Disability
Q. My Short-Term or Long-Term Disability claim has been denied and I’m no longer receiving my payment checks. What do I do?
First, you will need to find out what the company’s denial reason is and what the appeal guidelines are. To file a complaint to the department, and an appeal is available, you will need to submit:
- A written appeal request
- Letters of continued disability from ALL your treating providers
- Any new/not previously reviewed medical records, notes, test results to include: proof of continued care, course of treatment plan, and final prognosis.
**Please note, the department has limited authority or jurisdiction under Delaware Title 18 Insurance Laws regarding disability policies. WE CANNOT MAKE MEDICAL DECISIONS. The member has the right to bring a civil action under Section 502(a) of the Employee Retirement Income Security Act of 1974.
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General
Q. I was told the Department sells insurance. Can you tell me which carrier would be best?
As a regulatory agency, we enforce the current insurance laws for insurance carriers and agents/producers licensed in the state of Delaware. We do not sell insurance and as a regulatory agency, we have to remain impartial and cannot recommend or suggest one carrier over another.
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Homeowner’s
Q. Where can I get homeowner’s insurance?
There are many resources to assist you in obtaining homeowners insurance.
- Contact insurance agents/producers in the yellow pages of the phone book
- Contact insurance companies directly
- If you are not able to obtain homeowners insurance through a standard voluntary market, you may contact the Delaware FAIR Plan by phone at (800) 462-4972 or https://www.defairplan.com
Q. When can an insurance company cancel a homeowner policy after the coverage has been in effect for more than 60 days?
The policy may be cancelled when:
- The premium payment is not paid by the due date.
- There is fraud or material misrepresentation made by the policyholder.
- Willful or reckless acts or omissions by the policyholder increases property hazards.
- A change in the risk increases property hazard.
- A violation of fire, health, safety, building or construction regulation or ordinance increases any hazard.
- The continuation of the policy would place the insurance company in violation of state insurance laws.
- Taxes owed on the property have been delinquent for 2 or more years.
Q. When can an insurance company non-renew a homeowner policy?
A policy can be non-renewed when:
- 3 or more weather related claims have been made during the 36 months immediately preceding the expiration of the current policy period.
- 2 or more non-weather related claims have been made.
- A combination of weather related and non-weather related claims have been made during the 36 months immediately preceding the expiration of the current policy period.
- There has been a substantial change or increase in the hazard or risk.
- The policyholder has refused or failed to make necessary changes or repairs that change or increase the hazard or risk.
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Life
Q. My loved one has passed away and I think they had a life insurance policy but can’t find it. How do I find out if they had a life insurance policy?
The Delaware Department of Insurance (the “Department”) provides a missing policy search service to Delaware residents and their families to help them identify Delaware in force individual life insurance policies on the life of a deceased family member or Delaware individual annuity contracts where the deceased family member is an annuitant. This search applies only to companies who currently sell these products in Delaware. This a consumer service provided to Delawareans in an attempt to assist consumers and the Department does not guarantee that a policy will be located.
Who can submit a request: An executor, beneficiary or legal representative of:
- a deceased resident of Delaware; or
- a deceased, former resident of Delaware, who resided in Delaware at the time a policy was issued or an annuity purchased
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Personal Auto
Q. Is a 16 year old required to be placed on their parents’ auto policy when they first get their license/permit or can they wait until the license graduates at 17 years old?
The decision is totally up to the Insurance Company underwriting guidelines. Delaware does not have a law that requires a 16 year old with a permit to be placed on their parents’ policy, the insurance company underwriting department can make that decision.
If the 16 year old gets into an accident and the insurance company previously decided not to place them on the policy until the license graduates; the 16 year old will be force-placed on the policy and rated as well.
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