Delaware § 8805 - Policy conditions.

§ 8805. Policy conditions.

(a) (1) A pet insurer may issue a policy that excludes coverage on the basis of 1 or more preexisting conditions with appropriate disclosure to the consumer. The pet insurer has the burden of proving that the preexisting condition exclusion applies to the condition for which a claim is being made.

(2) A condition for which coverage is afforded on a policy may not be considered a preexisting condition on a renewal of the policy.

(b) A pet insurer may issue a policy that imposes a waiting period on effectuation of the policy that does not exceed 30 days for an illness or orthopedic condition not resulting from an accident. A waiting period for accidents is prohibited.

(1) A pet insurer utilizing a waiting period permitted under this subsection (b) shall include a provision in the contract that allows the waiting period to be waived upon completion of a medical examination. A pet insurer may require the examination to be conducted by a licensed veterinarian after the purchase of the policy.

a. The policyholder must pay for a medical examination under subsection (b) of this section, unless the policy specifies that the pet insurer must pay for the examination.

b. A pet insurer may specify an element to be included as part of the examination and require documentation thereof, but a specification may not unreasonably restrict a consumer’s ability to waive a waiting period under subsection (b) of this section.

(2) A waiting period, and a requirement applicable to a waiting period, must be clearly and prominently disclosed to consumers prior to the policy purchase.

(3) A waiting period may not be applied to a renewal of existing coverage.

(c) A pet insurer may not require a veterinary examination of the covered pet for the insured to have the insured’s policy renewed.

(d) If a pet insurer includes a prescriptive, wellness, or noninsurance benefit in the policy form, the benefit is made part of the policy contract and must follow applicable laws and regulations under this title.

(e) An insured’s eligibility to purchase a pet insurance policy must not be based on participation, or lack of participation, in a separate wellness program.

84 Del. Laws, c. 184, § 1;