CHAPTER 323

FORMERLY

SENATE BILL NO. 258

AS AMENDED BY HOUSE AMENDMENT NO. 1

AN ACT TO AMEND CHAPTERS 33 AND 35, TITLE 18, DELAWARE CODE TO CLARIFY COVERAGE OF INSUREDS DURING A PERIOD OF HOSPITALIZATION WHEN INSURERS CHANGE OR TERMINATE.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:

Section 1. Amend Title 18, Delaware Code Chapter 33, Section 3313 by

adding a new subsection (c) and (d) as follows:

"(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: If you are in the hospital when this policy non-renews or terminates for any reason except non-payment of premium, this policy shall continue coverage for that hospitalization at the same benefit level for a ten-day period from the date of termination.'

(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 ten consecutive days of hospitalization under this policy at the level provided by this policy notwithstanding any pre-existing conditions or other similar exclusions for the duration of the single continuing period of hsopitalization.' 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."

Section 2. Amend Title 18, Delaware Code Chapter 35, Section 3517 by

adding the notation "(a)" at the beginning of the existing text thereof and adding a new subsection (b) and (c) as follows:

"(b) Notwithstanding the above, a group health insurance policy issued by a health insurer, health service corporation or health maintenance organization shall contain a provision which extends coverage for an insured who is hospitalized on the date coverage terminates for a period of ten consecutive days during a single period of continuous hospitalization, if coverage terminates for any reason except nonpayment of premium. Benefits shall continue at the same level as provided in the terminated policy for the ten-day period.

(c) Following the termination of the ten-day period set forth in (b) above, the succeeding insurer, if any, shall provide benefits for an insured who is hospitalized on the effective date of coverage at the level provided in the policy then in force notwithstanding any pre-existing conditions or other similar exclusions contained in the new policy. This provision applies only to a continuing single period of hospitalization."

Section 3. Nothing in this section shall require an insurer to pay for

services otherwise properly excluded under the terms of its policies.

Section 4. This Act shall apply to contracts issued or renewed ninety (90) days after its enactment.

Approved July 7, 1992.