Third party payment mechanisms are reviewed from the viewpoint of one commercial insurer. Attention is focused upon insurance coverage for rehabilitation equipment, environmental modifications, orthotics, prosthetics, and durable medical equipment. Numerous variables influence coverage decisions. Typical examples, unique in rehabilitation literature, illustrate situations related to the major types of insurance (Group Health, Miscellaneous Lines, Workers' Compensation, and Reinsurance). The importance of the rights of disabled persons and the impact of national financial estimates are discussed. Consideration is given to several approaches which might improve the benefits available. Techniques to cope with the system include prompt communication, accurate correspondence, and employer policyholder awareness.