Health · Chapter 18 · Optional Provisions
Insurance With Other Insurer(s)
Definition
Optional provisions handling duplicate coverage with DIFFERENT insurers. Expense-incurred version: each insurer pays its pro rata (proportionate) share of the loss — total benefits can't exceed the actual loss — and excess premium is returned prorated. "Other than expense incurred" version (rare today): same prorating applied to indemnity/loss-of-time policies like disability income when the insurer wasn't told of other coverage before the claim.
In plain English
Two companies on the same bill each pay their slice — you never collect the whole bill twice. It's the individual-policy cousin of group COB.
Exam tip
Same-insurer duplicates → one policy pays, the other is refunded. Different insurers → everyone prorates. Both attack over-insurance.
Easy to confuse with
These are what this term gets tested against — if you can't tell them apart cold, drill the contrast.
Related terms