reglab/housing_qa huggingface dataset:
18 DE Code § 2317. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 23. Unfair Practices in the Insurance Business|§ 2317. Genetics based discrimination.

§ 2317. Genetics based discrimination. (a) As used in this section:  (1) “Genetic characteristic” means any inherited gene or chromosome, or alteration thereof, that is scientifically or medically believed to predispose an individual to a disease, disorder or syndrome, or to be associated with a statistically significant increased risk of development of a disease, disorder or syndrome. (2) “Genetic information” means information about inherited genes or chromosomes, and of alterations thereof, whether obtained from an individual or family member, that is scientifically or medically believed to predispose an individual to disease, disorder or syndrome, or believed to be associated with a statistically significant increased risk of development of a disease, disorder or syndrome. This includes, but is not limited to, information regarding carrier status, information regarding an increased likelihood of future disease or increased sensitivity to any substance, information derived from laboratory tests that identify mutations in specific genes or chromosomes, requests for genetic services or counseling, tests of gene products, and direct analysis of genes or chromosomes. (3) “Genetic test” means a test for determining the presence or absence of an inherited genetic characteristic in an individual, including tests of nucleic acids such as DNA, RNA and mitochondrial DNA, chromosomes or proteins in order to identify a predisposing genetic characteristic associated with disease, disorder or syndrome. (4) “Insurance” means health coverage as defined in this title or in regulations promulgated by the Insurance Commissioner, not including disability insurance or long term care insurance. (b) No person shall discriminate against any individual in the issuance, denial or renewal of or in the fixing of the rates, terms or conditions for insurance as defined in paragraph (a)(4) of this section. (c) No cause of action in the nature of defamation, invasion of privacy or negligence shall arise against any person for disclosing personal or privileged information in accordance with this section, nor shall such a cause of action arise against any person for furnishing personal or privileged information to an insurance institution, agent or insurance support organization; provided however, that this section shall provide no immunity for disclosing or furnishing false information with malice or wilful intent to injure any person. Additionally, no person shall be found in violation of this section because the person receives genetic information or the results of a genetic test through inadvertent disclosure by a medical professional. 71 Del. Laws, c. 457, §  1;
18 DE Code § 2318. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 23. Unfair Practices in the Insurance Business|§ 2318. Care by advanced practice nurses.

§ 2318. Care by advanced practice nurses. No health insurer, health service corporation or health maintenance organization shall deny benefits for eligible services when the services are rendered or performed by an advanced practice nurse as long as said advanced practice nurse acts within the scope of practice and/or definitions pursuant to Title 24. Any contract of insurance issued or issued for delivery in this State by health insurers, health service corporations or health maintenance organizations shall not exclude advanced practice nurses as providers of services covered in the contract. 67 Del. Laws, c. 452, §  1;  69 Del. Laws, c. 319, §  1;  70 Del. Laws, c. 186, §  1;
18 DE Code § 2319. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 23. Unfair Practices in the Insurance Business|§ 2319. Carrier post-claim adjudication audit record requests.

§ 2319. Carrier post-claim adjudication audit record requests. (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 plan of health insurance or health benefits subject to state insurance regulation. “Carrier” also includes any third-party administrator or other entity that adjusts, administers, or settles claims in connection with health benefit plans. (2) “Carrier” does not mean an entity that provides a plan of health insurance or health benefits designed for issuance to persons eligible for coverage under Titles XVIII, XIX and XXI of the Social Security Act (42 U.S.C. §§ 1395 et seq., 1396 et seq. and 1397 et seq.), known as Medicare, Medicaid, or any other similar coverage under state or federal governmental plans. (3) “Post-claim adjudication audit” means any audit of a claim by a carrier post payment.  (b) Except as set forth in subsection (e) of this section, medical records requests for post-claim adjudication audits are limited to 400 claims for a specific episode of care in a 45-day period per provider. Any request for records pursuant to this section shall be made in writing.  (c) A provider shall have no less than 45 days and no more than 60 days from the date of the letter to submit all of the requested records.  (d) A provider shall have no less than 30 days and no more than 60 days from the receipt date of the audit result/determination letter to appeal the audit determination.  (e) This section does not apply to post-claim adjudication audits which are any of the following:  (1) Based on a reasonable belief of fraud, waste, abuse or other intentional misconduct. (2) Required by, or initiated at the request of a self-insured plan. (3) Required by the state or federal government or a state or federal government plan.82 Del. Laws, c. 111, § 1;
18 DE Code § 2320. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 23. Unfair Practices in the Insurance Business|§ 2320. Discrimination prohibited; pre-exposure prophylaxis medication to prevent HIV infection.

§ 2320. Discrimination prohibited; pre-exposure prophylaxis medication to prevent HIV infection. A person engaged in the business of life, disability, or long-term care insurance may not do any of the following solely because an individual has been prescribed pre-exposure prophylaxis medication to prevent HIV infection:  (1) Deny, refuse to issue, refuse to renew, refuse to reissue, cancel, or otherwise terminate an insurance policy or restrict coverage. (2) Add any surcharge or rating factor to a premium of an insurance policy. (3) Otherwise discriminate in the offering, issuance, cancellation, amount of coverage, price, payment of claims, or any other condition of an insurance policy without additional actuarial justification.83 Del. Laws, c. 41, § 1;
18 DE Code § 2401. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 24. Insurance Fraud|§ 2401. Title.

§ 2401. Title. This chapter shall be known as and may be cited as the “Delaware Insurance Fraud Prevention Act.” 69 Del. Laws, c. 463, §  1;
18 DE Code § 2402. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 24. Insurance Fraud|§ 2402. Purpose.

§ 2402. Purpose. The purpose of this chapter is to confront aggressively the problem of insurance fraud in the State by facilitating the detection of insurance fraud, reducing the occurrence of such fraud through administrative enforcement and deterrence, requiring the restitution of fraudulently obtained insurance benefits and reducing the amount of premium dollars used to pay fraudulent claims. 69 Del. Laws, c. 463, §  1;
18 DE Code § 2403. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 24. Insurance Fraud|§ 2403. Definitions.

§ 2403. Definitions. (a) “Attorney General” means the Attorney General of the State or the Attorney General's designated representatives. (b) “Authorized agency” means any appropriate law-enforcement agency. (c) “Bad faith” means without any reasonable justification. (d) “Bureau” means the Delaware Insurance Fraud Prevention Bureau established by this chapter. (e) “Director” means the Director of the Delaware Insurance Fraud Prevention Bureau. (f) “Financial loss” includes, but is not limited to, loss of earnings, out of pocket and other expenses, repair and replacement costs and claims payments. (g) “Insurer” includes, but is not limited to, an authorized insurer, self-insurer, reinsurer, broker, producer or any agent thereof. (h) “Practitioner” means a licensee of this State authorized to practice medicine, surgery, psychology, chiropractic or law or any other licensee or business of this State whose services are compensated, directly or indirectly, by insurance proceeds, or a licensee similarly licensed in any other state, or the practitioner of any nonmedical treatment rendered in accordance with a recognized religious method of healing. (i) “Statement” includes, but is not limited to, any notice statement, proof of loss, bill of lading, receipt for payment, invoice, account, estimate of property damages, bill for services, diagnosis, prescription, hospital or doctor records, x-rays, test result or other evidence of loss, injury or expense. 69 Del. Laws, c. 463, §  1;  70 Del. Laws, c. 186, §  1;
18 DE Code § 2404. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 24. Insurance Fraud|§ 2404. Establishment of Delaware Insurance Fraud Prevention Bureau; Delaware Insurance Fraud Auxiliary Fund.

§ 2404. Establishment of Delaware Insurance Fraud Prevention Bureau; Delaware Insurance Fraud Auxiliary Fund. (a) The Delaware Insurance Fraud Prevention Bureau is hereby established within the Department of Insurance and authorized to employ investigators and appropriate support staff as is necessary to carry out its mandate. (b) The Commissioner shall appoint the full-time supervisory and investigative personnel of the Bureau including the Director and Chief Investigator, who shall hold their employment at the pleasure of the Commissioner and who shall be qualified by training and experience to perform the duties of their positions. The Commissioner shall also appoint the clerical and other staff necessary for the Bureau to fulfill its responsibilities under this chapter. (c) It shall be the duty of the Bureau:  (1) To initiate independent inquiries and conduct independent investigations when the Bureau has cause to believe that an act of insurance fraud has been, or is currently being committed; (2) To review reports or complaints of alleged insurance fraud from federal, state and local police, other law-enforcement authorities, governmental agencies or units, insurers and the general public and to determine whether such reports require further investigation and to conduct such investigations; (3) To conduct independent examinations of insurance fraud, and undertake independent studies to determine the extent of insurance fraud; and (4) To enforce § 2118(q)(4) of Title 21 by confiscating license plates of uninsured motorists who have failed to provide proof of insurance after being afforded an opportunity to prove proof of insurance as required in § 2118(q)(4) of Title 21. (d) There is hereby created within the Bureau a special revolving fund to be designated as the Delaware Insurance Fraud Auxiliary Fund which shall be used by the Bureau in the performance of the various functions and duties required of the Bureau by law. 69 Del. Laws, c. 463, §  1;  75 Del. Laws, c. 59, §  2;
18 DE Code § 2405. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 24. Insurance Fraud|§ 2405. Evidence, documentation and related materials.

§ 2405. Evidence, documentation and related materials. (a) The Commissioner or the Commissioner's designee, in addition to other provisions of this title, shall have the power and authority to administer oaths, subpoena witnesses and to compel the production of nonprivileged evidence, in any form, that is relevant or will lead to the discovery of relevant information regarding fraud investigation. Any natural or other person, as well as any State or governmental entities may be subpoenaed and shall produce the required evidence or to make such evidence available for inspection by the Bureau in a timely manner. The Superior Court of the State shall have exclusive jurisdiction regarding the enforcement or lawfulness of a subpoena on proper application by a party in interest. (b) If the Bureau seeks evidence, documentation, or related materials located outside this State pertinent to an investigation or examination, the Bureau may designate representatives or deputies, including officials of the State where the matter is located, to secure or inspect the evidence, documentation or materials on its behalf. (c) Subpoenas may be served in any manner that is authorized for service of original process or subpoenas under the Superior Court Rules of Civil Procedure. 69 Del. Laws, c. 463, §  1;  70 Del. Laws, c. 422, §§  1, 2;
18 DE Code § 2406. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 24. Insurance Fraud|§ 2406. Confidentiality and immunity from subpoena.

§ 2406. Confidentiality and immunity from subpoena. (a) All papers, records, documents, reports, materials or other evidence relevant to an insurance fraud investigation or examination shall remain confidential and shall not be subject to public inspection so long as the Bureau deems it is reasonably necessary to protect the privacy of the person or matter investigated or examined, to protect the person furnishing the material or to be in the public interest. (b) Such papers, records, documents, reports, materials or other evidence relevant to an insurance fraud investigation or examination shall not be subject to subpoena until opened for public inspection by the Bureau. 69 Del. Laws, c. 463, §  1;
18 DE Code § 2408. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 24. Insurance Fraud|§ 2408. Duties of insurers.

§ 2408. Duties of insurers. Any insurer which has a reasonable belief that an act of insurance fraud is being, or has been, committed shall send to the Bureau, on a form prescribed by the Bureau, any and all information and such additional information relating to such act as the Bureau may require. 69 Del. Laws, c. 463, §  1;
18 DE Code § 2409. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 24. Insurance Fraud|§ 2409. Immunity.

§ 2409. Immunity. In the absence of fraud or bad faith, no person shall be subject to civil liability (for libel, slander or any other relevant tort cause of action by virtue of filing reports, without malice, or furnishing other information, written or oral, without malice, required by this chapter or required by the Commissioner under the authority granted in this title), and no civil cause of action of any nature shall arise against such person:  (1) For any information relating to suspected fraudulent insurance acts furnished to or received from law-enforcement officials, their agents and employees; or (2) For any information relating to the suspected fraudulent insurance acts furnished to or received from other persons in this title; or (3) For any such information furnished in reports to the Insurance Department, the National Association of Insurance Commissioners or any organization established to detect and prevent fraudulent insurance acts, their agents, employees or designees, nor shall the Commissioner or any employee of the Insurance Department, (acting without malice) in the absence of fraud or bad faith, be subject to civil liability (for libel, slander or any other relevant tort) and no civil cause of action of any nature shall arise against such person by virtue of publication of any report or bulletin related to the official activities of the Insurance Department. Nothing herein is intended to abrogate or modify in any way any common law or statutory privilege or immunity heretofore enjoyed by any person.69 Del. Laws, c. 463, §  1;
18 DE Code § 2410. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 24. Insurance Fraud|§ 2410. Other law-enforcement authorities.

§ 2410. Other law-enforcement authorities. This chapter shall not:  (1) Preempt the authority or relieve the duty of any other law enforcement agency to investigate, examine and prosecute suspected violations of law; (2) Prevent or prohibit a person from voluntarily disclosing any information concerning insurance fraud to any law-enforcement agency other than the Bureau; or (3) Limit any of the powers granted elsewhere by the laws of this State to the Commissioner of Insurance or the Department of Insurance to investigate and examine possible violations of law and to take appropriate action.69 Del. Laws, c. 463, §  1;
18 DE Code § 2412. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 24. Insurance Fraud|§ 2412. Consent orders.

§ 2412. Consent orders. Any person so requested may enter into a consent order whereby such person, without admitting the conduct complained of, consents to the imposition of an administrative penalty and when so requested agrees to cease and desist the acts or omissions complained of. 69 Del. Laws, c. 463, §  1;
18 DE Code § 2413. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 24. Insurance Fraud|§ 2413. Criminal prosecution.

§ 2413. Criminal prosecution. The imposition of any fine or other sanction under this chapter shall not preclude prosecution for a violation of any of the criminal laws of this State. 69 Del. Laws, c. 463, §  1;
18 DE Code § 2414. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 24. Insurance Fraud|§ 2414. Application of Administrative Procedures Act.

§ 2414. Application of Administrative Procedures Act. Except as otherwise provided in this chapter, the State Administrative Procedures Act (Chapter 101 of Title 29) applies to and governs all administrative actions taken by the Bureau. 69 Del. Laws, c. 463, §  1;
18 DE Code § 2415. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 24. Insurance Fraud|§ 2415. Funding.

§ 2415. Funding. The costs of administration and operation of the Delaware Insurance Fraud Prevention Bureau shall be borne by all of the insurance companies admitted or authorized to transact the business of insurance in this State. The Commissioner shall assess $ 900 annually against each insurance company to provide the funds necessary for the operation of the Bureau. 71 Del. Laws, c. 69, §  2;  78 Del. Laws, c. 205, §  1;  81 Del. Laws, c. 341, § 1;
18 DE Code § 2501. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 25. Rates and Rating Organizations|§ 2501. Purpose of chapter; interpretation.

§ 2501. Purpose of chapter; interpretation. The purpose of this chapter is to promote the public welfare by regulating insurance rates (in accordance with the intent of Congress as expressed in Public Law 15—79th Congress) and to the end that they shall not be excessive, inadequate or unfairly discriminatory and to authorize and regulate cooperative action among insurers in rate making and in other matters within the scope of this chapter. Nothing in this chapter is intended:  (1) To prohibit or discourage reasonable competition; or (2) To prohibit, or encourage except to the extent necessary to accomplish the aforementioned purpose, uniformity in insurance rates, rating systems, rating plans or practices. This chapter shall be liberally interpreted to carry into effect this section. 18 Del. C. 1953, §  2501;  56 Del. Laws, c. 380, §  1;
18 DE Code § 2502. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 25. Rates and Rating Organizations|§ 2502. Scope of chapter.

§ 2502. Scope of chapter. (a) This chapter applies to:  (1) Casualty insurance, including workers' compensation, and all forms of motor vehicle insurance, on risks or operations in this State; (2) Surety insurance; (3) Fire, marine and inland marine insurance, as used in their generally accepted trade sense, on risks located in this State. Inland marine insurance shall be deemed to include insurance as defined by statute, or by ruling of the Commissioner; (4) Health insurance, group health insurance, blanket health insurance, Medicare supplement insurance and health service corporations; and (5) Title insurance. (b) This chapter shall not apply to:  (1) Reinsurance, except joint reinsurance as provided in § 2523 of this title; (2) Insurance of airborne or waterborne vessels or craft, their cargoes, legal liability of aircraft operators, marine protection and indemnity, or other risks commonly insured under aviation or marine, as distinguished from inland marine, insurance policies; or (3) Life insurance. (c) Nothing in this chapter shall abridge or restrict the freedom of contract between insurers and agents or brokers with respect to commissions or between insurers and their employees with respect to compensation. 18 Del. C. 1953, §  2502;  56 Del. Laws, c. 380, §  1;  60 Del. Laws, c. 388, §§  1, 2;  63 Del. Laws, c. 262, §  3;  70 Del. Laws, c. 186, §  1;  73 Del. Laws, c. 402, §  1;
18 DE Code § 2504. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 25. Rates and Rating Organizations|§ 2504. Rate filings.

§ 2504. Rate filings. (a) Every insurer shall file with the Commissioner, except as to inland marine risks which by general custom of the business are not written according to manual rates or rating plans, every manual, minimum, class rate, rating schedule or rating plan and every other rating rule, and every modification of any of the foregoing which it proposes to use. Every such filing shall state the proposed effective date thereof, and shall indicate the character and extent of the coverage contemplated. (b) When a filing is not accompanied by the information upon which the insurer supports such filing, and the Commissioner does not have sufficient information to determine whether such filing meets the requirements of this chapter he or she shall require the insurer to furnish the information upon which it supports the filing. The information furnished in support of a filing may include:  (1) The experience or judgment of the insurer or rating organization making the filing; (2) Its interpretation of any statistical data it relies upon; and (3) The experience of other insurers or rating organizations in conjunction with paragraph (b)(1) of this section; or (4) Any other relevant factors. A filing and supporting information shall be open to inspection by parties in interest after the filing becomes effective. (c) Specific inland marine rates on risks specially rated, made by a rating organization, shall be filed with the Commissioner and shall become effective when filed and shall be deemed approved and in compliance with the requirements of this chapter until such time as the Commissioner rejects the filing. 18 Del. C. 1953, §  2504;  56 Del. Laws, c. 380, §  1;  70 Del. Laws, c. 186, §  1;
18 DE Code § 2505. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 25. Rates and Rating Organizations|§ 2505. Exemption from filing.

§ 2505. Exemption from filing. Under such rules and regulations as he or she adopts, the Commissioner may, by written order, suspend or modify the requirement of filing as to any kind of insurance, subdivision or combination thereof, or as to classes of risks, the rates for which cannot practicably be filed before they are used. Such orders, rules and regulations shall be made known to insurers and rating organizations affected thereby. The Commissioner may make such examination as he or she deems advisable to ascertain whether any rates affected by such order meet the standards set forth in § 2503(a)(2) of this title. 18 Del. C. 1953, §  2505;  56 Del. Laws, c. 380, §  1;  70 Del. Laws, c. 186, §  1;