Chapter 88. Individual Accident and Sickness Insurance Minimum Standards  


Section 88.1. Purpose
Section 88.2. Applicability and scope
Section 88.11. Terms of renewability
Section 88.12. Noncancellable and guaranteed renewable policy
Section 88.13. Guaranteed renewable policy
Section 88.14. Renewable subject to consent of company and variants thereof
Section 88.15. Qualified right of renewal
Section 88.16. Single term nonrenewable policy
Section 88.17. Renewable at the option of the insured
Section 88.18. Conditional or limited continuance
Section 88.31. Family members
Section 88.32. Eligibility
Section 88.33. Subsequent eligibility
Section 88.34. Time limit on defenses
Section 88.35. Accidental injuries
Section 88.41. Family policy provisions
Section 88.51. Applicability of conditions
Section 88.52. Definitions
Section 88.53. Simplified application form
Section 88.61. Period of time
Section 88.71. Clarity
Section 88.81. Exception or exclusion
Section 88.82. Reduction
Section 88.83. Clear expression
Section 88.84. Listing of exclusions
Section 88.85. Unusual limitations, reductions, restrictions
Section 88.86. Waivers
Section 88.87. Military service exclusions
Section 88.91. Definition
Section 88.101. Application form
Section 88.102. Delivery to applicant
Section 88.103. Notice form
Section 88.104. Notice form for direct response insurer
Section 88.111. Confinements or disabilities
Section 88.121. Applications
Section 88.122. Assessable policy
Section 88.123. Use of certain words and terms
Section 88.124. Suspension and termination
Section 88.125. Multiple benefits
Section 88.126. Miscellaneous policy provisions
Section 88.131. Hospital
Section 88.132. Convalescent nursing home, extended care facility or skilled nursing facility
Section 88.133. Accident, accidental injury
Section 88.134. Sickness
Section 88.135. Physician
Section 88.136. Nurses
Section 88.137. Total disability
Section 88.138. Partial disability
Section 88.139. Residual disability
Section 88.140. Medicare
Section 88.141. Mental or nervous disorders
Section 88.142. Debit plan policies
Section 88.143. One period of confinement
Section 88.151. Compliance
Section 88.161. Minimum standards
Section 88.162. Basic hospital expense coverage
Section 88.163. Basic medical-surgical expense coverage
Section 88.164. Hospital confinement indemnity coverage
Section 88.165. Major medical expense coverage
Section 88.166. Coverage for each covered person
Section 88.167. Disability income protection coverage
Section 88.168. Accident only coverage
Section 88.169. Specified disease and specified accident coverage
Section 88.170. [Reserved]
Section 88.171. Supplemental insurance coverage
Section 88.181. Prohibition
Section 88.182. Disclosure statement
Section 88.183. Changes in terminology
Section 88.184. Print
Section 88.185. Text
Section 88.186. Basic hospital expense coverage form
Section 88.187. Basic medical-surgical expense coverage form
Section 88.188. Basic hospital and medical-surgical expense form
Section 88.189. Hospital confinement indemnity coverage form
Section 88.190. Major medical expense coverage form
Section 88.191. Disability income protection coverage form
Section 88.192. Accident only coverage form
Section 88.193. Specified disease or specified accident coverage form
Section 88.194. [Reserved]
Section 88.195. Supplemental insurance coverage form

Notation

Authority

   The provisions of this Chapter 88 issued under The Insurance Company Law of 1921 (40 P. S. § §  341—961); The Insurance Department Act of 1921 (40 P. S. § §  1—321); and sections 206, 506, 1501 and 1502 of The Administrative Code of 1929 (71 P. S. § §  66, 186, 411 and 412), unless otherwise noted.

Source

   The provisions of this Chapter 88 adopted June 23, 1978, effective June 24, 1978, 8 Pa.B. 1677, unless otherwise noted.

Notes of Decisions

   A determination of whether the provisions of 31 Pa. Code Chapter 88 are a product of an unconstitutional delegation of legislative power must first be sought through administrative procedures before a court may exercise its equity jurisdiction in the matter. American Family Life Assurance Company of Columbus v. Insurance Department, 414 A.2d 166 (Pa. Cmwlth. 1980).