reglab/statecodes huggingface dataset:
2023 Delaware Code › Title 18 - Insurance Code › Chapter 31. GROUP LIFE INSURANCE › § 3113. Grace period.

§ 3113. Grace period.
A group life insurance policy shall contain a provision that the policyholder is entitled to a grace period of 31 days for the payment of any premium due except the first, during which grace period the death benefit coverage shall continue in force, unless the policyholder shall have given the insurer written notice of discontinuance in advance of the date of discontinuance and in accordance with the terms of the policy. The policy may provide that the policyholder shall be liable to the insurer for the payment of a pro rata premium for the time the policy was in force during such grace period.
18 Del. C. 1953, §  3112;  56 Del. Laws, c. 380, §  1;  65 Del. Laws, c. 480, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 31. GROUP LIFE INSURANCE › § 3114. Incontestability.

§ 3114. Incontestability.
A group life insurance policy shall contain a provision that the validity of the policy shall not be contested except for nonpayment of premiums, after it has been in force for 2 years from its date of issue; and that no statement made by any person insured under the policy relating to insurability shall be used in contesting the validity of the insurance with respect to which such statement was made after such insurance has been in force prior to the contest for a period of 2 years during such person's lifetime nor unless it is contained in a written instrument signed by him or her; provided, however, that no such provision shall preclude the assertion at any time of defenses based upon provisions in the policy which relate to eligibility for coverage.
18 Del. C. 1953, §  3113;  56 Del. Laws, c. 380, §  1;  65 Del. Laws, c. 480, §  1;  70 Del. Laws, c. 186, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 31. GROUP LIFE INSURANCE › § 3115. Application; statements deemed representations.

§ 3115. Application; statements deemed representations.
A group life insurance policy shall contain a provision that a copy of the application, if any, of the policyholder shall be attached to the policy when issued, that all statements made by the policyholder or by the persons insured shall be deemed representations and not warranties, and that no statement made by any person insured shall be used in any contest unless a copy of the instrument containing the statement is or has been furnished to such person or, in the event of the death or incapacity of the insured person, to his or her beneficiary or personal representative.
18 Del. C. 1953, §  3114;  56 Del. Laws, c. 380, §  1;  65 Del. Laws, c. 480, §  1;  70 Del. Laws, c. 186, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 31. GROUP LIFE INSURANCE › § 3116. Insurability.

§ 3116. Insurability.
A group life insurance policy shall contain a provision setting forth the conditions, if any, under which the insurer reserves the right to require a person eligible for insurance to furnish evidence of individual insurability satisfactory to the insurer as a condition to part or all of his or her coverage.
18 Del. C. 1953, §  3115;  56 Del. Laws, c. 380, §  1;  65 Del. Laws, c. 480, §  1;  70 Del. Laws, c. 186, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 31. GROUP LIFE INSURANCE › § 3117. Misstatement of age.

§ 3117. Misstatement of age.
A group life insurance policy shall contain a provision specifying an equitable adjustment of premiums or of benefits or of both to be made in the event the age of a person insured has been misstated, such provision to contain a clear statement of the method of adjustment to be made.
18 Del. C. 1953, §  3116;  56 Del. Laws, c. 380, §  1;  65 Del. Laws, c. 480, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 31. GROUP LIFE INSURANCE › § 3118. Payment of benefits.

§ 3118. Payment of benefits.
A group life insurance policy shall contain a provision that any sum becoming due by reason of the death of the person insured shall be payable to the beneficiary designated by the person insured, except that where the policy contains conditions pertaining to family status the beneficiary may be the family member specified by the policy terms, subject to the provisions of the policy in the event there is no designated beneficiary, as to all or any part of each sums, living at the death of the person insured, and subject to any right reserved by the insurer in the policy and set forth in the certificate to pay at its option a part of such sum not exceeding $2,000 to any person appearing to the insurer to be equitably entitled thereto by reason of having incurred funeral or other expenses incident to the last illness or death of the person insured.
18 Del. C. 1953, §  3117;  56 Del. Laws, c. 380, §  1;  65 Del. Laws, c. 480, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 31. GROUP LIFE INSURANCE › § 3119. Certificate.

§ 3119. Certificate.
A group life insurance policy shall contain a provision that the insurer will issue to the policyholder for delivery to each person insured a certificate setting forth a statement as to the insurance protection to which he or she is entitled, to whom the insurance benefits are payable, a statement as to any dependent's coverage included in such certificate, and the rights and conditions set forth in §§ 3120-3123 of this title.
18 Del. C. 1953, §  3118;  56 Del. Laws, c. 380, §  1;  65 Del. Laws, c. 480, §  1;  70 Del. Laws, c. 186, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 31. GROUP LIFE INSURANCE › § 3120. Conversion on termination of eligibility.

§ 3120. Conversion on termination of eligibility.
(a) A group life insurance policy shall contain a provision that if the insurance, or any portion of it, on a person covered under the policy or on the dependent of a person covered, ceases because of termination of employment or of membership in the class or classes eligible for coverage under the policy, such person shall be entitled to have issued to him or her by the insurer, without evidence of insurability, an individual policy of life insurance without disability or other supplementary benefits, provided application for the individual policy shall be made, and the first premium paid to the insurer, within 31 days after such termination, and provided further that:
(1) The individual policy shall, at the option of such person, be on any 1 of the forms then customarily issued by the insurer at the age and for the amount applied for, except that the group may exclude the option to elect term insurance;
(2) The individual policy shall be in an amount not in excess of life insurance which ceases because of such termination, less the amount of any life insurance for which such person becomes eligible under the same or any other group policy within 31 days after such termination, provided that any amount of insurance which shall have matured on or before the date of such termination as an endowment payable to the person insured, whether in 1 sum or in installments or in the form of an annuity, shall not, for the purposes of this provision, be included in the amount which is considered to cease because of such termination; and
(3) The premium on the individual policy shall be at the insurer's then customary rate applicable to the form and amount of the individual policy, to the class of risk to which such person then belongs, and to the individual age attained on the effective date of the individual policy.
(b) Subject to the same conditions set forth above, the conversion privilege shall be available:
(1) To a surviving dependent, if any, at the death of the employee or member, with respect to the coverage under the group policy which terminates by reason of such death; and
(2) To the dependent of the employee or member upon termination of coverage of the dependent, while the employee or member remains under the group policy, by reason of the dependent ceasing to be a qualified family member under the group policy.
18 Del. C. 1953, §  3119;  56 Del. Laws, c. 380, §  1;  65 Del. Laws, c. 480, §  1;  70 Del. Laws, c. 186, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 31. GROUP LIFE INSURANCE › § 3121. Conversion on termination of policy.

§ 3121. Conversion on termination of policy.
A group life insurance policy shall contain a provision that if the group policy terminates or is amended so as to terminate the insurance of any class of insured person, every person insured thereunder at the date of such termination whose insurance terminates, including the insured dependent of a covered person, and who has been so insured for at least 5 years prior to such termination date shall be entitled to have issued by the insurer an individual policy of life insurance, subject to the same conditions and limitations as are provided by § 3120 of this title, except that the group policy may provide that the amount of such individual policy shall not exceed the smaller of:
(1) The amount of the person's life insurance protection ceasing because of the termination or amendment of the group policy, less the amount of any life insurance for which he or she is or becomes eligible under a group policy issued or reinstated by the same or another insurer within 31 days after such termination; and
18 Del. C. 1953, §  3120;  56 Del. Laws, c. 380, §  1;  65 Del. Laws, c. 480, §  1;  70 Del. Laws, c. 186, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 31. GROUP LIFE INSURANCE › § 3122. Death pending conversion.

§ 3122. Death pending conversion.
A group life insurance policy shall contain a provision that if a person insured under the group policy, or the insured dependent of a covered person, dies during the period within which the individual would have been entitled to have an individual policy issued in accordance with § 3120 or § 3121 of this title and before such an individual policy shall become effective, the amount of life insurance which he or she would have been entitled to have issued under such individual policy shall be payable as a claim under the group policy, whether or not application for the individual policy or the payment of the first premium therefor has been made.
18 Del. C. 1953, §  3121;  56 Del. Laws, c. 380, §  1;  65 Del. Laws, c. 480, §  1;  70 Del. Laws, c. 186, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 31. GROUP LIFE INSURANCE › § 3123. Disability provision.

§ 3123. Disability provision.
Where active employment is a condition of insurance, the group life insurance policy shall contain a provision that an insured may continue coverage during the insured's total disability by timely payment to the policyholder of that portion, if any, of the premium that would have been required from the insured had total disability not occurred. The continuation shall be on a premium paying basis for a period of 6 months from the date on which the total disability started, but not beyond the earlier of:
(1) Approval by the insurer of continuation of the coverage under any disability provision which the group insurance policy may contain; or
(2) The discontinuance of the group insurance policy.
65 Del. Laws, c. 480, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 31. GROUP LIFE INSURANCE › § 3124. Information to debtors.

§ 3124. Information to debtors.
In the case of a policy insuring the lives of debtors, such a group life insurance policy shall contain a provision that the insurer will furnish to the policyholder for delivery to each debtor insured under the policy a certificate of insurance describing the coverage and specifying that the death benefit shall first be applied to reduce or extinguish the indebtedness.
18 Del. C. 1953, §  3122;  56 Del. Laws, c. 380, §  1;  65 Del. Laws, c. 480, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 31. GROUP LIFE INSURANCE › § 3125. Notice as to conversion right.

§ 3125. Notice as to conversion right.
If any individual insured under a group life insurance policy hereafter delivered in this State becomes entitled under the terms of such policy to have an individual policy of life insurance issued without evidence of insurability, subject to making of application and payment of the first premium within the period specified in such policy, and if such individual is not given notice of the existence of such right at least 15 days prior to the expiration date of such period, then in such event the individual shall have an additional period within which to exercise such right, but nothing herein contained shall be construed to continue any insurance beyond the period provided in such policy. This additional period shall expire 15 days next after the individual is given such notice but in no event shall such additional period extend beyond 60 days next after the expiration date of the period provided in such policy. Written notice presented to the individual or mailed by the insurer to the last known address of the individual as furnished by the policyholder shall constitute notice for the purpose of this section.
18 Del. C. 1953, §  3123;  56 Del. Laws, c. 380, §  1;  65 Del. Laws, c. 480, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 31. GROUP LIFE INSURANCE › § 3126. Readjustment of premium.

§ 3126. Readjustment of premium.
Any group life insurance contract may provide for a readjustment of the premium rate based upon the experience thereunder.
18 Del. C. 1953, §  3124;  56 Del. Laws, c. 380, §  1;  65 Del. Laws, c. 480, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 31. GROUP LIFE INSURANCE › § 3127. Application of dividends; rate deduction.

§ 3127. Application of dividends; rate deduction.
If a policy dividend is hereafter declared or a reduction in rate is hereafter made or continued for the first or any subsequent year of insurance under any policy of group life insurance heretofore or hereafter issued to any policyholder, the excess, if any, of the aggregate dividends or rate reductions under such policy and all other group insurance policies of the policyholder over the aggregate expenditure for insurance under such policies made from funds contributed by the policyholder, or by an employer of insured persons, or by a union or association to which the insured persons belong, including expenditures made in connection with administration of such policies shall be applied by the policyholder for the sole benefit of insured employees or members.
18 Del. C. 1953, §  3125;  56 Del. Laws, c. 380, §  1;  65 Del. Laws, c. 480, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 31. GROUP LIFE INSURANCE › § 3128. Notification and reasons for cancellation [For application of this section, see 79 Del. Laws, c. 390, § 8].

§ 3128. Notification and reasons for cancellation [For application of this section, see 79 Del. Laws, c. 390, § 8].
A notice of cancellation of group life insurance coverage by an insurer due to nonpayment of premiums shall be in writing, shall be delivered to the policyholder or mailed to the policyholder at the last known address of the policyholder, shall state the effective date of the cancellation and shall be accompanied by a written explanation of the specific reasons for the cancellation. Proof of mailing of such cancellation notice shall be retained by the insurer for a period of not less than 1 year.
79 Del. Laws, c. 390, §  2;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 32. GROUP LIFE INSURANCE FOR STATE EMPLOYEES › § 3201. “Employee” defined.

§ 3201. “Employee” defined.
“Employee” shall mean a person who has been continuously employed by the State for 3 full calendar months immediately preceding the first day of any given month (exclusive of legal holidays and allowable leave) and who works the regularly scheduled full-time hours of the employing agency, or at least 30 or more hours per week, or 130 hours per month (with allowable interruptions) throughout the year. “Employee” shall include all elected and appointed state officials.
18 Del. C. 1953, §  3201;  56 Del. Laws, c. 380, §  1;  58 Del. Laws, c. 236;  72 Del. Laws, c. 94, §  42;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 32. GROUP LIFE INSURANCE FOR STATE EMPLOYEES › § 3202. Group life insurance.

§ 3202. Group life insurance.
Subject to Chapter 31 of this title, the State may enter into a contract of group life insurance including accidental death and dismemberment coverage with an insurance company or companies authorized to transact business within this State, which insurance shall specifically cover state employees or any class or classes thereof.
18 Del. C. 1953, §  3202;  56 Del. Laws, c. 380, §  1;  58 Del. Laws, c. 236.;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 32. GROUP LIFE INSURANCE FOR STATE EMPLOYEES › § 3203. Life insurance premiums.

§ 3203. Life insurance premiums.
The State may pay part of the premiums or charges for such group life insurance contract or contracts and may appropriate any money necessary to pay such premiums or charges, or portions thereof. Notwithstanding any other provision of the law, any contribution required of any employee toward the cost of such insurance may be deducted from the pay, salary or compensation of such employee. The expenditure of funds of the State for payment of part of the premiums shall be deemed to be a regular business expenditure and shall not be considered compensation paid to the employee so insured.
18 Del. C. 1953, §  3203;  56 Del. Laws, c. 380, §  1;  58 Del. Laws, c. 236.;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 32. GROUP LIFE INSURANCE FOR STATE EMPLOYEES › § 3204. Eligibility and waiver.

§ 3204. Eligibility and waiver.
Any contract of insurance procured pursuant to this chapter shall provide that each employee becoming eligible for insurance thereunder shall become insured, subject to any “actively at-work” requirement or requirements as to the health of the persons to be covered as specified in the insurance contract, at such time as the eligible employee submits an application for insurance and agrees to pay the applicable premium.
18 Del. C. 1953, §  3204;  56 Del. Laws, c. 380, §  1;  58 Del. Laws, c. 236;  70 Del. Laws, c. 186, §  1;  74 Del. Laws, c. 23, §  1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 32. GROUP LIFE INSURANCE FOR STATE EMPLOYEES › § 3205. Amount of coverage.

§ 3205. Amount of coverage.
(a) The amount of group life insurance on the life of any employee shall be at least in the following amount:
The employee's annual regular salary rounded to the next higher even thousand dollar subject to maxima established by the State Employee Benefits Committee. Contributions by the employee and the State to the cost of such insurance may be based on reasonable age classifications.
(b) The State Employee Benefits Committee shall meet at least annually to review the State's Group Life Insurance Plan and, when appropriate, adopt improvements thereto for the purpose of extending existing amounts or types, or both, of group life insurance coverage for state employees.
18 Del. C. 1953, §  3205;  56 Del. Laws, c. 380, §  1;  58 Del. Laws, c. 236;  63 Del. Laws, c. 100, §  3;  65 Del. Laws, c. 399, §  1;  72 Del. Laws, c. 204, §  8;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 32. GROUP LIFE INSURANCE FOR STATE EMPLOYEES › § 3206. State Employee Benefits Committee.

§ 3206. State Employee Benefits Committee.
(a) After reviewing competitive group plans, the State Employee Benefits Committee established by § 9602 of Title 29 shall select a carrier deemed to offer the best plan to satisfy the interests of the State and of its employees in carrying out the intent of this chapter. Such contract shall be for a uniform term of at least 1 year, but may be continued automatically at the option of the State Employee Benefits Committee from term to term in accordance with recognized group life insurance practices.
(b) The State Employee Benefits Committee shall be empowered to adopt rules and regulations which it deems necessary for the administration of the State's Group Life Insurance Plan.
18 Del. C. 1953, §  3206;  56 Del. Laws, c. 380, §  1;  58 Del. Laws, c. 236;  63 Del. Laws, c. 100, §  3;  70 Del. Laws, c. 186, §  1;  72 Del. Laws, c. 204, §  9;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 32. GROUP LIFE INSURANCE FOR STATE EMPLOYEES › § 3207. Legal agent of the State.

§ 3207. Legal agent of the State.
The Secretary of the Department of Human Resources shall be the legal agent for the State and shall be empowered to enter into the contract for group life insurance with any insurance carrier designated by the State Employee Benefits Committee.
18 Del. C. 1953, §  3207;  56 Del. Laws, c. 380, §  1;  58 Del. Laws, c. 236;  69 Del. Laws, c. 64, §  80;  72 Del. Laws, c. 204, §  10;  75 Del. Laws, c. 88, §  20(4);  81 Del. Laws, c. 66, § 12;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 32. GROUP LIFE INSURANCE FOR STATE EMPLOYEES › § 3208. Administration of chapter.

§ 3208. Administration of chapter.
The Secretary of the Department of Human Resources may perform all acts necessary or proper for administration of the insurance coverage provided.
18 Del. C. 1953, §  3208;  56 Del. Laws, c. 380, §  1;  58 Del. Laws, c. 236;  72 Del. Laws, c. 204, §  11;  75 Del. Laws, c. 88, §  20(4);  81 Del. Laws, c. 66, § 13;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 32. GROUP LIFE INSURANCE FOR STATE EMPLOYEES › § 3209. Application of dividends.

§ 3209. Application of dividends.
Dividends payable from group life insurance may be used to offset any contribution made by the State in the form of money or administrative costs, including the salaries of employees working full-time on the program and any other related expenses deemed appropriate by the State Employee Benefits Committee.
18 Del. C. 1953, §  3209;  56 Del. Laws, c. 380, §  1;  58 Del. Laws, c. 236;  72 Del. Laws, c. 204, §  12;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 32. GROUP LIFE INSURANCE FOR STATE EMPLOYEES › § 3210. Group Life Insurance Fund.

§ 3210. Group Life Insurance Fund.
Dividends in excess of any deduction made by the State for its contributions may be used solely for the benefit of the subscribers to the group life insurance program, and shall be maintained in a special fund identified as the Group Life Insurance Fund, which Fund shall be administered by the State Employee Benefits Committee. Funds derived from such dividends shall be invested by the State Treasurer in accordance with guidelines established by the Cash Management Policy Board, with all income from such investments reverting to the Group Life Insurance Fund. Under no circumstances shall these funds become a part of the State General Fund, or any fund other than the Group Life Insurance Fund.
18 Del. C. 1953, §  3210;  56 Del. Laws, c. 380, §  1;  58 Del. Laws, c. 236;  63 Del. Laws, c. 142, §  56;  72 Del. Laws, c. 204, §  13;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 32. GROUP LIFE INSURANCE FOR STATE EMPLOYEES › § 3211. Validity of contracts.

§ 3211. Validity of contracts.
This chapter shall not be construed to impair the validity of any contractive group life insurance plan for employees of the State which shall be in effect on July 9, 1971, but nothing herein contained shall permit duplicate coverage in any instance where the State would be a contributor to more than 1 plan.
18 Del. C. 1953, §  3211;  56 Del. Laws, c. 380, §  1;  58 Del. Laws, c. 236.;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3301. Scope of chapter.

§ 3301. Scope of chapter.
This chapter shall not apply to or affect:
(1) Any policy of liability or workers' compensation insurance with or without supplementary expense coverage therein;
(2) Any group or blanket policy;
(3) Life insurance, endowment or annuity contracts, or contracts supplemental thereto which contain only such provisions relating to health insurance as:
a. Provide additional benefits in case of death or dismemberment or loss of sight by accident or accidental means; or as
b. Operate to safeguard such contracts against lapse, or to give a special surrender value or special benefit or an annuity in the event that the insured or annuitant becomes totally and permanently disabled, as defined by the contract or supplemental contract;
(4) Reinsurance.
18 Del. C. 1953, §  3301;  56 Del. Laws, c. 380, §  1;  70 Del. Laws, c. 186, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3302. Short title.

§ 3302. Short title.
This subchapter may be cited as the “Uniform Health Policy Provisions Law.”
18 Del. C. 1953, §  3302;  56 Del. Laws, c. 380, §  1;  80 Del. Laws, c. 310, § 1;  81 Del. Laws, c. 78, § 5;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3303. Scope, format of policy [For application of this section, see 79 Del. Laws, c. 99, § 19].

§ 3303. Scope, format of policy [For application of this section, see 79 Del. Laws, c. 99, § 19].
No policy of health insurance shall be delivered or issued for delivery to any person in this State unless it otherwise complies with this title and complies with the following:
(1) The entire money and other considerations therefor shall be expressed therein;
(2) The time when the insurance takes effect and terminates shall be expressed therein;
(3) It shall purport to insure only 1 person, except that a policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family, who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children or any children under a specified age which shall not exceed 26 years and any other person dependent upon the policyholder;
(4) The style, arrangement and overall appearance of the policy shall give no undue prominence to any portion of the text, and every printed portion of the text of the policy and of any endorsements or attached papers shall be plainly printed in light-faced type of a style in general use, the size of which shall be uniform and not less than 10 points with a lower case unspaced alphabet length not less than 120 points (the “text” shall include all printed matter except the name and address of the insurer, name or title of the policy, the brief description, if any, and captions and subcaptions);
(5) The exceptions and reductions of indemnity shall be set forth in the policy and, other than those contained in §§ 3305-3326, inclusive, of this title, shall be printed, at the insurer's option, either included with the benefit provision to which they apply, or under an appropriate caption such as “exceptions,” or “exceptions and reductions,” except that if an exception or reduction specifically applies only to a particular benefit of the policy, a statement of such exception or reduction shall be included with the benefit provision to which it applies;
(6) Each such form, including riders and endorsements, shall be identified by a form number in the lower left-hand corner of the first page thereof; and
(7) The policy shall contain no provision purporting to make any portion of the charter, rules, constitution or bylaws of the insurer a part of the policy unless such portion is set forth in full in the policy, except in the case of the incorporation of, or reference to, a statement of rates or classification of risks, or short-rate table filed with the Commissioner.
(8) The policy shall contain no provision or nondisclosure clause prohibiting physicians or other health-care providers from giving patients information regarding diagnoses, prognoses and treatment options.
18 Del. C. 1953, §  3303;  56 Del. Laws, c. 380, §  1;  70 Del. Laws, c. 537, §  1;  70 Del. Laws, c. 186, §  1;  79 Del. Laws, c. 99, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3304. Required provisions; captions; omissions; substitutions.

§ 3304. Required provisions; captions; omissions; substitutions.
(a) Except as provided in subsection (b) of this section below, each such policy delivered or issued for delivery to any person in this State shall contain the provisions specified in §§ 3305-3316, inclusive, of this title, in the words in which the same appear; except, that the insurer may, at its option, substitute for 1 or more of such provisions corresponding provisions of different wording approved by the Commissioner which are in each instance not less favorable in any respect to the insured or the beneficiary. Each such provision shall be preceded individually by the applicable caption shown, or, at the option of the insurer, by such appropriate individual or group captions or subcaptions as the Commissioner may approve.
(b) If any such provision is in whole or in part inapplicable to or inconsistent with the coverage provided by a particular form of policy, the insurer, with the approval of the Commissioner, shall omit from such policy any inapplicable provision or part of a provision and shall modify any inconsistent provision or part of a provision in such manner as to make the provision as contained in the policy consistent with the coverage provided by the policy.
18 Del. C. 1953, §  3304;  56 Del. Laws, c. 380, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3305. Entire contract; changes.

§ 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 executive officer of the company and unless such approval be endorsed hereon or attached hereto. No agent has authority to change this policy or to waive any of its provisions.”
18 Del. C. 1953, §  3305;  56 Del. Laws, c. 380, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3306. Time limit on certain defenses.

§ 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 shall be used to void the policy or deny a claim for loss incurred as disability (as defined in the policy) commencing after the expiration of such 2-year period.
(2) No claim for loss incurred as disability (as defined in the policy) commencing 2 years from the date of issue of this policy shall be reduced or denied on the ground that a disease or physical condition not excluded from coverage by name or specific description effective on the date of loss had existed prior to the effective date of coverage of this policy.”
(b) The policy provision required by paragraph (a)(1) of this section above shall not be so construed as to affect any legal avoidance of a policy or denial of a claim during such initial 2-year period, nor to limit the application of §§ 3318-3320 of this title in the event of misstatement with respect to age or occupation or other insurance.
(c) A policy which the insured has the right to continue in force subject to its terms by the timely payment of premium (1) until at least age 50, or (2) in the case of a policy issued after age 44, for at least 5 years from its date of issue, may contain in lieu of the foregoing the following provision (from which the clause in parentheses may be omitted at the insurer's option) under the caption “Incontestable”:
“After this policy has been in force for a period of 2 years during the lifetime of the insured (excluding any period during which the insured is disabled), it shall become incontestable as to any statements, other than fraudulent statements, contained in the application.”
18 Del. C. 1953, §  3306;  56 Del. Laws, c. 380, §  1;  64 Del. Laws, c. 142, §  2;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3307. Grace period.

§ 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 due after the first premium, during which grace period the policy shall continue in force.”
A policy in which the insurer reserves the right to refuse any renewal shall have, at the beginning of the above provision:
“Unless not less than five days prior to the premium due date the company has delivered to the insured or has mailed to his/her last address as shown by the records of the company written notice of its intention not to renew this policy beyond the period for which the premium has been accepted.”
18 Del. C. 1953, §  3307;  56 Del. Laws, c. 380, §  1;  70 Del. Laws, c. 186, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3308. Reinstatement.

§ 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 premium, without requiring in connection therewith an application for reinstatement, shall reinstate the policy, provided, however, that if the company or such agent requires an application for reinstatement and issues a conditional receipt for the premium tendered, the policy will be reinstated upon approval of such application by the company or, lacking such approval, upon the forty-fifth day following the date of such conditional receipt unless the company has previously notified the insured in writing of its disapproval of such application. The reinstated policy shall cover only loss resulting from such accidental injury as may be sustained after the date of reinstatement and loss due to such sickness as may begin more than ten days after such date. In all other respects the insured and company shall have the same rights thereunder as they had under the policy immediately before the due date of the defaulted premium, subject to any provisions endorsed herein or attached hereto in connection with the reinstatement. Any premium accepted in connection with a reinstatement shall be applied to a period for which premium has not been previously paid, but not to any period more than sixty days prior to the date of reinstatement.”
(b) The last sentence of the above provision may be omitted from any policy which the insured has the right to continue in force subject to its terms by the timely payment of premiums:
(1) Until at least age 50; or
(2) In the case of a policy issued after age 44, for at least 5 years from its date of issue.
18 Del. C. 1953, §  3308;  56 Del. Laws, c. 380, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3309. Notice of claim.

§ 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. Notice given by or on behalf of the insured or the beneficiary to the company at . . . . . . . . . . . . . . (insert the location of such office as the company may designate for the purpose), or to any authorized agent of the company, with information sufficient to identify the insured, shall be deemed notice to the company.”
(b) In a policy providing a loss-of-time benefit which may be payable for at least 2 years, an insurer may at its option insert the following between the first and second sentences of the above provision:
“Subject to the qualifications set forth below, if the insured suffers loss of time on account of disability for which indemnity may be payable for at least two years, he/she shall, at least once in every six months after having given notice of the claim, give to the company notice of continuance of the disability, except in the event of legal incapacity. The period of six months following any filing of proof by the insured or any payment by the company on account of such claim or any denial of liability in whole or in part by the company shall be excluded in applying this provision. Delay in the giving of such notice shall not impair the insured's right to any indemnity which would otherwise have accrued during the period of six months preceding the date on which such notice is actually given.”
18 Del. C. 1953, §  3309;  56 Del. Laws, c. 380, §  1;  70 Del. Laws, c. 186, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3310. Claim.

§ 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 giving of such notice the claimant shall be deemed to have complied with the requirements of this policy as to proof of loss upon submitting, within the time fixed in the policy for filing proofs of loss, written proof covering the occurrence, the character and the extent of the loss for which claim is made. The nonhospital claim form to be used under this provision is the Health Care Financing Administration Form-1500 or its successor. This form requirement shall not apply to medical payments made by the federal government, prescription drug claims, dental claims or claims using an electronic paperless submission process.”
18 Del. C. 1953, §  3310;  56 Del. Laws, c. 380, §  1;  68 Del. Laws, c. 416, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3311. Proofs of loss.

§ 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 days after the termination of the period for which the company is liable and in case of claim for any other loss within ninety days after the date of such loss. Failure to furnish such proof within the time required shall not invalidate nor reduce any claim if it was not reasonably possible to give proof within such time, provided such proof is furnished as soon as reasonably possible and in no event, except in the absence of legal capacity, later than one year from the time proof is otherwise required.”
18 Del. C. 1953, §  3311;  56 Del. Laws, c. 380, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3312. Time of payment of claims.

§ 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 of such loss. Subject to due written proof of loss, all accrued indemnities for loss for which this policy provides periodic payment will be paid . . . . . . . . . . . . (insert period for payment which must not be less frequently than monthly) and any balance remaining unpaid upon the termination of liability will be paid immediately upon receipt of due written proof.”
18 Del. C. 1953, §  3312;  56 Del. Laws, c. 380, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3314. Physical examination; autopsy.

§ 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 pendency of a claim hereunder and to make an autopsy in case of death where it is not forbidden by law.”
18 Del. C. 1953, §  3314;  56 Del. Laws, c. 380, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3315. Legal actions.

§ 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 policy. No such action shall be brought after the expiration of three years after the time written proof of loss is required to be furnished.”
18 Del. C. 1953, §  3315;  56 Del. Laws, c. 380, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3316. Change of beneficiary.

§ 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 shall not be requisite to surrender or assignment of this policy or to any change of beneficiary or beneficiaries, or to any other changes in this policy.”
(b) The first clause of this provision, relating to the irrevocable designation of beneficiary, may be omitted at the insurer's option.
18 Del. C. 1953, §  3316;  56 Del. Laws, c. 380, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3317. Optional policy provisions.

§ 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 are in the words in which the same appear in the applicable section, except that the insurer may, at its option, use in lieu of any such provision a corresponding provision of different wording approved by the Commissioner which is not less favorable in any respect to the insured or the beneficiary. Any such provision contained in the policy shall be preceded individually by the appropriate caption or at the option of the insurer, by such appropriate individual or group captions or subcaptions as the Commissioner may approve.
18 Del. C. 1953, §  3317;  56 Del. Laws, c. 380, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3318. Change of occupation.

§ 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 compensation anything pertaining to an occupation so classified, the company will pay only such portion of the indemnities provided in this policy as the premium paid would have purchased at the rates and within the limits fixed by the company for such more hazardous occupation. If the insured changes his/her occupation to one classified by the company as less hazardous than that stated in this policy, the company, upon receipt of proof of such change of occupation, will reduce the premium rate accordingly and will return the excess pro rata unearned premium from the date of change of occupation or from the policy anniversary date immediately preceding receipt of such proof, whichever is the more recent. In applying this provision, the classification of occupational risk and the premium rates shall be such as have been last filed by the company prior to the occurrence of the loss for which the company is liable or prior to date of proof of change in occupation with the state official having supervision of insurance in the state where the insured resided at the time this policy was issued, but if such filing was not required, then the classification of occupational risk and the premium rates shall be those last made effective by the company in such state prior to the occurrence of the loss or prior to the date of proof of change in occupation.”
18 Del. C. 1953, §  3318;  56 Del. Laws, c. 380, §  1;  70 Del. Laws, c. 186, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3319. Misstatement of age.

§ 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. Laws, c. 380, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3322. Unpaid premiums.

§ 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 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3323. Conformity with state statutes.

§ 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 conform to the minimum requirements of such statutes.”
18 Del. C. 1953, §  3324;  56 Del. Laws, c. 380, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3324. Illegal occupation.

§ 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 engaged in an illegal occupation.”
18 Del. C. 1953, §  3325;  56 Del. Laws, c. 380, §  1;  80 Del. Laws, c. 310, § 1;
2023 Delaware Code › Title 18 - Insurance Code › Chapter 33. HEALTH INSURANCE CONTRACTS › Subchapter I. General Provisions › § 3325. Intoxicants and narcotics.

§ 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 the advice of a physician.”
18 Del. C. 1953, §  3326;  56 Del. Laws, c. 380, §  1;  80 Del. Laws, c. 310, § 1;