shall not be liable for any loss sustained or contracted in consequence of the insured’s being intoxicated or under the influence of any narcotic unless administered on…

§ 3326. Renewability. Health insurance policies, other than accident insurance only policies, in which the insurer reserves the right to refuse renewal on an individual basis, shall provide in substance in a provision thereof or in an endorsement thereon or rider attached thereto…

§ 3327. Order of certain provisions. The provisions which are the subject of §§ 3305-3326, inclusive, of this title, or any corresponding provisions which are used in lieu thereof in accordance with such sections shall be printed in the consecutive order of the provisions in such…

§ 3328. Third-party ownership. The word “insured,” as used in this subchapter, shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under s…

§ 3329. Requirements of other jurisdictions. (a) Any policy of a foreign or alien insurer, when delivered or issued for delivery to any person in this State, may contain any provision which is not less favorable to the insured or the beneficiary than the provisions of this chapte…

§ 3330. Policies issued for delivery in another state. If any policy is issued by a domestic insurer for delivery to a person residing in another state, and if the insurance commissioner or corresponding public official of such other state has informed the Commissioner that any s…

§ 3331. Conforming to statute. (a) No policy provision which is not subject to this chapter shall make a policy, or any portion thereof, less favorable in any respect to the insured or the beneficiary than the provisions thereof which are subject to this chapter. (b) A policy del…

§ 3332. Age limit. If any such policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if such date falls within a period for which premium is accepted by the insurer or if the insur…

§ 3333. Filing of rates. Each insurer issuing health insurance policies for delivery in this State shall, before use thereof, file with the Commissioner its premium rates and classification of risks pertaining to such policies. The insurer shall adhere to its rates and classifica…

§ 3334. Franchise health insurance law. Health insurance on a franchise plan is hereby declared to be that form of health insurance issued to: (1) Three or more employees of any corporation, copartnership, or individual employer or any governmental corporation, agency or departme…

§ 3335. Newborn children. (a) All individual and group health insurance policies providing coverage on an expense-incurred basis, and individual and group service or indemnity-type contracts issued by a nonprofit corporation, which provide coverage for a family member of the insu…

§ 3336. Midwife services reimbursement. (a) This section shall apply to every individual policy, contract or certificate issued thereunder, of health or sickness or accident insurance delivered or issued for delivery within the State which meets the requirements of subsection (d)…

§ 3337. Lead poisoning screening reimbursement [For application of this section, see 83 Del. Laws, c. 75, § 9]. (a) All individual health insurance policies which are delivered or issued for delivery in this State by any health insurer, health service corporation, health maintena…

§ 3338. Coverage of ovarian cancer monitoring and screening tests [For application of this section, see 84 Del. Laws, c. 254, § 4]. (a) Every individual health, sickness or accident insurance policy, contract or certificate, which is delivered or issued for delivery in this State…

§ 3338A. Equal reimbursement for oral and intravenous anticancer medication. (a) Every individual policy or contract of health insurance, or certificate issued thereunder, which is delivered, issued for delivery, renewed, modified, altered, or amended in this State on or after Ja…

§ 3338B. Coverage of drugs approved for treatment of certain cancers [For application of this section, see 81 Del. Laws, c. 180, §§ 3 and 4; 84 Del. Laws, c. 338, 3]. (a) No individual policy or contract of health insurance, or certificate issued thereunder, which is delivered, i…

§ 3339. Refusal to contract. (a) An insurer shall not refuse to contract with or compensate for covered services a participating or contracting healthcare provider solely because that provider has in good faith communicated with 1 or more of the provider’s current, former or pros…

§ 3340. Child abuse or neglect — Individual coverage. No individual policy or contract, or certificate issued thereunder, of health insurance which provides medical coverage for a child and which (1) covers a child who resides in this State, or (2) is delivered or issued for deli…

§ 3341. Newborns and mothers health protection. A carrier offering a health benefit plan shall comply with the provisions of 42 U.S.C. § 300gg-51 and any subsequent changes in federal law.71 Del. Laws, c. 143, § 16; 80 Del. Laws, c. 310, § 1;

§ 3342. Obstetrical and gynecological coverage. (a) This section applies to every individual policy or contract of health insurance, or certificate issued thereunder, which is delivered or issued for delivery in this State that requires an insured, participant, policyholder, subs…

§ 3342A. Contraceptive coverage. (a) For purposes of this section: (1) “Carrier” means any entity that provides health insurance in this State. “Carrier” includes an insurance company, health service corporation, health maintenance organization, and any other entity providing a p…

§ 3342B. Primary care coverage [For application of this section, see 81 Del. Laws, c. 392, § 12]. (a) For purposes of this section: (1) a. “Carrier” means any entity that provides health insurance in this State. “Carrier” includes an insurance company, health service corporation,…

§ 3343. Insurance coverage for serious mental illness [For application of this section, see 81 Del. Laws, c. 29, § 3; and 82 Del. Laws, c. 199, § 3] [Effective until Jan. 1, 2028]. (a) Definitions. — For purposes of this section: (1) “ASAM criteria” means the comprehensive set of…

§ 3344. Insurance coverage for diabetes. (a) Every individual or group hospital service corporation contract, individual or group medical service corporation contract, individual or group health service corporation contract, individual health insurance policy, group health insura…

§ 3344B. Cost sharing in prescription insulin drugs. (a) For purposes of this section, “prescription insulin drug” means a drug containing insulin that is dispensed under Chapter 47 of Title 16 for the treatment of diabetes. (b) An individual health insurance policy, contract, or…

§ 3344C. Coverage for insulin pumps. (a) For purposes of this section, “insulin pump” means a small, portable medical device that is approved by the U.S. Food and Drug Administration to provide continuous subcutaneous insulin infusion. (b) All individual health insurance policies…