RELATING TO ACCIDENT AND SICKNESS INSURANCE
AN ACT TO AMEND TITLE 18, DELAWARE CODE, RELATING TO ACCIDENT AND SICKNESS INSURANCE; TO ADD A NEW CHAPTER ENTITLED "ACCIDENT AND SICKNESS INSURANCE" PROVIDING FOR ACCIDENT AND SICKNESS POLICY PROVISIONS, AND TO AMEND AND REPEAL SECTIONS IN CONFLICT THEREWITH.
Be it enacted by the General Assembly of the State of Delaware:
Section 1. Title 18, Delaware Code, is amended by adding a new chapter as follows:
ACCIDENT AND SICKNESS INSURANCE
§ 3101. Purpose
The purpose of this chapter is to enact the provisions of the "Uniform Individual Accident and Sickness Provisions Law" as approved and adopted by the National Association of Insurance Commissioners on June 15, 1950. The General Assembly declares that this is a subject of concern respecting the health and welfare of the residents of this State, and considers it to be in the public interest to establish these standards with which individual policies of accident and sickness insurance must comply.
§ 3102. Definition of accident and sickness insurance policy
As used in this chapter, the term "policy of accident and sickness insurance" includes any policy or contract covering insurance against loss resulting from sickness or from bodily injury or death by accident, or both.
§ 3103. Form of policy
(a) No policy of accident and sickness insurance shall be delivered or issued for delivery to any person in this State unless;
(1) the entire money and other considerations therefor are expressed therein ;
(2) the time at which the insurance takes effect and terminates is expressed therein ;
(3) it purports to insure only one 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 two or more eligible members of that family, including husband, wife, dependent children or any children under a specified age which shall not exceed nineteen years and any other person dependent upon the policyholder;
(4) the style, arrangement and over-all appearance of the policy give no undue prominence to any portion of the text, and unless every printed portion of the text of the policy and of any endorsements or attached papers is plainly printed in light-faced type of a style in general use, the size of which shall be uniform and not less than ten-point with a lower-case unspaced alphabet length not less than one hundred and twenty-point (the "text" shall include all printed matter except the name and address of the insurance company, name or title of the policy, the brief description if any, and captions and subcaptions) ;
(5) the exceptions and reductions of indemnity are set forth in the policy and, except those which are set forth in section 3104 of this chapter, are printed, at the insurance company's option, either included with the benefit provision to which they apply, or under an appropriate caption such as EXCEPTIONS, or EXCEPTIONS AND REDUCTIONS, provided 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) it contains no provision purporting to make any portion of the charter, rules, constitution, or by-laws of the insurance company 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.
(b) If any policy is issued by an insurance company domiciled in this State for delivery to a person residing in another state, and if the official having responsibility for the administration of the insurance laws of such other state shall have advised the Commissioner that any such policy is not subject to approval or disapproval by such official, the Commissioner may by ruling require that such policy meet the standards set forth in subsection (a) of this section and in section 3104.
§ 3104. Accident and sickness policy provisions
(a) Required Provisions. Except as provided in subsection (c) of this section each such policy delivered or issued for delivery to any person in this State shall contain the provisions specified in this subsection in the words in which the same appear in this section; provided, however, that the insurance company may, at its option, substitute for one 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. Such provisions shall be preceded individually by the caption appearing in this subsection or, at the option of the insurance company, by such appropriate individual or group captions or subcaptions as the Commissioner may approve.
(1) 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.
(2) A provision as follows : TIME LIMIT ON CERTAIN DEFENSES : (A) After three 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 to deny a claim for loss incurred or disability (as defined in the policy) commencing after the expiration of such three year period.
The foregoing policy provision shall not be so construed as to affect any legal requirement for avoidance of a policy or denial of a claim during such initial three year period, nor to limit the application of section 3104 (b) (1), (2), (3), (4) and (5) in the event of misstatement with respect to age or occupation or other insurance.
A policy which the insured has the right to continue in force subject to its terms by the timely payment of premium (a) until at least age 50 or, (B) in the case of a policy issued after age 44, for at least five 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 insurance company's option, under the caption INCONTESTABLE: After this policy has been in force for a period of three years during the lifetime of the insured (excluding any period during which the insured is disabled), it shall become incontestable as to the statements contained in the application.
(B) No claim for loss incurred or disability (as defined in the policy) commencing after three 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.
(2) A provision as follows : GRACE PERIOD: 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 which contains a cancellation provision may add, at the end of the above provision: subject to the right of the company to cancel in accordance with the cancellation provision hereof.
A policy in which the insurance company 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 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.
(4) 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 company 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 hereon 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.
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 five years from its date of issue.
(5) 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.
In a policy providing a loss-of-time benefit which may be payable for at least two years, an insurance company 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 shall, at least once in every six months after having given notice of claim, give to the company notice of continuance of said 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.
(5) 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.
(7) 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.
(0) 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.
(0) A provision as follows: PAYMENT OF CLAIMS : Indemnity for loss of life will be payable in accordance with the beneficiary designation and the provisions respecting such payment which may be prescribed herein and effective at the time of payment. If no such designation or provision is then effective, such indemnity shall be payable to the estate of the insured. Any other accrued indemnities unpaid at the insured's death may, at the option of the company, be paid either to such beneficiary or to such estate. All other indemnities will be payable to the insured.
The following provisions, or either of them, may be included with the foregoing provision at the option of the insurance company: (A) 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 $1000), 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. (B) 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.
(10) 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.
(11) 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.
(12) A provision as follows : CHANGE OF BENEFICIARY: Unless the insured makes an irrevocable designation of beneficiary, the right to change of 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.
The first clause of this provision, relating to the irrevocable designation of beneficiary, may be omitted at the insurance company's option.
(b) Other Provisions. Except as provided in subsection (c) of this section, no such policy delivered or issued for delivery to any person in this State shall contain provisions respecting the matters set forth below unless such provisions are in the words-in which the same appear in this section ; provided, however, that the insurance company 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 appearing in this subsection or, at the option of the insurance company, by such appropriate individual or group captions or subcaptions as the Commissioner may approve.
(1) A provision as follows : CHANGE OF OCCUPATION : If the insured be injured or contract sickness after having changed his 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 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-rate 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.
(2) 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.
(3) A provision as follows: OTHER INSURANCE IN THIS COMPANY : If an accident or sickness or accident and sickness policy or policies previously issued by the company to the insured be in force concurrently herewith, making the ag-
gregate indemnity for (insert type of coverage
or coverages) in excess of $ (insert maximum limit
of indemnity or indemnities) the excess insurance shall be void and all premiums paid for such excess shall be returned to the insured or to his estate.
Or in lieu thereof : Insurance effective at any one time on the insured under a like policy or policies in this company is limited to the one such policy elected by the insured, his beneficiary or his estate, as the case may be, and the company will return all premiums paid for all other such policies.
(0) A provision as follows: INSURANCE WITH OTHER COMPANIES : If there be other valid coverage, not with this company, providing benefits for the same loss on a provision of service basis or on an expense incurred basis and of which this company has not been given written notice prior to the occurrence or commencement of loss, the only liability under any expense incurred coverage of this policy shall be for such proportion of the loss as the amount which would otherwise have been payable hereunder plus the total of the like amounts under all such other valid coverages for the same loss of which this company had notice bears to the total like amounts under all valid coverages for such loss, and for the return of such portion of the premiums paid as shall exceed the pro-rata portion for the amount * so determined. For the purpose of applying this provision when other coverage is on a provision of service basis,
the "like amount" of such other coverage shall be taken as the amount which the services rendered would have cost in the absence of such coverage.
If the foregoing policy provision is included in a policy which also contains the next following policy provision there shall be added to the caption of the foregoing provision the phrase EXPENSE INCURRED BENEFITS. The insurance company may, at its option, include in this provision a definition of "other valid coverage", approved as to form by the Commissioner, which definition shall be limited in subject matter to coverage provided by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada, and by hospital or medical service organizations, and to any other coverage the inclusion of which may be approved by the Commissioner. In the absence of such definition such term shall not include group insurance, automobile medical payments insurance, or coverage provided by hospital or medical service organizations or by union welfare plans or employer or employee benefit organizations. For the purpose of applying the foregoing policy provision with respect to any insured, any amount of benefit provided for such insured pursuant to any compulsory benefit statute (including any workmen's compensation or employer's liability statute) whether provided by a governmental agency or otherwise shall in all cases be deemed to be other valid coverage of which the insurance company has had notice. In applying the foreging policy provision no third party liability coverage shall be included as other valid coverage.
(5) A provision as follows: INSURANCE WITH OTHER COMPANIES : If there be other valid coverage, not with this company, providing benefits for the same loss on other than an expense incurred basis and of which this company has not been given written notice prior to the occurrence or commencement of loss, the only liability for such benefits under this policy shall be for such proportion of the indemnities otherwise provided hereunder for such loss as the like indemnities of which the company had notice (including the indemnities under this policy) bear to the total amount of all like indemnities for such loss, and for the return of such portion of the premium paid as shall exceed the pro-rata portion for the indemnities thus determined.
If the foregoing policy provision is included in a policy which also contains the next preceding policy provision there shall be added to the caption of the foregoing provision the phrase OTHER BENEFITS. The insurance company may, at its option, include in this provision a definition of "other valid coverage", approved as to form by the Commissioner, which definition shall be limited in subject matter to coverage provided by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada, and to any other coverage the inclusion of which may be approved by the Commissioner. In the absence of such definition such term shall not include group insurance, or benefits provided by union welfare plans or by employer or employee benefit organizations. For the purpose of applying the foregoing policy provision with respect to any insured, any amount of benefit provided for such insured pursuant to any compulsory benefit statute (including any workmen's compensation or employer's liability statute) whether provided by a governmental agency or otherwise shall in all cases be deemed to be other valid coverage of which the insurance company has had notice. In applying the foregoing policy provision no third party liability coverage shall be included as other valid coverage.
(6) A provision as follows: RELATION OF EARNINGS TO INSURANCE: If the total monthly amount of loss of time benefits promised for the same loss under all valid loss of time coverage upon the insured, whether payable on a weekly or monthly basis, shall exceed the monthly earnings of the insured at the time disability commenced or his average monthly earnings for the period of two years immediately preceding a disability for which claim is made, whichever is the greater, the company will be liable only for such proportionate amount of such benefits under this policy as the amount of such monthly earnings or such average monthly earnings of the insured bears to the total amount of monthly benefits for the same loss under all such coverage upon the insured at the time such disability commences and for the return of such part of the premiums paid during such two years as shall exceed the pro-rata amount of the premiums for the benefits actually paid hereunder; but this shall not operate to reduce the total monthly amount of
benefits payable under all such coverage upon the insured below the sum of two hundred dollars or the sum of the monthly benefits specified in such coverages, whichever is the lesser, nor shall it operate to reduce benefits other than those payable for loss of time.
The foregoing policy provision may be inserted only in a 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 insured after age 44, for at least five years from its date of issue. The insurance company may, at its option, include in this provision a definition of "valid loss of time coverage", approved as to form by the Commissioner which definition shall be limited in subject matter to coverage provided by governmental agencies or by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada, or to any other coverage the inclusion of which may be approved by the Commissioner or any combination of such coverages. In the absence of such definition such term shall not include any coverage provided for such insured pursuant to any compulsory benefit statute (including any workmen's compensation or employer's liability statute), or benefits provided by union welfare plans or by employer or employee benefit organizations.
(7) 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.
(8) A provision as follows: CANCELLATION: The company may cancel this policy at any time by written notice delivered to the insured, or mailed to his last address as shown by the records of the company, stating when, not less than five days thereafter, such cancellation shall be effective; and after the policy has been continued beyond its original term the insured may cancel this policy at any time by written notice delivered or mailed to the company, effective upon receipt or on such later date as may be specified in such notice. In the event of cancellation, the company will return promptly the unearned portion of any premium paid. If the insured cancels, the earned
premium shall be computed by the use of the short-rate table last filed with the state official having supervision of insurance in the state where the insured resided when the policy was issued. If the company cancels, the earned premium shall be computed pro-rata. Cancellation shall be without prejudice to any claim originating prior to the effective date of cancellation.
(9) 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.
(10) 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.
(11) 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 intaicicated or under the influence of any narcotic unless administered on the advice of a physician.
(c) Inapplicable or inconsistent provisions. If any provision of this section is in whole or in part inapplicable to or inconsistent with the coverage provided by a particular form of policy the insurance company, 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 the provision in such manner as to make the provision as contained in the policy consistent with the coverage provided by the policy.
(d) Order of certain policy provisions. The provisions which are the subject of subsections (a) and (b) of this section, or any corresponding provisions which are used in lieu thereof in accordance with such subsections, shall be printed in the consecutive order of the provisions in such subsections or, at the option of the insurance company, any such provision may appear
as a unit in any part of the policy, with other provisions to which it may be logically related, provided the resulting policy shall not be in whole or in part unintelligible, uncertain, ambiguous, abstruse, or likely to mislead a person to whom the policy is offered, delivered or issued.
(e) Third party ownership. As used in this chapter, the word "insured" shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnities, benefits and rights provided therein.
(f) Requirements of other jurisdictions.
(1) Any policy of a foreign or alien insurance company, when delivered or issued for delivery to any person in this state, may contain any provision which is not less favorable to the insured or the beneficiary than the provisions of this chapter and which is prescribed or required by the law of the state under which the insurance company is organized.
(2) Any policy of a domestic insurance company may, when issued for delivery in any other state or country, contain any provision permitted or required by the laws of such other state or country.
(g) Approval and filing of forms.
(1) No policy of accident and sickness insurance shall be issued or delivered to any person in this State, or shall be issued anywhere by an insurance company organized under the laws of this State, nor shall any application, rider or endorsement be used in connection therewith until a copy of the form thereof and of the classification or risk and the premium rates, or, in the case of cooperatives or assessment companies the estimated cost pertaining thereto have been filed with the Commissioner. The Commissioner may make such reasonable rules and regulations concerning the procedure for the filing or submission of policies subject to this chapter as are necessary, proper or advisable to the administration of this chapter. This provision shall not abridge any other authority granted the Commissioner by law.
(2) No such policy shall be issued, nor shall any application, rider or endorsement be used in connection therewith, until the expiration of 30 days after it has been so filed unless the Commissioner shall sooner give his written approval thereto.
(3) The Commissioner may within 30 days after the filing of any such form, disapprove such form (A) if the benefits provided therein are unreasonable in relation to the premium charged, or (B) if it contains a provision or provisions which are unjust, unfair, inequitable, misleading, deceptive or such as to encourage misrepresentation of such policy, or (C) if it fails to comply with any of the requirements of this chapter. If the Commissioner notifies the insurance company which has filed any such form that it does not comply with the provisions of this subsection, such company shall not thereafter issue such form or use it in connection with any policy. In such notice the Commissioner shall specify the reasons for his disapproval and state that a hearing will be granted within 20 days after request in writing by the insurance company.
(4) The Commissioner may at any time, after a hearing of which not less than 20 days' written notice shall have been given to the insurance company, withdraw his approval of any such form on any of the grounds stated in this subsection. The insurance company shall not issue such form or use it in connection with any policy after the effective date of such withdrawal of approval. The notice of any hearing called under this subsection shall specify the matters to be considered at such hearing and any decision affirming disapproval or directing withdrawal of approval under this subsection shall be in writing and shall specify the reasons therefor.
§ 3105. Conforming to statute
(a) No policy provision which is not subject to section 3104 of this chapter shall make a policy, or any portion thereof, less favorable in any respect to the insured or the beneficiary than the provisions therof which are subject to this chapter.
(b) A policy delivered or issued for delivery to any person in this State in violation of this chapter shall be held valid but
shall be construed as provided in this chapter. When any provision in a policy subject to this chapter is in conflict with any provision of this chapter, the rights, duties and obligations of the insurance company, the insured and the beneficiary shall be governed by the provisions of this chapter.
§ 3106. Application
(a) The insured shall not be bound by any statement made in an application for a policy unless a copy of such application is attached to or endorsed on the policy when issued as a part thereof. If any such policy delivered or issued for delivery to any person in this State shall be reinstated or renewed, and the insured or the beneficiary or assignee of such policy shall make written request to the insurance company for a copy of the application, if any, for such reinstatement or renewal, the insurance company shall within fifteen days after the receipt of such request at its home office or any branch office of the insurance company, deliver or mail to the person making such request, a copy of such application. If such copy shall not be so delivered or mailed, the insurance company shall be precluded from introducing such application as evidence in any action or proceeding based upon or involving such policy or its reinstatement or renewal.
No alteration of any written application for any such policy shall be made by any person other than the applicant without his written consent, except that insertions may be made by the insurance company, for administrative purposes only, in such manner as to indicate clearly that such insertions are not to be ascribed to the applicant.
() The falsity of any statement in the application for any policy covered by this chapter may not bar the right to recovery thereunder unless such false statement materially affected either the acceptance of the risk or the hazard assumed by the insurance company.
§ 3107. Notice, waiver
The acknowledgement by any insurance company of the receipt of notice given under any policy covered by this chapter, or the furnishing of forms for filing proofs of loss, or the ac-
ceptance of such proofs, or the investigation of any claim thereunder shall not operate as a waiver of any of the rights of the insurance company in defense of any claim arising under such policy.
§ 3108. Age limit
If any such policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if such date falls within a period for which premium is accepted by the insurance company or if the insurance company accepts a premium after such date, the coverage provided by the policy will continue in force subject to any right of cancellation until the end of the period for which premium has been accepted. In the event the age of the insured has been misstated and if, according to the correct age of the insured, the coverage provided by the policy would not have become effective, or would have ceased prior to the acceptance of such premium or premiums, then the liability of the insurance company shall be limited to the refund, upon request, of all premiums paid for the period not covered by the policy.
§ 3109. Non-application to certain policies
Nothing in this chapter shall apply to or affect (1) any policy of workmen's compensation insurance or any policy of liability insurance with or without supplementary coverage therein ; or (2) any policy or contract of reinsurance ; or (3) any blanket or group policy of insurance; or (4) life insurance, endowment or annuity contracts, or contracts supplemental thereto which contain only such provisions relating to accident and sickness insurance as (a) provide additional benefits in case of death or dismemberment or loss of sight by accident, 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 shall become totally and permanently disabled, as defined by the contract or supplemental contract.
§ 3110. Violation
Any person, partnership or corporation willfully violating any provision of this chapter or order of the Commissioner made
in accordance with this chapter, shall forfeit to the people of the State a sum not to exceed $500 for each such violation, which may be recovered by a civil action. The Commissioner may also suspend or revoke the license of an insurance company or agent for any such willful violation.
§ 3111. Judicial review
(a) Any order, decision or act of the Commissioner under this chapter shall be subject to judicial review upon petition of any company, person or organization aggrieved. The appeal shall be to the Court of Chancery in any county of this State. A petition for the review of the action of the Commissioner shall be filed within 60 days from notice of the order, decision or act of the Commissioner. The commencement of such proceeding shall not affect the enforcement or validity of the Commissioner's action under review unless the court shall determine after notice to the Commissioner, that a stay of enforcement until further direction of the court will not unduly injure the interests of the public.
(b) The Commissioner may, through the Attorney General of this State, invoke the aid of the Court of Chancery to enforce any order made or action taken by him pursuant to this chapter, which proceedings may be instituted in any county of the state as may seem most convenient. In such proceedings, the court may make such orders, either preliminary or final, as it deems right and proper under the facts as presented and established before it.
§ 3112. Effective date of chapter
A policy, rider or endorsement, which could have been lawfully used or delivered or issued for delivery to any person in this State immediately before the effective date of this chapter may be used or delivered or issued for delivery to any such person during five years after the effective date of this chapter without being subject to the proVisions of sections 3103, 3104 or 3105 of this chapter.
(b) (2) Accident and health insurance;
Section 3. § 2317, Title 18, Delaware Code, is amended by striking out and repealing said section.
Approved June 23, 1955.