Common use of Coordination of Coverage Clause in Contracts

Coordination of Coverage. If the Insured Person is covered under this policy and another insurance policy or plan, benefits will be co-ordinated with the other policy and/or plan following insurance industry standards. These standards determine where the claim should be sent first. The guidelines are as follows: a) if the Employee is claiming expenses for the Insured Spouse and the Spouse is covered for those expenses under another plan, the claim should be sent to the Spouse’s plan first. b) if the Employee is claiming expenses for Insured Dependent Child(ren), and both the Employee and Spouse have coverage under different plans, the Employee must claim under the plan of the parent with the earlier birthday (month and day) in the calendar year. For example, if the Employee’s birthday is May 1 and the Spouse’s birthday is June 5, the Employee must claim under his plan first. If both parents have the same birthday, claim under the plan of the parent whose first name begins with the earlier letter of the alphabet. c) the maximum amount that the Employee can receive from all plans for eligible expenses is one hundred per cent (100%) of actual expenses. d) when submitting a claim to a second payor, include payment details provided by the first payor.

Coordination of Coverage. If the Insured Person is covered under this policy and another insurance policy or plan, benefits will be co-ordinated with the other policy and/or plan following insurance industry standards. These standards determine where the claim should be sent first. The guidelines are as follows: a) if the Employee is claiming expenses for the Insured Spouse and the Spouse is covered for those expenses under another plan, the claim should be sent to the Spouse’s plan first. b) if the Employee is claiming expenses for Insured Dependent Child(ren), and both the Employee and Spouse have coverage under different plans, the Employee must claim under the plan of the parent with the earlier birthday (month and day) in the calendar year. For example, if the Employee’s birthday is May 1 and the Spouse’s birthday is June 5, the Employee must claim under his plan first. If both parents have the same birthday, claim under the plan of the parent whose first name begins with the earlier letter of the alphabet. c) the maximum amount that the Employee can receive from all plans for eligible expenses is one hundred per cent (100%) of actual expenses. d) when submitting a claim to a second payor, include payment details provided by the first payor.

Coordination of Coverage. If the Insured Person is covered under this policy and another insurance policy or plan, benefits will be co-ordinated coordinated with the other policy and/or plan following insurance industry standards. These standards determine where the claim should be sent first. The guidelines are as follows: a) if the Employee is claiming expenses for the Insured Spouse and the Spouse is covered for those expenses under another plan, the claim should be sent to the Spouse’s plan first. b) if the Employee is claiming expenses for Insured Dependent Child(ren), and both the Employee and Spouse have coverage under different plans, the Employee must claim under the plan of the parent with the earlier birthday (month and day) in the calendar year. For example, if the Employee’s birthday is May 1 and the Spouse’s birthday is June 5, the Employee must claim under his plan first. If both parents have the same birthday, claim under the plan of the parent whose first name begins with the earlier letter of the alphabet. c) the maximum amount that the Employee can receive from all plans for eligible expenses is one hundred per cent (100%) of actual expenses. d) when submitting a claim to a second payor, include payment details provided by the first payor.