Questions & answers · Vision insurance
How does United Concordia Insurance Company's vision insurance policy handle other insurance covering the same loss?
AI-drafted from filed documents · reviewed: pendingother insurance / coordination of benefitsUnited Concordia Insurance Company
Under United Concordia Insurance Company’s filed form in Idaho (ID), the policy allows for coordination of benefits (COB) when multiple plans cover the same loss [1]. The insurer has the right to recover any excess payments made if they exceed the policy’s provisions [1]. This recovery can come from the member or from any other insurance company or organization that provided coverage [1]. Members must provide information and documents as needed to enforce this right [1]. The term "Plan" includes various types of coverage such as group and nongroup insurance contracts, Medicare, and automobile insurance, among others [1]. When a plan coordinates benefits, the contract specifies which coverages are considered under the COB provision [1]. This does not appear in these excerpts — check the full policy.
Information only — not legal advice. The insurer decides.
These answers quote forms insurers filed with state regulators. Your own policy, its endorsements and your state’s rules control. A filed form may not be the version sold to you.
Where this comes from (1)
[1] United Concordia Insurance Company · ID · SERFF UCIN-135029573 · form ID9804V (10/21) · p. 10 · 21.20 · Material Costs at Provider Offices
4. Right to Recovery We have the right to retrieve any excess amounts that may have been paid out should they exceed the provisions of the Policy. This can be from the Member for whom the payments were made. It can also be from any other insurance company or organization. Members are required to provide information and documents as necessary to enforce this provision. “Plan” means a form of coverage with which coordination is allowed. Separate parts of a plan for members of a group that are provided through alternative contracts that are intended to be part of a coordinated package of benefits are considered one plan and there is no COB among the separate parts of the plan. If a plan coordinates benefits, its contract states the types of coverage that will be considered in applying the COB provision of that contract. Plan includes: 1. Group and nongroup insurance contracts and subscriber contracts; 2. Uninsured group or group-type coverage arrangements; 3. Group and nongroup coverage through closed panel plans; (4. Group-type contracts; 5. The medical care components of long-term care contracts, such as skilled nursing care; 6. Medicare or other governmental benefits.7. The medical benefits coverage in automobile "no fault" and traditional automobile "fault" type contracts. 8. … (excerpt — the filed text continues)
Drafted by a local AI model from the excerpts above, then checked by rules (citations, no rankings, no “not covered” claims from a partial excerpt). Question id Qb4253252. Spotted an error? Tell us.