Section 89.80. Loss of time benefits

(a) Loss of time policies may not require that the loss from accidental injury commence within less than 30 days after the date of an accident, nor may the accident policy which the insurer may cancel or refuse to renew require that it be in force at the time the loss commences.

(b) A policy of health and accident insurance will not be approved which contains a provision that the disability period shall be considered to commence with the date on which written notice is actually received by the company.

(c) Policies which limit benefits for loss of time to specified items, such as business overhead policies, shall provide for a premium refund in accordance with a short rate table in the event that none of the items to be indemnified exist at the time the policy is cancelled, for example, where a professional person discontinues his office, but only if the insured requests cancellation of the policy and gives timely notice. A premium refund may be limited to 1 year’s premium.

(d) The definition of total disability should be sufficiently clear so as not to confuse or mislead the insured. Wording in the definition of total disability should be that claim administration will be uniform as possible and the coverage is in the best interests of the insurance buying public.

(e) A provision for accidental death benefit may not contain a requirement that death must occur within a specific time period.

The provisions of this § 89.80 amended June 23, 1978, effective June 24, 1978, 8 Pa.B. 1678. Immediately preceding text appears at serial page (21915).