Title 18, Insurance Code

§ 6412. Confidentiality of health information. Any data or information pertaining to the diagnosis, treatment or health of any enrollee or applicant obtained from such person or from any health-care provider by any managed care organization shall be held in confidence and shall n…

§ 6413. Freedom of choice. In order to promote freedom of choice by employers and others in Delaware who purchase group health-care coverage, it shall be unlawful for any insurer, health service corporation or other person in the business of providing or insuring health-care serv…

§ 6414. Nondisclosure clause. A managed care organization contract shall contain no provision or nondisclosure clause prohibiting physicians or other health-care providers from giving patients information regarding diagnoses, prognoses and treatment options.63 Del. Laws, c. 382, …

§ 6415. Refusal to contract. A managed care organization shall not refuse to contract with or compensate for covered services an otherwise eligible health-care provider solely because that provider has in good faith communicated with 1 or more of the provider’s current, former or…

§ 6416. Independent health care appeals program. (a) There is established the Independent Health Care Appeals Program in the Department of Insurance. The program will include, at a minimum, a final step in the grievance process which provides for a review by an Independent Utiliz…

§ 6417. Appeal reviews; independent utilization review organizations. (a) The Insurance Commissioner or designee shall certify such organizations that meet the requirements of this section or regulations to be promulgated pursuant to it or shall deem certified any independent rev…

§ 6418. Indemnification and immunity of employees. (a) An employee of the Department who participates in the program shall not be liable in any action for damages to any person for any action taken within the scope of that employee’s function in the program. The Attorney General …

§ 6419. Violations; penalties. (a) A carrier that violates any provision of this chapter shall be liable to a civil penalty of not less than $250 and not greater than $10,000 for each day that the carrier is in violation of the chapter if 10-days notice in writing is given of the…

§ 6420. Enforcement; adoption of rules and regulations. The Insurance Commissioner shall enforce the provisions of this chapter. The Insurance Commissioner shall adopt rules and regulations, pursuant to the Administrative Procedure Act (Chapter 101 of Title 29), necessary to carr…

§ 6501. Definitions. As used in this chapter: (1) “Administrator” means the Insurance Coverage Administrator, hereinafter established by § 6505 of this title. (2) “The Committee” means the Insurance Coverage Determination Committee, hereinafter established by § 6502 of this title…

§ 6502. Insurance for the protection of the State and the public; determination of coverage. There is hereby established the Insurance Coverage Determination Committee, which shall be composed of the Secretary of the Department of Human Resources, the State Auditor and the Insura…

§ 6503. Forms of coverage. The Committee shall: (1) Protect this State from loss to state-owned property; (2) Protect the public from wrongful actions of state officials and employees and failure or malfunction of state-owned property; (3) Secure for this State the maximum econom…

§ 6504. Rules and regulations. The Insurance Coverage Administrator, with the approval of the Committee, shall promulgate such rules and regulations as shall be necessary to carry out the policy determinations of the Committee in administering the state insurance coverage program…

§ 6505. Establishment of Insurance Coverage Office. There is hereby established under the direction and supervision of the Secretary of the Department of Human Resources the Insurance Coverage Office, the executive head of which shall be the Insurance Coverage Administrator, who …

§ 6506. Qualifications of the Insurance Coverage Administrator. The Administrator shall be qualified for the office by virtue of the Administrator’s education and experience. The Administrator shall not be associated directly or indirectly with any insurance agency, firm or corpo…

§ 6507. Salary of the Director of Insurance Coverage [Repealed].18 Del. C. 1953, § 6505; 57 Del. Laws, c. 187, § 2; repealed by 79 Del. Laws, c. 286, § 6, eff. July 1, 2014.;

§ 6508. Duties of the Insurance Coverage Office. The Insurance Coverage Office shall provide: (1) The placement of all insurance with commercial insurers as directed by the Committee; (2) The operation of the Self-Insurance Fund, as established in subchapter III of this chapter; …

§ 6509. Insurance by other agencies of the State. No other agency of this State, for which coverage is herein provided, shall be authorized to place any insurance, any law to the contrary notwithstanding, and all insurance for such agencies shall be placed by and through the Insu…

§ 6510. Existing insurance contracts. Existing insurance contracts and any renewals thereof may continue in full force and effect unless and until otherwise provided by the Administrator.18 Del. C. 1953, § 6508; 57 Del. Laws, c. 187, § 2; 79 Del. Laws, c. 286, § 9;

§ 6511. Defense of sovereignty prohibited. The defense of sovereignty is waived and cannot and will not be asserted as to any risk or loss covered by the state insurance coverage program, whether same be covered by commercially procured insurance or by self-insurance, and every c…

§ 6520. Placement of commercial insurance. When the Administrator shall determine and declare it to be advisable to insure against a certain risk or risks with commercially procured insurance, with the approval of the Committee, then, as to such risk or risks, the Insurance Cover…

§ 6521. Payment of premiums on commercial insurance. The estimated appropriation necessary for commercially procured insurance as authorized by § 6520 of this title for each fiscal year shall be determined by the Insurance Coverage Office and submitted to the Secretary of the Dep…

§ 6522. Administration and records. The administration of the commercially insured part of the state insurance coverage program shall be the responsibility of the Insurance Coverage Office which shall keep in some safe and secure place all policies of insurance and all records pe…

§ 6530. Placement of self-insurance. (a) When the Administrator shall determine and declare it to be advisable to insure against a certain risk or risks through a self-insurance program, then a request shall be made of the General Assembly in an amount equal to anticipated claims…

§ 6531. Capitalization of the State Self-Insurance Fund.18 Del. C. 1953, § 6531; 57 Del. Laws, c. 187, § 2; 59 Del. Laws, c. 279, § 1; repealed by 79 Del. Laws, c. 286, § 13, eff. July 1, 2014.;

§ 6532. Payment of premium allocations. The estimated appropriation necessary for each fiscal year shall be determined by the Insurance Coverage Office and submitted to the Secretary of the Department of Human Resources for review and consideration as part of the annual budget re…

§§ 6533, 6534. Maximum level of effective capitalization and termination of premium payments; Emergency Back-Up Fund. Repealed by 59 Del. Laws, c. 279, § 3, effective Mar. 27, 1974.

§ 6535. Administration and custody of the State Self-Insurance Fund.18 Del. C. 1953, § 6532; 57 Del. Laws, c. 187, § 2; 63 Del. Laws, c. 142, § 38; repealed by 79 Del. Laws, c. 286, § 15, eff. July 1, 2014.;

§ 6536. Investment of moneys in the Fund.18 Del. C. 1953, § 6533; 57 Del. Laws, c. 187, § 2; 63 Del. Laws, c. 142, § 39; repealed by 79 Del. Laws, c. 286, § 16, eff. July 1, 2014.;

§ 6537. Provisions for deductible limits. The Committee, from time to time, may declare and enforce such deductible limits on any insured risk covering loss to state-owned property, both real, personal and mixed, as it shall deem appropriate.18 Del. C. 1953, § 6534; 57 Del. Laws,…

§ 6538. Provisions for reinsurance. The Committee, from to time, may determine the advisability of purchasing commercial reinsurance contracts as to any risk or risks covered by the Fund and direct the Insurance Coverage Office to place such insurance, in such amount as the Commi…

§ 6539. Adjusting claims and paying losses. The Insurance Coverage Office shall have the responsibility of adjusting all claims and paying all losses in risks covered by the Fund, and shall carry out its duties in conformity with appropriate regulations promulgated for that purpo…

§ 6540. Arbitration of disputes and litigation of claims. (a) Any dispute between the Insurance Coverage Office and a state agency claimant, which cannot be amicably resolved, shall be referred to arbitration before an arbitrator selected by the Secretary of State. The expense of…

§ 6541. Inspections of insured property. The Insurance Coverage Office shall have available to it the services of the State Fire Marshal and the State Fire Marshal’s deputies for the purpose of inspecting self-insured real and personal property of the State, and may call upon the…

§ 6542. Independent contractors. The Administrator shall first employ all resources available in the Insurance Coverage Office, the Insurance Department, the office of the State Fire Marshal, the Justice Department, and the Auditor’s Office before retaining independent contractor…

§ 6543. Fidelity bonds. In the event that the Committee determines and declares it advisable to self-insure the statutory required fidelity bonds of the officials and/or employees of the State or its herein covered subdivisions, and establishes a self-insurance program in that re…

§ 6601. Definitions [For application of this section, see 79 Del. Laws, c. 434, § 3]. As used in this chapter: (1) “College or university” shall mean any nonprofit college in the State which is accredited by the appropriate regional accrediting agency. (2) “Covered person” is def…

§ 6602. Payment for beneficiaries; tuition payments; burial expenses. (a) Upon certification by the Insurance Commissioner that a claim under this chapter has been approved, the State Treasurer shall: (1) For claims submitted prior to July 1, 1997, pay to the beneficiary or benef…

§ 6603. Designation or determination of beneficiary [For application of this section, see 79 Del. Laws, c. 434, § 3]. (a) Each covered person under this chapter shall submit to the person’s employing state, county or municipal agency, volunteer fire department or ambulance operat…

§ 6604. Records of agencies. Every county and local police agency, volunteer and municipal fire department, the Department of Health and Social Services, the National Guard, the Department of Safety and Homeland Security and every organization providing voluntary ambulance servic…

§ 6605. Administration of Fund; adjudication of claims. (a) The Insurance Commissioner must receive claims against the Fund under this chapter. The Commissioner must determine the validity of all such claims and determine whether a death resulting in any such claim was in the lin…

§ 6606. Appeals. Any aggrieved claimant may appeal a decision of the Insurance Commissioner to Superior Court, which shall have final appellate jurisdiction under this chapter. Such appeal shall be an appeal on the record. Superior Court may, by rule, set forth the procedure for …

§ 6607. Payments to be diminished by amounts of other benefits. Repealed by 65 Del. Laws, c. 273, § 1, effective May 28, 1986.

§ 6608. Source of payments under this chapter. Payments made pursuant to this chapter shall be made from the State Self-Insurance Fund, as provided in Chapter 65 of this title. The General Assembly shall, when necessary, from time to time, provide for the adequate funding to the …

§ 6609. Tax exemption for payments. Payments made under this chapter to a beneficiary shall not be subject to Delaware income taxes or Delaware estate taxes.18 Del. C. 1953, § 6609; 58 Del. Laws, c. 504, § 1;

§ 6701. Definitions. As used in this chapter, the following words and terms have the following meanings: (1) “Covered firefighters” shall mean enrolled firefighters, ladies auxiliary members, and volunteer ambulance and rescue company members in good standing either according to …