PENNSYLVANIA, October 6 - purchase the following benefits for you, your spouse or

other relatives or minors in your custody or in the

custody of your relatives, residing in your household,

occupants of your motor vehicle or persons struck by your

motor vehicle:

(1) Medical benefits, up to at least $100,000.

(1.1) Extraordinary medical benefits, from $100,000

to $1,100,000 which may be offered in increments of

$100,000.

(2) Income loss benefits, up to at least $2,500 per

month up to a maximum benefit of at least $50,000.

(3) Accidental death benefits, up to at least

$25,000.

(4) Funeral benefits, $2,500.

(5) As an alternative to paragraphs (1), (2), (3)

and (4), a combination benefit, up to at least $177,500

of benefits in the aggregate or benefits payable up to

three years from the date of the accident, whichever

occurs first, subject to a limit on accidental death

benefit of up to $25,000 and a limit on funeral benefit

of $2,500, provided that nothing contained in this

subsection shall be construed to limit, reduce, modify or

change the provisions of section 1715(d) (relating to

availability of adequate limits).

(6) [Uninsured, underinsured and bodily] Bodily

injury liability coverage up to at least $100,000 because

of injury to one person in any one accident and up to at

least $300,000 because of injury to two or more persons

in any one accident or, at the option of the insurer, up

to at least $300,000 in a single limit for these

20210SB0893PN1134 - 6 -

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