Health insurance not covering crash?

[estilley]

Anyone ever heard of a health insurance company not covering a crash? Is there a difference between a race and just a ride in their eyes?

As coverage becomes more and more risk-focused I wonder if this could be imminent in the future.


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[Dead Man]

The idea that you could be denied medical insurance coverage because of the nature of the activity that led to the injury.... Madness. Is this actually happening?

[stackie]

Life insurance excludes hang gliding and Mt Everest. My work partner paraglide instead and had to buy a policy just for Everest.

I could see medical insurance saying increased premium for certain activities. They do for smoking. If they don't then everyone's premium would go up to subsidize the higher risk insurees. Though I think it would be hard to deny coverage.

Jon

[estilley]

No evidence of it happening yet, but the collarbone bills started coming in and I did get a questionnaire from the insurance company asking how the accident happened (work,
Sports, etc) and what property it was on and the property owners health insurance company. As it was basically at a public park (high school) and with all the waivers signed, it doesn't seem like anyone could be held liable.

Of course, they'll do whatever they can not to pay, which got me thinking about risk premiums.


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[Ralph]

Organized competition? There may be some fine print about that.

[Epicus07]

I suppose if they wanted you to get extra coverage for voluntarily increasing your risk of injury they might be able to get a premium from you. Enforcing it would be expensive and tricky.

ICD-10 codes are specific but not that specific "Pedal cycle rider injured in collision with other pedal cycle"

Your ER notes may mention that you were in a race if it was provided during a short report but i'm not sure the insurance company would have access to those records.

They would have to investigate the claim and i doubt they would.

[Idris Icabod]

Funnily enough I'm getting the exact opposite messages from health care providers. I just received an offer that if I cycle 50 miles per month (or week) I could save on health insurance premiums. I'm guessing the benefit of being healthy outweighs the potential costs associated with accidents.

I broke my clavicle a couple of years ago which required surgery and there was no issue with insurance, usual forms seeing if they could pin the costs on someone else, but it was my own stupid fault.

[yngpunk]

Originally Posted by estilley

No evidence of it happening yet, but the collarbone bills started coming in and I did get a questionnaire from the insurance company asking how the accident happened (work,
Sports, etc) and what property it was on and the property owners health insurance company. As it was basically at a public park (high school) and with all the waivers signed, it doesn't seem like anyone could be held liable.

Of course, they'll do whatever they can not to pay, which got me thinking about risk premiums.


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Let's be fair here. This is about liability and not about not paying. For example, if the injury happened at work, then your employers workers comp could be liable for covering the injury. Pretty standard operating procedure from what I've seen

[Mikej]

They want to know if it was somebodies fault, or it happened because of a business or at the neglect of another party, city side walk crack etc. - if you are in a law suit because of it etc. Insurance company is trying to make sure they have to pay or if they have to chase somebody down due to circumstances - expect a letter every few months for a year or so...

[fignon's barber]

Originally Posted by estilley

No evidence of it happening yet, but the collarbone bills started coming in and I did get a questionnaire from the insurance company asking how the accident happened (work,
Sports, etc) and what property it was on and the property owners health insurance company. As it was basically at a public park (high school) and with all the waivers signed, it doesn't seem like anyone could be held liable.

Of course, they'll do whatever they can not to pay, which got me thinking about risk premiums.


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This is nothing to worry about, it's standard practice. They ask this, for example, because in many states if a bike accident happens on a road, it's covered by your car insurance, not health insurance.

[PSC]

When I got hit by a car, my lawyer used my auto insurance PIP as primary and my health insurance was secondary to pay for my injuries. Eventually we settled with the other guy's insurance.

[rePhil]

I got hit, driver had the minimum. We understood our carrier was going to be difficult and hired an attorney who went after our underinsured coverage. Our health insurance exercised their subrogation rights, which our attorney negotiated.
There were no questions asked by the hospital or MD's once we gave insurance info.

[Mr. Pink]

Well, I ski a lot, which is a much more injury prone activity than cycling, and have never been told that there are any restrictions because of that sport. And I have made claims.

[BobO]

Originally Posted by fignon's barber

This is nothing to worry about, it's standard practice. They ask this, for example, because in many states if a bike accident happens on a road, it's covered by your car insurance, not health insurance.

Agree. If I am on a public road, my auto policy covers my injuries if the crash was my fault, to certain limits where the health plan theoretically takes over. This is true whether I am in an organized race or not. Racing on private property is another story, usually the health plan controls. Of course there are few providers in network but that's a whole different rant.

As an aside my homeowner's policy covers the bike for theft whether it's at home or away.

[estilley]

Right, it was definitely just my own fault. No one else even went down around me.

I like the idea of saving on premiums, definitely agree that the health benefits outweigh the risks.


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