Pennsylvania Code & Bulletin

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 53 Pa.B. 1782 (March 25, 2023).

31 Pa. Code § 66.53. [Reserved].

§ 66.53. [Reserved].


   The provisions of this §  66.53 amended through March 6, 1981, effective April 6, 1981, 11 Pa.B. 809; reserved January 3, 1997, effective January 4, 1997, 27 Pa.B. 19. Immediately preceding text appears at serial pages (215690) to (215692).

Notes of Decisions

   Collateral Benefits

   Citing subsection (c)(4)(v) as support, the court held there was no reason not to include HMO benefits as collateral benefits in ‘‘benefits and advantages’’ to be set off under the Pennsylvania Assigned Claim Plan (40 P. S. §  1009.108 (a)(3)). Grant v. Travelers Insurance Company, 494 A.2d 862 (Pa. Super. 1985).


   Insured’s inability to collect on primary medical coverage provided through an HMO did not render excess insurance carrier liable where the insured disqualified herself under the HMO contract by choosing the services of a non-HMO doctor. The provision of subsection (c)(1) for coverage where ‘‘no named insured has such coverage in effect...’’ does not apply when coverage is in effect at the time of the accident but is later voluntarily rejected by the insured. Carr v. Erie Insurance Co., 493 A.2d 97 (Pa. Super. 1985).

   Waiting Period

   If a claimant has not made the election to use the one week waiting period for work loss benefits provided by 40 P. S. §  1009.202(e)(2), the claimant is subject either to a two week waiting period under the provisions of 31 Pa. Code §  66.53(c)(1) or to no waiting period at all, depending on whether he is a ‘‘named insured’’ under the policy. Zepp v. Nationwide Insurance Company, 434 A.2d 112 (Pa. Super. 1981).

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