Insurance corner

What’s the difference between primary and secondary health coverage?

Where an individual is covered by more than one health insurance plan, for example as an employee under the first and dependent spouse under the second, insurers have had to develop rules to manage resulting claims and limit over-payment by multiple plans.

In the Cayman Islands, health insurers use the rules as contained in the Coordination of Benefits Agreement affected in August 2002 to determine which coverages are primary and which are secondary.

Under the agreement, the health plan in which the individual is enrolled as an employee is primary, while that in which he or she is enrolled as a dependent is secondary. This means that where a medical claim is incurred by the insured, the primary plan will pay benefits first and the balance will be paid under the secondary plan.

In the case of a child covered under separate group policies through his/her parents’ employers, the coverage provided by the father’s insurance is considered primary, while that provided through the mother is secondary.

What is business insurance?

The term ‘Business Insurance’ refers to a class of insurance coverages that can used to reduce, mitigate or compensate for losses incurred by business from a variety of sources.

Business insurance as a class includes workers’ compensation, employers’ liability, public liability, product liability, business interruption (continuity), key person life and disability, partnership life and disability, and professional indemnity coverages.

How does auto insurance pay for property damage in the event of a car accident?

There are generally two types of auto insurance coverage: comprehensive coverage and third party coverage.

Comprehensive coverage insures you and your property (such as medical expenses, damage to your vehicle, the insurance company’s duty to defend you if you are sued as the result of you operation of a vehicle, etc.)

Third party coverage pays for injury or property damage when you are responsible for all or part of an accident (although it does not cover the vehicle you drive).

The coverage and exclusions (things not covered) are set forth in a policy contract with the insurance company in exchange for the payment of a premium

Do you have a question on insurance? Email us at:

[email protected]

Or write to us at:

Sagicor General

PO Box 2171

Grand Cayman KY1-1105

Cayman Islands

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