A secondary insurer is an insurance company that covers expenses not paid by the primary insurer. The primary insurer is the initial insurance company responsible for paying claims up to the policy limit. The secondary insurer only covers additional costs not covered by the primary insurer.
A secondary insurer is an insurance company that handles any portion of a claim not covered by the primary insurer. The primary insurer is the initial insurance company obligated by contract to settle a claim up to the policy limit before any other insurer becomes responsible for any part of the same claim. For instance, if an individual has two insurance policies covering the same loss, the primary insurer will pay up to the policy limit, and the secondary insurer will cover any remaining amount exceeding the primary insurer’s limit. Another example is when a person has employer-provided health insurance and Medicare. The employer’s health insurance serves as the primary insurer, while Medicare acts as the secondary insurer. The primary insurer pays first, and the secondary insurer covers any remaining amount not included in the primary insurer’s coverage.
A secondary insurer is an insurance company that provides coverage for expenses that are not covered by the primary insurer. They typically come into play when the primary insurer’s coverage limits have been exhausted.
A secondary insurer becomes involved when the primary insurer’s coverage limits have been reached or when the primary insurer denies coverage for certain expenses.
The secondary insurer typically reviews the primary insurer’s explanation of benefits (EOB) to determine the amount of coverage provided. They then coordinate their coverage to fill in any gaps or provide additional coverage as needed.
In most cases, you cannot choose your secondary insurer. The secondary insurer is usually determined by the terms of your primary insurance policy or by the coordination of benefits rules set by your state’s insurance regulations.
Yes, you will typically have to pay separate premiums for your secondary insurance coverage. These premiums are in addition to the premiums you pay for your primary insurance.
Secondary insurance is designed to supplement primary insurance coverage. If you don’t have primary insurance, you may not be eligible for secondary insurance benefits.
Yes, a secondary insurer can deny coverage if the expenses are not covered under the terms of the policy or if the primary insurer has already denied coverage for those expenses.
Yes, you have the right to appeal a denial of coverage by your secondary insurer. You should review your policy documents for the specific steps and timelines for filing an appeal.
In some cases, you may be able to switch your secondary insurer. However, this will depend on the terms of your primary insurance policy and the coordination of benefits rules set by your state’s insurance regulations.
In some situations, you may be eligible for coverage from multiple secondary insurers. This can occur if you have multiple insurance policies that provide secondary coverage or if you are covered under a group insurance plan and also have individual secondary coverage. However, the coordination of benefits rules will determine how the coverage is coordinated and any limitations that may apply.
This site contains general legal information but does not constitute professional legal advice for your particular situation. Persuing this glossary does not create an attorney-client or legal adviser relationship. If you have specific questions, please consult a qualified attorney licensed in your jurisdiction.
This glossary post was last updated: 16th April 2024.
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