State RegulationsPA specificDifficulty 2/5
Under 31 Pa. Code 90f.4, which restriction may an insurer permissibly place on an accelerated benefit provision in a Pennsylvania life policy?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
31 Pa. Code 90f.4 addresses exclusions and restrictions on accelerated benefits and permits the insurer to limit acceleration where the condition results from certain causes, such as intentionally self-inflicted injury. This is a genuine restriction allowed by the Pennsylvania framework, aimed at preventing living benefits from rewarding intentional harm. The restriction must exist in the policy itself, not be improvised after a claim arrives.
Why the other options are wrong
- B) A court proceeding to prove financial hardship is not part of Pennsylvania's accelerated benefits framework; qualifying conditions are medical, not litigated.
- C) The living benefit belongs to the insured under the policy; the beneficiary's consent is not a condition of payment.
- D) The accelerated amount is fixed by the policy's terms, not invented by the insurer when the claim is filed.
Memory hook
Self-inflicted harm can be excluded — the rider never pays a person for hurting himself.