(a) There shall be a provision as follows:
“Payment of Claims:
(b) The following provisions, or either of them, may be included with the foregoing provision at the option of the insurer:
(1) “If any indemnity of this policy shall be payable to the estate of the insured, or to an insured or beneficiary who is a minor or otherwise not competent to give a valid release, the company may pay such indemnity, up to an amount not exceeding $. . . . . . . . . . . . (insert an amount which shall not exceed $1,000), to any relative by blood or connection by marriage of the insured or beneficiary who is deemed by the company to be equitably entitled thereto. Any payment made by the company in good faith pursuant to this provision shall fully discharge the company to the extent of such payment.”
(2) “Subject to any written direction of the insured in the application or otherwise all or a portion of any indemnities provided by this policy on account of hospital, nursing, medical or surgical services may, at the company's option and unless the insured requests otherwise in writing not later than the time of filing proofs of such loss, be paid directly to the hospital or person rendering such services, but it is not required that the service be rendered by a particular hospital or person.”
(c) There shall be a provision as follows in contracts issued by an insurer, health service corporation or health maintenance organization:
“Payment of claims when coverage terminated during a period of hospitalization:
(d) There shall be a provision as follows in contracts issued by an insurer, health service corporation or health maintenance organization:
“If this policy immediately succeeds prior coverage, and if you are in the hospital when this coverage becomes effective, benefits for that hospitalization will start at the end of 10 consecutive days of hospitalization under this policy at the level provided by this policy notwithstanding any preexisting conditions or other similar exclusions for the duration of the single continuing period of hospitalization.”
The requirements of this subsection shall not apply to specified accident, specified disease, hospital indemnity, Medicare supplement, long-term care or other limited benefit health insurance policies.
Structure Delaware 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].
§ 3304. Required provisions; captions; omissions; substitutions.
§ 3305. Entire contract; changes.
§ 3306. Time limit on certain defenses.
§ 3312. Time of payment of claims.
§ 3314. Physical examination; autopsy.
§ 3316. Change of beneficiary.
§ 3317. Optional policy provisions.
§ 3320. Overinsurance; all coverages.
§ 3321. Relation of earnings to insurance.
§ 3323. Conformity with state statutes.
§ 3325. Intoxicants and narcotics.
§ 3327. Order of certain provisions.
§ 3328. Third-party ownership.
§ 3329. Requirements of other jurisdictions.
§ 3330. Policies issued for delivery in another state.
§ 3331. Conforming to statute.
§ 3334. Franchise health insurance law.
§ 3336. Midwife services reimbursement.
§ 3338. Coverage of cancer monitoring test.
§ 3338A. Equal reimbursement for oral and intravenous anticancer medication.
§ 3340. Child abuse or neglect — Individual coverage.
§ 3341. Newborns and mothers health protection.
§ 3342. Obstetrical and gynecological coverage.
§ 3342A. Contraceptive coverage.
§ 3344. Insurance coverage for diabetes.
§ 3344B. Cost sharing in prescription insulin drugs.
§ 3344C. Coverage for insulin pumps.
§ 3345. Annual pap smear coverage reimbursement.
§ 3346. Colorectal cancer screening.
§ 3347. Required coverage for reconstructive surgery following mastectomies.
§ 3349A. Required coverage for volunteer ambulance company services.
§ 3350. Prescription medication.
§ 3351B. Experimental treatment coverage.
§ 3352. Newborn and infant hearing screening; coverage and reimbursement.
§ 3353. Use of social security numbers on insurance cards.
§ 3355. Phenylketonuria (PKU) and other inherited metabolic diseases.
§ 3356. Required coverage for scalp hair prosthesis.
§ 3358. Dental services for children with a severe disability.
§ 3359. Health insurance; pharmacies; electronic reimbursement.
§ 3359B. Electronic medical (non-pharmaceutical) claims.
§ 3360. Screening of infants and toddlers for developmental delays.
§ 3362. Reimbursement for orthotic and prosthetic services.
§ 3363. Recommended immunizations.
§ 3364. Specialty tier prescription coverage.
§ 3365. School-based health centers.
§ 3366. Autism spectrum disorders coverage.
§ 3367. Payment for emergency medical services.
§ 3370. Telehealth and telemedicine.
§ 3370A. Network disclosure and transparency.
§ 3370C. Time of submitting claim for reimbursement.
§ 3370D. Coverage for epinephrine autoinjectors.
§ 3370E. Annual behavioral health well check [Effective Jan. 1, 2024].