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LSDefine

Simple English definitions for legal terms

coordination-of-benefits clause

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A quick definition of coordination-of-benefits clause:

A coordination-of-benefits clause is a rule in insurance that says the total amount of money paid for medical care cannot be more than the benefits you can get from all your insurance policies combined. This means that if you have more than one insurance policy, they will work together to cover your medical expenses, but they won't pay more than what is necessary.

A more thorough explanation:

A coordination-of-benefits clause is a provision in an insurance policy that limits the total amount of benefits that can be received from multiple insurance policies. This means that if a person has more than one insurance policy, the total amount of benefits they receive cannot exceed the total cost of their medical or hospital care.

For example, if a person has two health insurance policies and incurs a medical bill of $1,000, the coordination-of-benefits clause would ensure that the total amount paid by both insurance policies does not exceed $1,000. This prevents the person from receiving more benefits than they are entitled to and helps to prevent insurance fraud.

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