reglab/housing_qa huggingface dataset:
18 DE Code § 3710. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 37. Delaware Consumer Credit Insurance Model Act|§ 3710. Claims.

§ 3710. Claims. (a) All claims shall be promptly reported to the insurer or its designated claim representative and the insurer shall maintain adequate claim files. All claims shall be settled as soon as possible and in accordance with the terms of the insurance contract. (b) All claims shall be paid either by draft drawn upon the insurer, by electronic funds transfer or by check of the insurer to the order of the claimant to whom payment of the claim is due pursuant to the policy provisions or upon direction of such claimant to one specified. (c) No plan or arrangement shall be used whereby any person, firm or corporation other than the insurer or its designated claim representative shall be authorized to settle or adjust claims. The creditor shall not be designated as claim representative for the insurer in adjusting claims; provided, that a group policyholder may, by arrangement with the group insurer, draw drafts, checks or electronic transfers in payment of claims due to the group policyholder subject to audit and review by the insurer. 70 Del. Laws, c. 576, §  1;
18 DE Code § 3711. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 37. Delaware Consumer Credit Insurance Model Act|§ 3711. Existing insurance — Choice of insurer.

§ 3711. Existing insurance — Choice of insurer. When consumer credit insurance is required as additional security for any debt, the debtor shall, upon request to the creditor, have the option of furnishing the required amount of insurance through existing policies of insurance owned or controlled by the debtor or of procuring and furnishing the required coverage through any insurer authorized to transact any insurance business within this State. 70 Del. Laws, c. 576, §  1;
18 DE Code § 3712. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 37. Delaware Consumer Credit Insurance Model Act|§ 3712. Duties of an insurer.

§ 3712. Duties of an insurer. Except as otherwise prohibited by law, duties imposed upon an insurer within this chapter may be carried out by a creditor if the creditor is acting as a common law or statutory agent on behalf of the insurer. 70 Del. Laws, c. 576, §  1;
18 DE Code § 3713. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 37. Delaware Consumer Credit Insurance Model Act|§ 3713. Enforcement; penalties.

§ 3713. Enforcement; penalties. (a) The Commissioner may, after notice and hearing, issue such rules and regulations as the Commissioner deems appropriate for the supervision of this chapter. (b) Whenever the Commissioner finds that there has been a violation of this chapter or any rules or regulations issued pursuant thereto, and after written notice thereof and hearing given to the insurer or other person authorized or licensed by the Commissioner, the Commissioner may impose an administrative penalty in accordance with § 329 of this title. The Commissioner, in his or her discretion, may revoke or suspend the license or certificate of authority of the person, firm or corporation guilty of repeated wilful violations. (c) Before the Commissioner may impose or order a penalty pursuant to this section, the violator shall be given notice of the violation and an opportunity to be heard at a public hearing. The procedures for such notice and hearing, and any appeal from the Commissioner's decision shall be the same as set forth in the Delaware Administrative Procedures Act, Chapter 101 of Title 29. (d) The Commissioner may set forth by regulation prima facie reasonable premium rates, together with corresponding safe-harbor benefit provisions, which premium rates shall be conclusively presumed reasonable in relation to the benefits provided when used for policies containing such benefit provisions. 70 Del. Laws, c. 576, §  1;  70 Del. Laws, c. 186, §  1;
18 DE Code § 3801. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 38. Dental Plan Organization Act|§ 3801. Short title.

§ 3801. Short title. This chapter shall be known and may be cited as the “Dental Plan Organization Act.” 63 Del. Laws, c. 49, §  1;
18 DE Code § 3802. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 38. Dental Plan Organization Act|§ 3802. Definitions.

§ 3802. Definitions. Definitions as used in this chapter:  (1) “Child with a severe disability” means a person under the age of 21 who, due to a significant mental or physical condition, illness, or disease, is likely to require specialized treatment or supports to secure effective access to dental care. (2) “Dental plan” means any contractual arrangement for dental services provided directly or arranged for or administered directly on a prepaid or postpaid individual or group capitation basis. (3) “Dental plan organization” means any person who undertakes to provide directly or to arrange for or administer 1 or more dental plans providing dental services. (4) “Dental services” means services included in the practice of dentistry as defined in § 1121 of Title 24. (5) “Enrollee” means an individual and that individual's dependents who are enrolled in a dental plan organization. (6) “Evidence of coverage” means any certificate, agreement or contract issued to an enrollee setting out the dental services to which the enrollee is entitled.63 Del. Laws, c. 49, §  1;  70 Del. Laws, c. 186, §  1;  77 Del. Laws, c. 54, §  3;
18 DE Code § 3805. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 38. Dental Plan Organization Act|§ 3805. General surplus; special contingent surplus.

§ 3805. General surplus; special contingent surplus. (a) The Commissioner may determine, at his or her discretion, the amount of a general surplus, if any, that the dental plan organization shall be required to maintain. (b) A dental plan organization utilizing in the aggregate the services of more than 10 full-time equivalent dentists shall accumulate and maintain a special contingent surplus in excess of its assets over liabilities the rate of 2 percent annually of its net contract and certificate income until the surplus totals $50,000. 63 Del. Laws, c. 49, §  1;  70 Del. Laws, c. 186, §  1;
18 DE Code § 3806. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 38. Dental Plan Organization Act|§ 3806. Bonding requirement.

§ 3806. Bonding requirement. Any director, officer, employee or partner of a dental plan organization who receives, collects, reimburses or invests moneys in connection with the activities of the organization shall be bonded for his or her fidelity in an amount which shall be determined by the Commission. 63 Del. Laws, c. 49, §  1;  70 Del. Laws, c. 186, §  1;
18 DE Code § 3807. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 38. Dental Plan Organization Act|§ 3807. Medical negligence insurance.

§ 3807. Medical negligence insurance. Each dentist employed by a dental plan organization shall be insured against professional liability or medical negligence by an insurer licensed to conduct business in this State for such minimum amounts as shall be determined by the Commissioner. 63 Del. Laws, c. 49, §  1;  71 Del. Laws, c. 373, §  3;
18 DE Code § 3808. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 38. Dental Plan Organization Act|§ 3808. Evidence of coverage.

§ 3808. Evidence of coverage. (a) An enrollee shall be entitled to receive evidence of coverage or a certificate indicating specifically the nature and extent of coverage, and evidence of the total amount or percentage of payment, if any, which the enrollee is obligated to pay for dental services. If an individual enrollee obtains coverage through an insurance policy or through a contract issued by a medical or dental service corporation, whether by option or otherwise, the insurer or medical or dental service corporation shall issue the evidence of coverage. Otherwise, the dental plan organization shall issue the evidence of coverage. (b) No evidence of coverage or amendment thereto shall be issued or delivered to any person until a copy of the form of evidence of coverage or amendment thereto has been filed with the Commissioner. (c) Evidence of coverage shall contain a clear and complete statement if a contract, or a reasonably complete summary if a certificate, of:  (1) The dental services and the insurance and other benefits, if any, to which enrollees are entitled; (2) Any limitations on the services, kind of services, benefits, or kind of benefits to be provided including any charge, deductible or co-payment features; (3) Where and in what manner information is available as to how services may be obtained; and (4) A clear and understandable description of the dental plan organization's method for resolving enrollees' complaints. (d) Any subsequent change in the evidence of coverage, or the amount or percentage of payment which the enrollee is obligated to pay, shall be evidenced in a separate document issued to the enrollee. 63 Del. Laws, c. 49, §  1;
18 DE Code § 3809. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 38. Dental Plan Organization Act|§ 3809. Schedule of charges.

§ 3809. Schedule of charges. (a) No schedule of charges for enrollee coverage for dental services, or amendment thereto, may be used by a dental plan organization until a copy of such schedule, or amendment thereto, has been filed with the Commissioner. The Commissioner may disapprove the schedule of charges at any time if he or she finds that the charges are excessive, inadequate or unfairly discriminatory. If the Commissioner disapproves the schedule of charges he or she shall notify the dental plan organization within 5 days of the day of disapproval and specify in the notice the reason for his or her disapproval. A hearing shall be granted within 20 days after a request in writing by the filer. It shall be unlawful for any dental plan organization whose schedule of charges has been disapproved to effect any contract or issue any subscription certificate which uses the disapproved schedule of charges until a revised schedule of charges has been filed. (b) Charges shall be established in accordance with actuarial principles, but charges applicable to an enrollee shall not be individually determined based on the status of his or her health. 63 Del. Laws, c. 49, §  1;  70 Del. Laws, c. 186, §  1;
18 DE Code § 3810. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 38. Dental Plan Organization Act|§ 3810. Examination of records.

§ 3810. Examination of records. (a) The Commissioner or his or her designee may, as often as he or she may reasonably determine, investigate the business and examine the books, accounts, records and files of every dental plan organization. For that purpose the Commissioner or his or her designee shall have reasonably free access to the offices and places of business, books, accounts, papers, records and files of all dental plan organizations. A dental plan organization shall keep and use in its business such books, accounts and records as will enable the Commissioner to determine whether the dental plan organization is complying with this chapter and with the rules and regulations promulgated pursuant to it. A dental plan organization shall preserve its books, accounts and records for at least 3 years; except that preservation by photographic reproduction or records in photographic form shall constitute compliance with this chapter. (b) For the purpose of the examination, the Commissioner may, within the limits of funds appropriated for such purpose, contract with such persons as he or she may deem advisable to conduct the same or assist therein. (c) The expenses incurred in making any examination pursuant to this section, up to $1,000 annually, shall be assessed against and paid by the dental plan organization so examined. Upon written notice by the Commissioner of the total amount of an assessment, a dental plan organization shall become liable for and shall pay the assessment to the Commissioner. 63 Del. Laws, c. 49, §  1;  70 Del. Laws, c. 186, §  1;
18 DE Code § 3811. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 38. Dental Plan Organization Act|§ 3811. Complaint system.

§ 3811. Complaint system. (a) A dental plan organization shall establish and maintain a complaint system to provide reasonable procedures for the resolution of written complaints initiated by enrollees concerning dental plan services. The dental plan organization shall maintain records of all written complaints initiated by enrollees. (b) The Commissioner may examine the complaint system and if he or she determines that the system is not adequate he or she may require a revision of the complaint system. 63 Del. Laws, c. 49, §  1;  70 Del. Laws, c. 186, §  1;
18 DE Code § 3812. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 38. Dental Plan Organization Act|§ 3812. Annual report.

§ 3812. Annual report. (a) Every dental plan organization annually on or before March 1 shall file with the Commissioner a report covering its activities for the preceding calendar year. (b) The reports shall be on forms prescribed by the Commissioner and shall include:  (1) A financial statement of the dental plan organization, including its balance sheet, receipts and disbursements for the preceding year certified by a certified public accountant; (2) Any significant modification of information submitted with the application for a certificate of authority; (3) The number of persons who became enrollees during the year, the number of enrollees as of the end of the year and the number of enrollments terminated during the year; (4) A description of the enrollee complaint system including the procedures of the complaint system, the total number of written complaints handled through the system, a summary of causes underlying the complaints filed, and the number, amount and disposition of medical negligence claims settled during the year by the dental plan organization and any of the dentists used by it; and (5) Any other information relating to the performance of the dental plan organization as required by the Commissioner.63 Del. Laws, c. 49, §  1;  71 Del. Laws, c. 373, §  3;
18 DE Code § 3813. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 38. Dental Plan Organization Act|§ 3813. Maximum portion of income used for expenses.

§ 3813. Maximum portion of income used for expenses. A dental plan organization shall not use more than 30 percent of its gross contract and certificate income in the first year of operation, 25 percent in the second year of operation and 20 percent in any subsequent year for general expenses, acquisition expenses and miscellaneous taxes, licenses and fees. 63 Del. Laws, c. 49, §  1;
18 DE Code § 3814. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 38. Dental Plan Organization Act|§ 3814. Advertising.

§ 3814. Advertising. (a) No dental plan organization, or representative thereof, may cause or knowingly permit the use of advertising which is untrue or misleading, solicitation which is untrue or misleading, or any form of evidence of coverage which is deceptive. For purposes of this subsection:  (1) A statement or item of information shall be deemed to be untrue if it does not conform to fact in any respect which is or may be significant to an enrollee of, or person considering enrollment in, a dental plan; (2) A statement or item of information shall be deemed to be misleading, whether or not it may be literally untrue, if, in the total context in which the statement is made or the item of information is communicated, the statement or item of information may be reasonably understood by a person who does not possess special knowledge regarding dental plan coverage, as indicating any benefit or advantage or the absence of any exclusion, limitation or disadvantage of possible significance to an enrollee of, or person considering enrollment in a dental plan, if the benefit or advantage or absence of exclusion, limitation or disadvantage does not in fact exist; and (3) Evidence of coverage shall be deemed to be deceptive if the evidence of coverage taken as a whole, and with consideration given to typography, format and language, may cause a person who does not possess special knowledge regarding dental plans and evidences of coverage therefor, to expect benefits, services, charges or other advantages which the evidence of coverage does not provide or which the dental plan organization issuing the evidence of coverage does not regularly make available for enrollees covered under such evidence of coverage. (b) No dental plan organization, unless licensed as an insurer, may use in its name, evidence of coverage or literature any of the words “insurance,” “assurance,” “casualty,” “surety,” “mutual” or any other words descriptive of the insurance, casualty or surety business or deceptively similar to the name or description of any insurer licensed to do business in this State. (c) This section shall be enforced by the Division of Consumer Protection and, where applicable, the Commissioner. Nothing in this chapter shall limit the powers of the Attorney General and the procedures with respect to consumer fraud. 63 Del. Laws, c. 49, §  1;  69 Del. Laws, c. 291, §  98(c);
18 DE Code § 3815. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 38. Dental Plan Organization Act|§ 3815. Suspension or revocation of certificate of authority.

§ 3815. Suspension or revocation of certificate of authority. (a) The Commissioner may suspend or revoke any certificate of authority issued to a dental plan organization pursuant to this chapter if he or she finds that any of the following conditions exists:  (1) The dental plan organization is operating in a manner significantly contrary to that described in § 3803 of this title; (2) The dental plan organization issues an evidence of coverage which does not comply with the requirements of § 3808 of this title; (3) The dental plan organization does not provide or arrange for an effective dental plan as determined by the Commissioner; (4) The dental plan organization can no longer be expected to meet its obligations to enrollees; (5) The dental plan organization, or any authorized person on its behalf, has advertised or merchandised its services in an untrue or misleading manner; (6) The dental plan organization has failed to comply with this chapter or any rules and regulations promulgated thereunder. (b) When the Commissioner has cause to believe that grounds for the suspension or revocation of a certificate of authority exist, he or she shall notify the dental plan organization in writing, specifically stating the grounds for suspension or revocation. A hearing on the matter shall be granted by the Commissioner within 20 days after a request in writing by the dental plan organization. After the hearing, or upon failure of the dental plan organization to appear at the hearing, the Commissioner shall take action on his or her findings. (c) If the Commissioner suspends the certificate of authority, the dental plan organization shall not accept any additional enrollees or engage in any advertising or solicitation during the period of the suspension. (d) If the Commissioner revokes the certificate of authority, the dental plan organization shall proceed to dissolve its structure immediately following the effective date of the order of revocation, and shall conduct no further business except as may be essential to the orderly conclusion of the affairs of the dental plan organization. The Commissioner by written order, however, may permit such further operation of the dental plan organization as he or she finds to be in the best interest of enrollees to the end that enrollees shall be afforded the greatest practical opportunity to obtain continuing dental plan coverage. (e) Notwithstanding subsections (c) and (d) of this section, a dental plan organization which has had its certificate of authority suspended or revoked, or has suffered an adverse decision by the Commissioner, shall be entitled to appeal this decision. The appeal shall be granted as a matter of right and shall be taken to the Court of Chancery in any county in this State. 63 Del. Laws, c. 49, §  1;  70 Del. Laws, c. 186, §  1;
18 DE Code § 3816. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 38. Dental Plan Organization Act|§ 3816. Cease and desist order.

§ 3816. Cease and desist order. (a) The Commissioner may issue an order directing a dental plan organization or a representative of a dental plan organization to cease and desist from engaging in any act or practice in violation of this chapter. (b) Within 20 days after service of the order of cease and desist, the respondent may request a hearing on a question of whether acts or practices in violation of this chapter have occurred. 63 Del. Laws, c. 49, §  1;
18 DE Code § 3817. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 38. Dental Plan Organization Act|§ 3817. Civil penalty; exceptions.

§ 3817. Civil penalty; exceptions. Any dental plan organization which violates any provisions of this chapter, or neglects, fails or refuses to comply with any of the requirements of this chapter, except the failure to file an annual report and the failure to reply in writing to inquiries of the Commissioner, shall be liable for a civil penalty of no more than $1,000 for each violation. 63 Del. Laws, c. 49, §  1;
18 DE Code § 3818. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 38. Dental Plan Organization Act|§ 3818. Injunctive power.

§ 3818. Injunctive power. Whenever any dental plan organization shall become insolvent or shall suspend its ordinary business for want of funds to carry on the same, or whenever the Commissioner shall ascertain, as a result of examination as authorized by this chapter, or in any other manner, that the dental plan organization is exceeding its powers or violating the law or that its condition or methods of business may render the continuance of its operations hazardous to its enrollees or the public, or that its assets are less than its liabilities, the Commissioner may institute an action in the Court of Chancery to enjoin it from the transaction of any further business, or from the transfer or disposal of its property in any manner whatsoever. The Court may proceed in the action in a summary manner or otherwise. It may grant injunctive relief and appoint a receiver, with power to sue for, collect, receive and take into his or her possession all the goods and chattels, rights and credits, moneys and effects, lands and tenement, books, papers, choses in action, bills, notes and property of every description belonging to the dental plan organization and sell and convey and assign the same, and authorize the purchase of continuing coverage for enrollees utilizing the remaining assets, and hold and dispose of the proceeds thereof. The Court may cause the receiver to continue the existing operation of the organization, under Court supervision, until the next anniversary of the subscription certificates and contracts then in force. The dental plan organization may be deemed insolvent whenever it is presently or prospectively unable to fulfill its outstanding contracts and to maintain the surpluses required pursuant to this chapter. 63 Del. Laws, c. 49, §  1;  70 Del. Laws, c. 186, §  1;
18 DE Code § 3819. (2021)
2021 Delaware Code|Title 18 - Insurance Code|Chapter 38. Dental Plan Organization Act|§ 3819. Confidentiality of documents.

§ 3819. Confidentiality of documents. Applications, filings and reports required under this chapter, except contracts referred to in § 3803(c)(4) and (5) of this title, shall be treated as public documents and shall not be considered confidential. 63 Del. Laws, c. 49, §  1;  80 Del. Laws, c. 376, § 5;