Accident/Health Cert - DE Title 18 - Chapters 3 - 25

The Commissioner shall be elected by 1. _______ at a general election for 2. _______ and shall be commissioned by 3. ________.

1. The qualified electors of the state
2. a term of 4 years
3. the Governor

The Commissioner shall assume office on

The 1st Tuesday of January after election

Orders and notices of the Commissioner shall be effective only when

in writing signed by the Commissioner or by the Commissioner's authority.

Every order of the Commissioner shall state its effective date and shall concisely state what 3 things?

(1) Its intent or purpose;
(2) The grounds on which based;
(3) The provisions of this title pursuant to which action is taken or proposed to be taken; but failure to so designate a particular provision shall not deprive the Commissioner of the right to re

[313] The Commissioner, through the Attorney General of this State, may invoke the aid of

The Superior Court, through proceedings instituted in any county of this State, to enforce any lawful order made or action taken by the Commissioner.

The Commissioner will conduct an examination of every insurer licensed in this State not less frequently than

Every 5 years

[320] Upon determining that an examination should be conducted, the Commissioner shall issue an

Examination warrant appointing 1 or more examiners to perform the examination and instructing them as to the scope of the examination.

Following the completion of the examination, the examiner in charge shall file with the Department a verified written report of Examination under oath, No later than __ days after the exam

60 days

Upon receipt of the verified report, the Department shall transmit the report to the company examined, together with a notice which shall afford the company examined a reasonable opportunity of not more than __ days to make a written submission or rebutta

30 days

The Commissioner shall furnish a copy of the report to the person examined not less than

20 days prior to filing the same in the Department

The expense of examination of an insurer shall be borne by

The person/insurer examined

If the Commissioner finds that the application is made in good faith the Commissioner shall hold the hearing within

30 days after filing of the application unless postponed by mutual consent.

[324] Notice of hearing.
(a) Except where a longer period is expressly provided in this title, the Commissioner shall give written notice of the hearing to all parties not less than

20 days in advance

The Commissioner may hold a hearing in

Dover or any other place of convenience to parties and witnesses as the Commissioner determines

In no event shall the administrative penalty per violation exceed:

$15,000 for those licensed under Chapter 17 of this title, and $50,000 per violation for insurance companies, insurance holding companies and all other persons licensed under this title.

Health-care provider

An entity licensed by this State to provide health-care or professional services, provided, however, that the term "health-care provider" shall not mean or include the following:
a. Any nursing service or facility conducted by or for those who rely upon t

Insurance Carrier

Any entity that provides health insurance in this State. Includes an insurance company, health services corporation, health maintenance organization and any other entity providing a plan of health insurance or health benefits subject to state insurance re

The arbitration program shall be administered by

the Department of Insurance

Health-care providers shall attempt to resolve disputes how before requesting formal proceedings?

informally with insurance carriers before requesting arbitration pursuant to this section

[501] "Stock insurer" defined

A "stock insurer" is an incorporated insurer with its capital divided into shares and owned by its stockholders

[502] "Mutual" insurer defined.

A "mutual" insurer is an incorporated insurer without capital stock and the governing body of which is elected by its policyholders

[503] "Reciprocal" insurer defined.

A "reciprocal" insurer is an unincorporated aggregation of subscribers operating individually and collectively through an attorney-in-fact common to all such persons to provide reciprocal insurance among themselves.

To apply for an original certificate of authority, an insurer shall file with the Commissioner it's:

If a life or health insurer, a copy of the insurer's rate book and each form of policy (and application) currently proposed to be issued in this State

Although issued and delivered to the insurer, the certificate of authority at all times shall be the property of

the State

[536] "Funding agreement

A "funding agreement" is an agreement for an insurer to accept and accumulate funds and to make 1 or more payments at future dates in amounts that are not based on mortality or morbidity contingencies (of the holder of the funding agreement).

[903] "Health insurance

Health insurance is insurance of human beings against bodily injury, disablement or death by accident or accidental means, or the expense thereof, or against disablement or expense resulting from sickness, and every insurance appertaining thereto.

[1108] Health insurance policy reserves
For all health insurance policies the insurer shall maintain an active

Life reserve which shall place a sound value on its liabilities under such policies and be not less than the reserve according to appropriate standards set forth in regulations issued by the Commissioner and, in no event, less in the aggregate than the pr

[1704] Exceptions to licensing - A person who secures and furnishes information for the purpose of group or blanket accident and health insurance, where no commission is paid,

Is not required to be licensed.

[1925f] - One-third of the funds received by the Insurance Commissioner in accordance with the provisions of subsection (b) of this section shall be paid to the State Treasurer and shall be set aside as a special fund to provide funding for

Health insurance premiums for retired county and municipal police and firefighters

[Chapter 23] - No person shall make or permit any unfair discrimination between Individuals of the same class and of essentially the same hazard in the amount of

Premium, policy fees or rates charged for any policy or contract of accident or health insurance or in the benefits payable thereunder, or in any of the terms or conditions of such contract, or in any other manner whatever.