State RegulationsPA specificDifficulty 2/5
An insured dies while covered by an accident and health policy. His beneficiary predeceased him and no contingent beneficiary is named, so the death benefit is payable to his estate. His adult daughter asks the insurer for the money. Under 40 P.S. § 753(A)(9), what may the insurer do?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
40 P.S. § 753(A)(9) directs that death benefits be paid to the beneficiary or, absent one, to the insured's estate. When the money is payable to the estate, a minor, or an incompetent, the insurer is protected when it pays a relative or person equitably entitled to the benefit an amount not exceeding $1,000. The insurer therefore may make a limited protected payment to the daughter without waiting for formal estate administration.
Why the other options are wrong
- A) The protected relative payment is capped at $1,000; the insurer may not simply hand the entire benefit to the nearest relative.
- B) The payment-to-relative allowance exists precisely so the insurer need not wait for estate machinery on modest amounts.
- D) Unclaimed-property transfer is not the statutory mechanism here; the payment-of-claims provision authorizes a limited payment to an equitably entitled relative.
Memory hook
Estate or minor? The insurer can slide $1,000 to the right relative — no more.