Chapter 1. General Definitions and Provisions
TITLE 18
Insurance Code
Insurance
CHAPTER 1. GENERAL DEFINITIONS AND PROVISIONS
§ 101. Short title.
This part constitutes the Delaware Insurance Code.
18 Del. C. 1953, § 101; 56 Del. Laws, c. 380, § 1.;
§ 102. Definitions.
As used in this part:
(1) "Person" means corporations, companies, associations, firms, partnerships, societies and joint stock companies and individuals as is provided in § 302 of Title 1. In addition, "person" includes syndicates, organizations, statutory trusts, business trusts, attorneys-in-fact and every natural or artificial legal entity.
(2) "Insurance" means a contract whereby one undertakes to pay or indemnify another as to loss from certain specified contingencies or perils, called "risks," or to pay or grant a specified amount or determinable benefit in connection with ascertainable risk contingencies or to act as surety.
(3) "Insurer" includes every person engaged as principal and as indemnitor, surety or contractor in the business of entering into contracts of insurance; provided that with respect to a corporation established under Chapter 7 of Title 5, "insurer" means an insurance department or division of such corporation (but not the corporation itself) which maintains separate books and records in the same manner and to the same extent as if it were a separately incorporated subsidiary of such corporation, with separate capital accounts, assets and liabilities.
(4) "Commissioner" means the Insurance Commissioner of this State.
(5) "Department" means the Insurance Department of this State.
(6) A "domestic" insurer is one formed under the laws of this State.
(7) A "foreign" insurer is one formed under the laws of any jurisdiction other than this State.
(8) An "alien" insurer is a foreign insurer formed under the laws of any country other than the United States of America, its states, districts, commonwealths and possessions.
(9) The "domicile" of an insurer means:
a. As to Canadian insurers, the province in which the insurer's head office is located;
b. As to other alien insurers authorized to transact insurance in one or more states, as provided in § 532 (retaliatory provision) of this title;
c. As to alien insurers other than those referred to in a. or b. above, the country under the laws of which the insurer was formed;
d. As to all other insurers, the state under the laws of which the insurer was formed.
(10) An "authorized" insurer is one duly authorized to transact insurance in this State by a subsisting certificate of authority issued by the Commissioner.
(11) "Balance billing" means a health care provider's demand that a patient pay a greater amount for a given service than the amount the individual's insurer, managed care organization or health service corporation has paid or will pay for the service.
(12) "Third-party administrator" shall mean a person, firm or entity who directly or indirectly underwrites, collects charges or premiums from, or who approves, denies, adjusts or settles claims on residents of this State, in connection with health coverage offered or provided by an insurer. A third-party administrator shall be subject to the jurisdiction of the Department of Insurance. A third-party administrator shall not include any person, firm or entity who operates a billing and/or paying service only and who does not perform any of the other functions of a third-party administrator described above. Additionally, a third-party administrator shall not include any person, firm or entity which holds a certificate of authority as an insurer, health service corporation, MCO, or HMO under this title. The Commissioner shall promulgate regulations which shall provide for the registration, licensing and regulation of third-party administrators and enforcement of applicable provisions of this title to third-party administrators. Third-party administrators doing business in this State shall pay all fees and costs for registration, examination, assessments, fines and/or penalties as provided for in this title or as the Commissioner shall establish by regulation. All revenues from the application of this provision to third-party administrators shall be deposited in accordance with the provisions of § 305 of this title.
18 Del. C. 1953, § 102; 56 Del. Laws, c. 380, § 1; 67 Del. Laws, c. 223, § 17; 73 Del. Laws, c. 96, § 3; 73 Del. Laws, c. 329, § 60; 74 Del. Laws, c. 157, § 4.;
§ 103. "Transacting insurance" defined.
In addition to other aspects of insurance operations to which provisions of this title by their terms apply, "transact" with respect to a business of insurance includes any of the following:
(1) Solicitation or inducement;
(2) Negotiations;
(3) Effectuation of a contract of insurance;
(4) Transaction of matters subsequent to effectuation and arising out of such a contract.
18 Del. C. 1953, § 103; 56 Del. Laws, c. 380, § 1.;
§ 104. Application of Code as to particular types of insurers.
No provision of this title shall apply with respect to:
(1) Domestic mutual assessment property insurers, except as stated in Chapter 53 (Mutual Assessment Property Insurers) of this title;
(2) Domestic mutual benefit associations, except as stated in Chapter 55 (Mutual Benefit Associations) of this title;
(3) Fraternal benefit societies, except as stated in Chapter 62 (Fraternal Benefit Societies) of this title.
18 Del. C. 1953, § 104; 56 Del. Laws, c. 380, § 1; 66 Del. Laws, c. 401, § 1; 69 Del. Laws, c. 111, § 2.;
§ 105. Particular provisions prevail.
Provisions of this title as to a particular kind of insurance, type of insurer or matter shall prevail over provisions relating to insurance, insurers or matters in general.
18 Del. C. 1953, § 105; 56 Del. Laws, c. 380, § 1.;
§ 106. General penalty.
(a) Each violation of this title for which a greater penalty is not provided by a provision of this title or other applicable laws of this State, in addition to any applicable prescribed denial, suspension or revocation of certificate of authority or license shall, upon conviction thereof, subject the violator to a fine of not more than $2,300 or imprisonment of not more than 1 year, or both, except that if the violator is a corporation, the fine shall be not more than $6,900 as to each violation. Any director, officer, manager, employee or representative of a corporation shall be subject to fine and imprisonment as above provided.
(b) Prosecutions for any such violation shall be brought in the Superior Court of the county in which the offense occurred.
(c) At the discretion of the Commissioner and the Attorney General, any fine provided for above may be recovered on behalf of the State by a civil action brought against the violator.
18 Del. C. 1953, § 106; 56 Del. Laws, c. 380, § 1; 58 Del. Laws, c. 278, § 1; 67 Del. Laws, c. 260, § 1.;