State RegulationsPA specificDifficulty 3/5
A disability insured becomes disabled shortly after the policy is issued. No benefits are paid for the first stretch of the disability, after which benefits begin. Separately, the policy states that certain illnesses are not covered at all unless the policy has been in force for a set period. Which terms correctly name these two features in individual accident and health coverage?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
In individual accident and health policy design, the elimination period is the span at the start of a disability during which no benefits are paid before benefits begin, while the probationary period is the span from policy issue during which specified illnesses are excluded altogether. Candidates reading policies governed by the Pennsylvania uniform provisions of 40 P.S. § 753 and the individual accident and health rules should keep the two timers distinct: one waits out a claim, the other waits out the policy's youth.
Why the other options are wrong
- A) The two provisions do different jobs; merging them into one interchangeable term hides how each actually restricts coverage.
- B) The grace period concerns late premium payment, not the start of disability benefits or new-illness exclusions.
- C) Coinsurance and a deductible are cost-sharing devices that split paid amounts and set per-claim thresholds; neither names the two timing features described.
Memory hook
Elimination waits out the disability; probation waits out the policy.