State RegulationsPA specificDifficulty 1/5
Under 40 P.S. § 753(A)(11), when may an insured begin a legal action on an accident and health claim?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
The legal-actions provision, 40 P.S. § 753(A)(11), bars any lawsuit before 60 days have passed after written proof of loss is filed. The waiting period gives the insurer a final window to investigate and pay without litigation, and it works alongside the outside bar: no action may be brought at all after three years from the time written proof is required.
Why the other options are wrong
- B) Suit cannot be filed on day one; the statute imposes a 60-day waiting period after written proof of loss before the courthouse door opens.
- C) The 60-day clock runs from written proof of loss, not from the furnishing of claim forms, and 90 days is not the measure.
- D) Departmental involvement is not a precondition; the policyholder may sue after the statutory waiting period without first going to the regulator.
Memory hook
Sixty days of patience after proof — then the courtroom opens.