Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90d - INDIVIDUAL ACCIDENTAL DEATH BENEFITS; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90d.4 - Exclusions and restrictions

Current through Register Vol. 54, No. 28, July 13, 2024
The form contains exclusions and restrictions:
(1) It contains none or one or more of the
				following exclusions and restrictions:
(i)
				Bodily or mental infirmity or disease of any kind.
(ii) Bodily or mental infirmity or disease of
				any kind, whether or not the proximate or precipitating cause of death is
				accidental bodily injury.
(iii)
				War, declared or undeclared, or an act of war, whether or not serving in the
				military forces or any civilian noncombatant unit serving with the
				forces.
(iv) Committing an assault
				or felony, whether sane or insane.
(v) Participation in a riot or
				insurrection.
(vi) A fight in which
				the insured is a voluntary participant.
(vii) Suicide or attempted suicide, whether
				sane or insane.
(viii)
				Intentionally self-inflicted injury, whether sane or insane.
(ix) Engaging in an illegal
				occupation.
(x) Travel or flight in
				an aircraft or spacecraft, or descent from such a craft while in flight, or
				subsequent drowning, if the insured is a pilot, officer or crew member of the
				craft; is giving or receiving aviation training or instruction; has duties on
				or relating to the craft; or is being flown for the purpose of descent from the
				craft while in flight.
(xi)
				Voluntary taking or injection of drugs unless prescribed or administered by a
				licensed physician. The wording "taken as prescribed" or "taken in the manner
				prescribed" is not present.
(xii)
				Voluntary taking or injection of drugs, whether legal or illegal, unless
				prescribed or administered by a licensed physician. The wording "taken as
				prescribed" or "taken in the manner prescribed" is not present.
(xiii) The voluntary taking of any drugs
				prescribed for the insured by a licensed physician and intentionally not taken
				as prescribed.
(xiv) The voluntary
				taking of any drugs, whether legal or illegal, prescribed for the insured by a
				licensed physician and intentionally not taken as prescribed.
(xv) Sensitivity to drugs voluntarily taken,
				unless prescribed by a physician.
(xvi) Sensitivity to drugs, whether legal or
				illegal, voluntarily taken, unless prescribed by a physician.
(xvii) Drug addiction, unless addiction
				results from the voluntary taking of drugs prescribed or administered by a
				licensed physician or from the involuntary taking of drugs.
(xviii) Drug addiction, unless addiction
				results from the voluntary taking of drugs, whether legal or illegal,
				prescribed or administered by a licensed physician or from the involuntary
				taking of drugs, whether legal or illegal.
(xix) Voluntary taking of any poison except
				in the case of food poisoning.
(xx)
				Voluntary taking of any poison except in the case of accidental food
				poisoning.
(xxi) Voluntary inhaling
				of any kind of gas, except during the course of employment.
(xxii) Chronic alcoholism.
(xxiii) Directly or indirectly from the
				voluntary taking of alcohol alone or in combination with a drug, medication or
				sedative when this action results in legal intoxication as defined by
				Pennsylvania law. The company provides a certification that the Pennsylvania
				legal definition for intoxication will be used if the form does not refer to
				"intoxication as defined by Pennsylvania law."
(xxiv) Medical or surgical
				treatment.
(xxv) For dismemberment
				or loss of eyesight, loss must occur within
____________
days of accidental bodily injury. Note: The specified number
				  of days is not less than 90.