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<section article="gin" article_name="Insurance" number="15-223" title_number="15" title_name="Health Insurance" subtitle_number="2" subtitle_name="Individual Health Insurance Policy Forms and Provisions">
  <level label="a">
    <text>A policy of health insurance may contain the following provision:</text>
    <text>“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.”</text>
  </level>
  <level label="b">
    <text>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.</text>
  </level>
  <level label="c">
    <level label="1">
      <text>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.</text>
    </level>
    <level label="2">
      <text>The insurer may include in the provision set forth in subsection (a) of this section a definition of “other valid coverage” if the definition:</text>
      <level label="i">
        <text>is approved as to form by the Commissioner; and</text>
      </level>
      <level label="ii">
        <text>is limited to:</text>
        <level label="1">
          <text>coverage provided by organizations subject to regulation by insurance law or insurance authorities of this State, another state, or a province of Canada; and</text>
        </level>
        <level label="2">
          <text>any other coverage the Commissioner may approve for inclusion.</text>
        </level>
      </level>
    </level>
    <level label="3">
      <text>Unless defined otherwise, “other valid coverage” does not include:</text>
      <level label="i">
        <text>group insurance; or</text>
      </level>
      <level label="ii">
        <text>coverage provided by union welfare plans or by employer or employee benefit organizations.</text>
      </level>
    </level>
    <level label="4">
      <text>“Other valid coverage” may not include third party liability coverage.</text>
    </level>
  </level>
</section>
