Delaware Administrative Code
Title 18 - Insurance
1400 - Health Insurance Specific Provisions
1408 - Standards for Prompt, Fair and Equitable Settlement of Claims for Long-Term Care Insurance
Section 1408-3.0 - Definitions
The following words and terms, when used in this regulation, shall have the following meaning unless the context clearly indicates otherwise:
"Carrier" means any entity that provides long-term care insurance in this State. "Carrier" also includes any 3rd-party administrator or other entity that adjusts, administers or settles claims in connection with long-term care plans.
"Days" means calendar days.
"Institutional Provider" means a hospital, nursing home, or any other medical or health-related service facility caring for the sick or injured or providing care or other coverage which may be provided in a long-term care policy. An entity must be a Provider under this Regulation in order to be an Institutional Provider.
"Policyholder," "Insured," or "Subscriber" means a person covered under a long-term care insurance policy or a representative (other than a provider) designated by such person and entitled to make claims on his behalf.
"Provider" means any entity or individual licensed, certified, or otherwise permitted by law pursuant to Titles 16 or 24 of the Delaware Code to provide long-term care services, irrespective of whether the entity or the individual is a participating provider pursuant to a written agreement with the carrier. When used alone, the term "provider" shall include individual providers and institutional providers.
