31 Pa. Code § 73.115

Current through Register Vol. 54, No. 44, November 2, 2024
Section 73.115 - Benefit exclusions

Exclusions may be contained in a credit insurance plan as provided in §§ 73.104(a), 73.107(a) and 73.110(a) (relating to life insurance and life insurance with TPD benefit; accident and health insurance benefits; and involuntary unemployment insurance benefits).

(1) The following exclusions may also be contained in a life insurance plan or a life insurance with TPD benefit plan:
(i) Death due to suicide within 1 year of the effective date of coverage.
(ii) TPD due to intentionally self-inflicted injury.
(iii) A preexisting conditions exclusion due to a condition for which the insured debtor received medical advice, consultation, diagnosis or treatment from a physician or podiatrist within 6 months before the effective date of coverage and due to which death occurs or TPD commences within 6 months after the effective date of coverage. This exclusion applies only if and to the extent that the total amount of all insurance that would otherwise be subject to the preexisting conditions exclusion exceeds $1,000.
(iv) For the application of the exclusions contained in subparagraphs (i)-(iii), the effective date of coverage for each portion of the insurance attributable to a different advance under an open end loan, is the date on which the advance or charge occurs, or if later, the date on which coverage is elected.
(2) The following exclusions may also be contained in an A and H insurance plan:
(i) Normal pregnancy.
(ii) Intentionally self-inflicted injury.
(iii) Nonscheduled aircraft flight.
(3) The following exclusions may also be contained in an involuntary unemployment insurance plan:
(i) Voluntary resignation of employment.
(ii) Voluntary leave of absence.
(iii) Voluntary forfeiture of salary, wages or income.
(iv) Retirement.
(v) Injury or disease.
(vi) Disability.
(vii) Strike or unionized labor dispute.
(viii) Discharge by employer for cause.
(ix) Involuntary unemployment for which severance pay is received by the debtor.

31 Pa. Code § 73.115