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It's not at the discretion of the insurance company as to who is the primary or the secondary. It is the sole decision of the policy holder(you). They are a paid service and are there to serve you. Correction: No, it's not at the discretion of the policy holder. The primary coverage is based on who's birthday comes first. For example, in this particular case, the child lives with his mother and stepfather, and the stepfather and the biological father both have him on their medical insurance policies. The father's birthday is in October and the stepfather's birthday is in December. So the father's insurance is primary, and the stepfather's insurance is secondary. These are the quidelines insurance companies use to determine which one is primary, and which one is secondary.

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15y ago
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Q: If a child has primary and secondary medical insurance who settles the dispute when the primary decides the secondary should now be primary instead of secondary as they had been for several years now?
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