Joe (born on April 27, 1974) has coverage for his son, Patrick (born on May 25, 2000), provided by his employer with an 80 percent coinsurance provision and a $100 deductible. Joe's wife, Elizabeth (born on November 3, 1977), also has dependent coverage provided by her employer with an 80 percent coinsurance provision and a $250 deductible. Patrick suffers a $5,000 loss that is covered by both policies. Assuming that the 1985 NAIC rules are in effect, Elizabeth's insurer will pay

Question

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According to the 1985 NAIC Coordination of Benefits rules, the primary policy is determined by the birthday rule, which states that the parent whose birthday comes first in the calendar year provides the primary coverage. Joe's birthday is in April, and Elizabeth's is in November, so Joe's policy is primary. Joe's policy will cover 80% of the loss after the $100 deductible, which is $3,920. The remaining $1,080 is covered by Elizabeth's policy, which is secondary.

Joe (Born on April 27, 1974) Has Coverage for His