Pennsylvania Code › Title 31 - INSURANCE › Part IV - Life Insurance › Chapter 90f - INDIVIDUAL IMMINENT DEATH/LIFETIME HEALTH CARE FACILITY CONFINEMENT BENEFITS PROVIDED AS ACCELERATED DEATH BENEFIT OR SETTLEMENT OF DEATH BENEFIT; PROVIDED BY RIDERS OR BUILT INTO POLICIES-STATEMENT OF POLICY › Section 90f.3 - Benefit design

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
Alternatives.
(1) The form
				discloses that a benefit will be paid if elected by the owner when the
				following condition occurs: Due to a medically determinable condition suffered
				by the insured, the insured's life expectancy is expected to be for a limited
				period of time. The allowable time periods range from "6 months or less" to "12
				months or less."
(2) The form
				discloses that a benefit will be paid if elected by the owner when the
				following condition occurs: The insured suffers from a medical condition that
				would in the absence of treatment result in death within a limited period of
				time. The allowable time periods range from "6 months or less" to "12 months or
				less."
(3) The form discloses that
				a benefit will be paid if elected by the owner when the following condition
				occurs: The insured suffers a total and permanent disability which prevents the
				insured from performing any work for pay or profit for a period of time. The
				allowable time period is no longer than "12 months."
(4) The form discloses that a benefit will be
				paid if elected by the owner when the following condition occurs: The insured
				suffers a disability which prevents the insured from engaging in the
				substantial and material duties of an occupation for which the insured is or
				may reasonably become qualified by reason of education, experience or training
				for a period of time. The allowable time period is no longer than "12
				months."
(5) The form discloses
				that a benefit will be paid if elected by the owner when one or more of the
				following conditions occurs:
(i) Due to a
				medically determinable condition suffered by the insured, the insured's life
				expectancy is expected to be for a limited period of time. The allowable time
				periods range from "6 months or less" to "12 months or less."
(ii) The insured suffers from a medical
				condition that would in the absence of treatment result in death within a
				limited period of time. The allowable time periods range from "6 months or
				less" to "12 months or less."
(iii)
				The insured suffers a total and permanent disability. The disability prevents
				the insured from performing any work for pay or profit and exists for a period
				of time. The allowable time period is no longer than "12 months."
(iv) The insured suffers a disability which
				prevents the insured from engaging in the substantial and material duties of an
				occupation for which the insured is or may reasonably become qualified by
				reason of education, experience or training for a period of time. The allowable
				time period is no longer than "12 months."
(6) The form discloses that a benefit will be
				paid if elected by the owner when any one of the preceding alternatives applies
				with the addition of the following alternative condition: The insured is
				confined to an eligible health care facility with the expectation that the
				insured will remain in the facility for his entire lifetime.