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When a member is injured in an auto accident or on the job, another insurer is often primary. The guidelines below will help you submit these coordination of benefit claims.
Reminder: Third-party liability claims, like other claims requiring attachments, must be mailed. Submit original claim forms. We cannot accept faxes and photocopies for processing.
If you’re submitting a claim for a member who has related: | You can bill us for any outstanding balance after: | Be sure to: |
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Auto insurance | The auto insurer:
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Workers’ compensation insurance | The workers’ compensation insurer has:
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* Other states’ Blue Cross Blue Shield Plans may have other Personal Injury Protection (PIP) dollar limits.
Notes:
If you have questions about billing claims related to other types of accidental injury (for example, dog bites or falls), please contact our Third-Party Liability Department at 1-800-444-6502.
How to appeal a third-party liability claim involving a Massachusetts member
If we reject your claim because of an error in the claim, follow the replacement claim process. However, if your third-party liability claim involves a Massachusetts member and you disagree with the third-party liability denial, fax a Request for Claim Review Form and any required documents to our Third-Party Liability Department at 1-617-246-9967. BlueCard (out-of-state) third-party liability appeals should be mailed to the claims address for Professional or Institutional claims. |