31 Pa. Code § 88.61

Current through Register Vol. 54, No. 49, December 7, 2024

Section 88.61 - Period of time

Probationary or waiting periods shall relate to that period of time which may be specified in the policy and which must follow the date a person is initially insured under the policy, or following reinstatement of a policy, before the coverage or coverages of the policy shall become effective as to such person. A probationary or waiting period shall not be used with respect to any loss resulting from accidental injuries as defined in the policy. However, as to loss resulting from sickness a policy may specify a probationary or waiting period which shall not exceed 30 days, except as follows:

(1) For normal pregnancy and childbirth, 30 days where the probationary or waiting period is expressed in terms of the inception of the pregnancy.

(2) For elective surgery, not to exceed six months. The following is a list of surgical procedures which may be considered elective surgery:

(i) Cataract operations.

(ii) Strabismus operations.

(iii) Tonsilectomies, adenoidectomies.

(iv) Herniotomies.

(v) Arthrotomies.

(vi) Hemorrhoidectomies.

(vii) Laminectomies.

(viii) Varicose veins.

(ix) Gall bladder.

(x) Appendectomies concurrent with gall bladder operation.

31 Pa. Code § 88.61