Pennsylvania Code (Last Updated: April 5, 2016) |
Title 31. INSURANCE |
PART IV. Life Insurance |
Chapter 88. Individual Accident and Sickness Insurance Minimum Standards |
Section 88.133. Accident, accidental injury
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(a) The definition of accident, accidental injury shall employ result language and shall not include words which establish an accidental means test or use words such as external, violent, visible wounds or similar words of description or characterization.
(b) No definition shall be more restrictive than the following: Injury or injuries, for which benefits are provided, means accidental bodily injuries sustained by the insured person which are the direct and independent cause of the loss and occur while the insurance is in force. The definition may provide that injuries shall not include injuries for which benefits are provided under any workmens compensation, employers liability or similar law.