Legal Definitions - coordination-of-benefits clause

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.