(a) A policy of health insurance may contain the following provision:
“Insurance with other insurers: If there be other valid coverage, not with this insurer, providing benefits for the same loss on other than 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 for such benefits under this policy shall be for such proportion of the indemnities otherwise provided hereunder 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.”
(b) The phrase “-- Other 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 out in § 15-222 of this subtitle.
(c) (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; and
2. any other coverage the Commissioner may approve for inclusion.
(3) Unless defined otherwise, “other valid coverage” does not include:
(i) group insurance; or
(ii) coverage provided by union welfare plans or by employer or employee benefit organizations.
(4) “Other valid coverage” may not include third party liability coverage.
Structure Maryland Statutes
Subtitle 2 - Individual Health Insurance Policy Forms and Provisions
Section 15-201 - Form of Policy
Section 15-202 - Language and Order of Policy Provisions
Section 15-203 - Right to Refuse Renewal
Section 15-204 - Age Limit; Misstatement of Age
Section 15-205 - Policies of Foreign or Alien Insurers; Policies of Domestic Insurers
Section 15-206 - Policies and Provisions at Variance With Subtitle
Section 15-207 - Entire Contract; Changes
Section 15-208 - Time Limit on Specified Defenses
Section 15-210 - Reinstatement
Section 15-211 - Notice of Claim
Section 15-213 - Proofs of Loss
Section 15-214 - Time of Payment of Claims
Section 15-215 - Payment of Claims
Section 15-216 - Physical Examinations and Autopsy
Section 15-217 - Time for Bringing Legal Actions
Section 15-218 - Change of Beneficiary
Section 15-219 - Change of Occupation
Section 15-220 - Misstatement of Age
Section 15-221 - Other Insurance With Insurer
Section 15-222 - Insurance With Other Insurers -- Expense Incurred Benefits
Section 15-223 - Insurance With Other Insurers -- Other Benefits
Section 15-224 - Relation of Earnings to Insurance