Dual Insurance Sample Clauses
The Dual Insurance clause defines how situations are handled when more than one insurance policy covers the same risk or loss. In practice, this clause typically outlines the process for determining which insurer is primarily responsible for payment, how claims are coordinated between insurers, and may require the insured to notify all relevant insurers of the overlap. Its core function is to prevent double recovery by the insured and to allocate responsibility among insurers, thereby ensuring fair and efficient claims resolution.
Dual Insurance. If at the time of any incident which results in a claim under this Policy, there is another insurance covering the same loss, damage, expense or liability we will not pay more than our proportional share other than insurance section C.
Dual Insurance. PROVIDER is required to determine if the CONSUMER is dually insured, prior to submitting claims to PAYOR and at a minimum of monthly. In instances when the CONSUMER has dual insurance (i.e., Blue Cross and Medicaid), the PROVIDER must bill the commercial insurance first. Medicaid is always the PAYOR of last resort. It is the PROVIDER’s responsibility to follow all insurance rules and collect directly from the primary insurance. In order to qualify for any Medicaid benefit, CONSUMER must be receiving services through the CMH where services are being authorized and the PROVIDER must first obtain the Authorization Form from the PAYOR. The PROVIDER must notify the PAYORS in writing that the CONSUMER is dually insured. This should occur prior to ABA treatment beginning under the BHT benefit. If requirements are met as described, the PROVIDER must submit the actual EOBs from the primary insurance to the PAYOR in order to receive consideration of payment through Medicaid. The Medicaid benefit will only reimburse the PROVIDER for the difference between any primary insurance payment and the PROVIDER’s contracted rate with PAYOR. The PROVIDER may not seek nor accept additional or supplemental payment from the CONSUMER, their family, or other representative when the CONSUMER is enrolled in the BHT benefit. The PROVIDER must notify the PAYOR of any changes to the CONSUMER’s primary insurance at any time during treatment.
Dual Insurance. Incentive For employees enrolled on Dual Insurance, the employee will receive an incentive equivalent to 50% of the ▇▇▇▇▇▇ Permanente Access PPO Healthcare premiums that the City would otherwise contribute to health insure the dependents.
Dual Insurance. 6.1 If You have another policy of legal expenses insurance that provides cover for Your Claim and Litigation, We will only cover Our proportionate share of the Claim and Litigation assuming that the other policy of legal expenses insurance had paid out in full.
Dual Insurance. For employees enrolled on Dual Insurance, the employee will receive an incentive equivalent to 50% of the lower-premium $250 deductible plan (HealthFirst 250 or ▇▇▇▇▇▇ Access 250) premiums that the City would otherwise contribute to health insure the dependents.
Dual Insurance. Should the Insured have other policies covering, or partial covering, the same event covered by this Policy the Company is only liable to contribute a pro-rata proportion of such loss or event.
Dual Insurance. Eligible employees (see Section A) who elect to not participate in the Employer hospitalization program shall be provided a Section 125 cash option of $1,600 per year.