THEODORE R. McKELDIN GOVERNOR 2011
added to the caption of the foregoing provision the phrase
"-EXPENSE INCURRED BENEFITS". The insurer may, at its option,
include in this provision a definition of "other valid coverage",
approved as to form ~by the Commissioner, which definition
shall be limited in subject matter to coverage provided by or-
ganizations subject to regulation by insurance law or by in-
surance authorities of this or any other state of the United
States or any province of Canada, and by hospital or medical
service organizations, and to any other coverage the inclusion
of which may be approved by the Commissioner. In the absence
of such definition such term shall not include group insurance,
automobile medical payments insurance, or coverage provided
by hospital or medical service organizations or by union wel-
fare plans or employer or employee benefit organizations. For
the purpose of applying the aforegoing policy provision with
respect to any insured, any amount of benefit provided for such
insured pursuant to any compulsory benefit statute (including
any workmen's compensation or employer's liability statute)
whether provided by a governmental agency or otherwise shall
in all cases be deemed to be "other valid coverage" of which the
insurer has had notice. In applying the foregoing policy pro-
vision no third party liability coverage shall be included as
"other valid coverage". )
(5) A provision as follows: (Insurance with Other Insurers. )
If there be other valid coverage, not with this insurer, provid-
ing benefits for the same loss on other than an expense in-
curred basis and of which this insurer has not been given writ-
ten notice prior to the occurrence or commencement of loss,
the only liability for such benefits under this policy shall be
for such proportion of the indemnities otherwise provided here-
under for such loss as the like indemnities of which the insurer
had notice (including the indemnities under this policy) bear
to the total amount of all like indemnities for such loss, and for
the return of such portion of the premium paid as shall exceed
the pro-rata portion for the indemnities thus determined.
(If the foregoing policy provision is included in a policy
which also contains the next preceding policy provision there
shall be added to the caption of the foregoing provision the
phrase "-OTHER BENEFITS". The insurer may, at its option, in-
clude in this provision a definition of "other valid coverage",
approved as to form by the Commissioner, which definition
shall be limited in subject matter to coverage provided by or-
ganizations subject to regulation by insurance law or by in-
surance authorities of this or any other state of the United
States or any province of Canada, and to any other coverage
the inclusion of which may be approved by the Commissioner.
In the absence of such definition such term shall not include
|
![clear space](../../../images/clear.gif) |