PARRIS N. GLENDENING, Governor

Ch. 35

PROVISION OF SERVICE BASIS OR ON AN EXPENSE INCURRED BASIS AND OF WHICH
THIS INSURER HAS NOT BEEN GIVEN WRITTEN NOTICE PRIOR TO THE OCCURRENCE
OR COMMENCEMENT OF LOSS, THE ONLY LIABILITY UNDER ANY EXPENSE
INCURRED COVERAGE OF THIS POLICY SHALL BE FOR SUCH PROPORTION OF THE
LOSS AS THE AMOUNT WHICH WOULD OTHERWISE HAVE BEEN PAYABLE
HEREUNDER PLUS THE TOTAL OF THE LIKE AMOUNTS UNDER ALL SUCH OTHER
VALID COVERAGES FOR THE SAME LOSS OF WHICH THIS INSURER HAD NOTICE
BEARS TO THE TOTAL LIKE AMOUNTS UNDER ALL VALID COVERAGES FOR SUCH
LOSS, AND FOR THE RETURN OF SUCH PORTION OF THE PREMIUMS PAID AS SHALL
EXCEED THE PRO RATA PORTION FOR THE AMOUNT SO DETERMINED. FOR THE
PURPOSE OF APPLYING THIS PROVISION WHEN OTHER COVERAGE IS ON A
PROVISION OF SERVICE BASIS, THE 'LIKE AMOUNT' OF SUCH OTHER COVERAGE
SHALL BE TAKEN AS THE AMOUNT WHICH THE SERVICES RENDERED WOULD HAVE
COST IN THE ABSENCE OF SUCH COVERAGE."

(B) CAPTION.

THE PHRASE "— EXPENSE INCURRED BENEFITS" SHALL BE ADDED TO THE
CAPTION OF THE PROVISION SET FORTH IN SUBSECTION (A) OF THIS SECTION IF THE
PROVISION IS INCLUDED IN A POLICY THAT CONTAINS THE POLICY PROVISION SET
FORTH IN § 15-223 OF THIS SUBTITLE.

(C) DEFINITION OF "OTHER VALID COVERAGE".

(1) A BENEFIT PROVIDED FOR THE INSURED UNDER A COMPULSORY
BENEFIT STATUTE, INCLUDING A WORKERS' COMPENSATION OR EMPLOYER'S
LIABILITY STATUTE, WHETHER PROVIDED BY A GOVERNMENTAL UNIT OR
OTHERWISE, SHALL BE CONSIDERED "OTHER VALID COVERAGE" OF WHICH THE
INSURER HAS HAD NOTICE,

(2) THE INSURER MAY INCLUDE IN THE PROVISION SET FORTH IN
SUBSECTION (A) OF THIS SECTION A DEFINITION OF "OTHER VALID COVERAGE" IF
THE DEFINITION:

(I) IS APPROVED AS TO FORM BY THE COMMISSIONER; AND

(II) IS LIMITED TO:

1. COVERAGE PROVIDED BY ORGANIZATIONS SUBJECT TO
REGULATION BY INSURANCE LAW OR INSURANCE AUTHORITIES OF THIS STATE,
ANOTHER STATE, OR A PROVINCE OF CANADA;

2. COVERAGE PROVIDED BY HOSPITAL OR MEDICAL
SERVICE ORGANIZATIONS; AND

3. ANY OTHER COVERAGE THAT THE COMMISSIONER MAY
APPROVE FOR INCLUSION.

(3) UNLESS DEFINED OTHERWISE, "OTHER VALID COVERAGE" DOES
NOT INCLUDE:

- 985 -