Which statement best describes how 31 Pa. Code 90f.3 governs the conditions under which an accelerated benefit becomes payable in a Pennsylvania life policy?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
31 Pa. Code 90f.3 requires accelerated benefit provisions to be structured around defined qualifying conditions — the framework Pennsylvania adopted so living benefits are paid on objective medical triggers stated in the policy, not on a claimant's unsupported say-so or on unrelated events. When a policy's qualifying condition is met, the insurer pays the accelerated amount and deducts it from the death benefit. This keeps the trigger, the payment, and the death-benefit reduction tied together as one mechanism supervised under the Pennsylvania Insurance Department's regulatory scheme.
Why the other options are wrong
- A) The regulation is built on defined qualifying conditions in the policy; self-certification without meeting a defined trigger does not start payment.
- C) Loss of a job is not a qualifying medical event for accelerated benefits under Pennsylvania's accelerated benefits framework.
- D) The defining feature of the rider is payment while the insured is living; benefits paid only after death would not be living benefits at all.
Memory hook
Defined trigger, early payment, smaller death benefit — one package under 90f.3.