How to Get Proof of Coordinating Benefits

It could happen to anyone: say you're a double policy holder, with two different insurance policies from your own or a spouse's employer, or self-purchased plans. Insurance companies use coordinating of benefits policies to get around paying members and policy holders when a claim goes out. Don't let this happen to you. Clarify coordination of benefits policies up front to be ready when something happens.

Instructions

• 1

  Review your member package. Many times, applicable information on coordinating benefits is in your original paperwork. But just as often, it isn't. If you can't find a relevant policy, it's time to go get one.

• 2

  Call your broker. Is there a person who arranged the policy for you? If so, he may know offhand how a policy coordinates benefits. Get him to show you the proof, and you're done.

• 3

  Get a rep on tape. This one might be harder: you will need permission from the agent at the insurance company to record their testimony on how the company coordinates benefits.

• 4

  Escalate. It may be really hard even to find someone in the insurance company's office who knows what the policy is on coordinating benefits. But from a member standpoint, "I don't know" is not acceptable. Coordinating benefits policy has a profound affect on coverage, and you'll need to escalate the issue until you find a responsible person who can get you that proof. If a company will not specify their policies, they're probably stonewalling you to accommodate denials of claims later in the game. Don't fall for that trick: be merciless in your pursuit of solid information.

• 5

  Get it in writing. Again, a lack of paper in your hand facilitates an easy claim denial. When you file a claim, whatever anybody told you on the phone won't count. Demand that your insurance company send you proof that your policy will pay as a second or first payer on claims, and keep that paperwork for any eventuality.