Title 18 — Insurance Code

§ § 6702A. Source of payments under this chapter. Payments made under this chapter must be made from the fund established under subchapter III of Chapter 65 of this title. The General Assembly shall, when necessary, provide adequate funding to the fund to cover claims under this …

§ 6702B. Benefits. A policy shall be purchased by the Insurance Coverage Office on behalf of those who are eligible under § 6703B of this title for the following benefits. Lump sum cash benefit payable after diagnosis from a covered condition as follows: (1) Early-stage cancer be…

§ 6703. Physical examinations. No firefighter shall receive disability benefits under this chapter until he or she has been examined by a duly qualified physician or surgeon, selected by the firefighter or, if not selected by the firefighter, selected by the Commissioner for that…

§ 6703B. Eligibility. (a) A volunteer or paid firefighter, EMT, paramedic, fire instructor, fire marshal, and fire police will be eligible for coverage under this provision after 3 years of active service. (b) Any person who was simultaneously a member of more than 1 class at the…

§ 6704. Adjudication of claims. (a) The Commissioner shall receive claims for disability benefits under this chapter. The Commissioner shall determine the validity of all such claims and determine whether a disability resulting in any such claim was in the line of duty under the …

§ 6704B. Adjudication of claims. Claims shall be filed with the insurer by the eligible volunteer or paid firefighter, EMT, paramedic, fire instructor, fire marshal, or fire police covered individual, representative, or estate.83 Del. Laws, c. 123, § 1;

§ 6705. Appeals. Any aggrieved claimant may appeal a decision of the Commissioner to Superior Court, which shall have final jurisdiction under this chapter. Such appeal shall be an appeal on the record. The Superior Court may, by rule, set forth the procedure for processing appea…

§ 6705B. Appeals. Any aggrieved claimant may appeal a decision to the Department of Insurance. The Commissioner may hold a hearing on those claims at which time the Commissioner may receive evidence, make findings, and render a decision. If the claimant is not satisfied with the …

§ 6706. Payments to be diminished by amounts of other benefits. If any claimant under this chapter is entitled to receive, as a result of the same disability in the line of duty which gave rise to a claim under this chapter, any payment of state, federal, county or municipal fund…

§ 6706B. Payments to be diminished by amounts of other benefits. If any claimant under the policy is entitled to receive, as a result of a covered disability, any other income, the payment pursuant to the policy shall be reduced by the amount of such other payment or payments to …

§ 6707. 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 …

§ 6707B. Source of funding and administration of such policy. (a) Administration of this policy and funding will be through the State Insurance Coverage Office. A separate budget line will be established in which the funds will be transferred from the State Treasurer to the State…

§ 6708. Exemption from tax and execution. Payments made for permanent disability under this chapter are hereby exempted from any state, county or municipal tax and shall not be subject to execution or attachment or to any legal process whatsoever and shall be unassignable.59 Del.…

§ 6708B. Exemption from tax and execution. Benefits payable under the policy are hereby exempted from any state, county, or municipal tax and shall not be subject to execution or attachment or to any legal process whatsoever and shall be unassignable.83 Del. Laws, c. 123, § 1;

§ 6709B. Statute of limitation A claimant shall not bring forth a claim or action after 2 years following the time the claimant was diagnosed with a qualifying cancer as defined in § 6701B of this title. 83 Del. Laws, c. 123, § 1;

§ 6750. Funeral expenses for deceased volunteer firefighters [Transferred]. Transferred to § 6701A of this title by 85 Del. Laws, c. 215, § 1, effective Oct. 1, 2025.

§ 7001. Sealed container defense in product liability [Transferred to § 2501I of Title 6].66 Del. Laws, c. 45, § 1; 70 Del. Laws, c. 186, § 1;

§ 7101. Statement of purpose. The purpose of this chapter is to promote the public interest; to promote the availability of long-term care insurance policies; to protect applicants for long-term care insurance, as defined in this chapter, from unfair or deceptive sales or enrollm…

§ 7102. Scope. The requirements of this chapter shall apply to policies delivered or issued for delivery in this State on or after January 1, 1990. This chapter is not intended to supersede the obligations of entities subject to this chapter to comply with the substance of other …

§ 7103. Definitions. The following words, terms and phrases, when used in this chapter, shall have the meanings ascribed to them in this section, except where the context clearly indicates a different meaning: (1) “Applicant” shall mean: a. In the case of an individual long-term …

§ 7104. Extraterritorial jurisdiction; group long-term care insurance. No group long-term care insurance coverage may be offered to a resident of this State under a group policy issued in another state to a group described in § 7103(4) of this title, unless this State or another …

§ 7105. Disclosure and performance standards for long-term care insurance. (a) The Commissioner may adopt regulations that include standards for full and fair disclosure setting forth the manner, content and required disclosures for the sale of long-term care insurance policies, …

§ 7106. Nonforfeiture benefit requirement. (a) No insurer may issue or deliver a long-term care insurance policy in this State unless the insurer offers to the applicant the option to purchase a policy that provides for nonforfeiture benefits. (b) The Insurance Commissioner shall…

§ 7107. Administrative procedures. The Commissioner shall issue reasonable regulations to establish minimum standards for marketing practices, agent compensation, agent testing, penalties and reporting practices for long-term care insurance, and any other rules and regulations ne…

§ 7108. Title. This chapter shall be known and may be cited as the “Long-Term Care Insurance Act.”67 Del. Laws, c. 102, § 1; 70 Del. Laws, c. 351, § 1;

§ 7109. Penalties. In addition to any other penalties provided by the laws of this State, any insurer or agent found to have violated any requirement of this State relating to the regulation of long-term care insurance or the marketing of such insurance shall be subject to a fine…

§ 7201. Purpose. The purpose and intent of this chapter are to promote the availability of health insurance coverage to small employers regardless of their health status or claims experience, to prevent abusive rating practices, to require disclosure of rating practices to purcha…

§ 7202. Definitions [For application of this section, see 79 Del. Laws, c. 99, § 19]. As used in this chapter: (1) “Actuarial certification” means a written statement by a member of the American Academy of Actuaries, or other individual acceptable to the Commissioner, that a smal…

§ 7203. Applicability and scope. This chapter shall apply to any health benefit plan provided by a small employer which provides coverage to the employees of such small employer in this State.68 Del. Laws, c. 175, §§ 1, 3; 68 Del. Laws, c. 340, § 1;

§ 7204. Establishment of classes of business. (a) A small employer carrier may establish more than 1 class of business only to reflect substantial differences in expected claims experience or administrative costs related to the following reasons: (1) The small employer carrier us…

§ 7205. Restrictions relating to premium rates. Premium rates for health benefit plans subject to this chapter shall be subject to the following provisions: (1) The index rate for any class of business shall not exceed the index rate for similar coverage for any other class of bu…

§ 7206. Renewability of coverage. (a) A health benefit plan subject to this chapter shall be renewable with respect to all eligible employees or dependents, at the option of the small employer, except in any of the following cases: (1) Nonpayment of the required premiums; (2) Fra…

§ 7207. Availability of coverage; preexisting conditions; minimum participation [For application of this section, see 79 Del. Laws, c. 99, § 19]. (a) (1) Subject to paragraph (a)(4) of this section, every small employer carrier shall, as a condition of transacting business in thi…

§ 7208. Notice of intent to operate as a risk-assuming carrier. (a) (1) Each small employer carrier desiring to operate as a risk-assuming carrier shall make application to the Commissioner within 30 days of January 4, 1993 to operate as a risk-assuming carrier, pursuant to § 720…

§ 7209. Application to become a risk-assuming carrier. (a) A small employer carrier may apply to become a risk-assuming carrier by filing an application with the Commissioner in a form and manner prescribed by the Commissioner. (b) The Commissioner shall consider the following fa…

§ 7210. Small Employer Health Reinsurance Program [Repealed]. Repealed by 77 Del. Laws, c. 106, § 3, effective July 6, 2009.

§ 7211. Health benefit plan committee. (a) The Commissioner shall appoint a Health Benefit Plan Committee. The Committee shall be composed of representatives of carriers, small employers and employees, health-care providers and producers. (b) The Committee shall recommend the for…

§ 7212. Periodic market evaluation. The board, in consultation with the Committee, shall study and report at least every 3 years to the Commissioner on the effectiveness of this chapter. The report shall analyze the effectiveness of the chapter in promoting rate stability, produc…

§ 7213. Waiver of certain state laws. No law requiring the coverage of a health-care service or benefit, or requiring the reimbursement, utilization or inclusion of a specific category of licensed health-care practitioner, shall apply to a basic health benefit plan delivered or i…

§ 7214. Administrative procedures. The Commissioner shall issue regulations in accordance with § 314 of this title and Chapter 101 of Title 29, for the implementation and administration of this chapter.68 Del. Laws, c. 340, § 1;

§ 7215. Standards to assure fair marketing. (a) Each small employer carrier shall actively market health benefit plan coverage, including the basic and standard health benefit plans, to eligible small employers in the State. If a small employer carrier denies coverage to a small …

§ 7216. Regulations; exceptions. (a) The Commissioner may establish regulations to implement the provisions of this section and to assure that rating practices used by small employer carriers are consistent with the purposes of this chapter, including regulations that: (1) Assure…

§ 7217. Disclosure of rating practices; certification of compliance. (a) In connection with the offering for sale of any health benefit plan to a small employer, a small employer carrier shall make a reasonable disclosure, as part of its solicitation and sales materials, of all o…

§ 7218. Factors for premium rates; premium rate variations; premium rate adjustments; “stop-loss” policies prohibited. (a) The only factors, other than plan design and family composition, that may be considered by a small employer carrier in setting premium rates for small employ…

§ 7301. Title. This chapter shall be known as the “Pharmacy Access Act.”69 Del. Laws, c. 227, § 1;

§ 7302. Purpose and applicability. (a) The General Assembly finds that pharmaceutical services and prescription drugs are an essential service to the people of this State and that the broadest possible access to such services should be mandated and therefore finds that this chapt…

§ 7303. Access and prohibitions. (a) Any person in the State may select the pharmacy of the person’s choice as long as the pharmacy has agreed to participate in the plan according to the terms offered by the insurer. (b) Any pharmacy or pharmacist has the right to participate as …

§ 7401. Title. This chapter may be cited as the “HIV Testing For Insurance Act.”70 Del. Laws, c. 176, § 1;

§ 7402. Definitions. For the purpose of this chapter, the following definitions apply: (1) “Applicant” means the individual proposed for insurance coverage. (2) “HIV” means the human immunodeficiency virus or any other identified causative agent of acquired immune deficiency synd…

§ 7403. Insurer requirements; informed consent; use of results; information. (a) No insurer shall request or require that an applicant submit to an HIV test unless the insurer first: (1) Obtains the applicant’s prior written informed consent; (2) Reveals to the applicant the use …