Health insurance legal questionaire?

early
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University Heights, OH, USA
11/1/2023 2:56pm
truck wrote:
ER visit and follow up for an ACL or broken bone are peanuts compared to one big get off with liver laceration and dropped lung and...

ER visit and follow up for an ACL or broken bone are peanuts compared to one big get off with liver laceration and dropped lung and a trip or two to the OR and several days in ICU after the helicopter ride from the track. There are very few other activities that expose the body to the kind of velocity and impacts that moto does.

I do tend to believe the fear that people have about moto not being covered or this being some big secret that insurance companies don't know about are very overblown, and I'll tell you why. They still cover street bike injuries and those are more brutal and far far more frequent. Riding on the street is also entirely elective, lot of states don't have helmet laws, and health insurance still pays when drunk uncle Larry can't hold the curve on his Harley and bounces his head off the guardrail and never lives a normal life again. Moto isn't really even a blip on their radar as far as it being worth excluding. The stuff we're talking about in this thread is just about trying to get some other insurance company to chip in. 

I made the initial comment about access to insurance. I meant both medical and track insurance, since the topic was about the medical insurance going after the track insurance to pay the bills. If you get hurt on a Harley on a public road the insurance company can't go after a private owner or liability insurance company to recover the cost.

A sport that costs thousands of dollars a year, where landowners have no legal protection besides expensive insurance, where landowners have trouble because of sound and zoning, where injured people are expected to not say what they were doing and where, where trespassing is widespread, and where theres a high risk of catastrophic injury and death. These are all issues, especially when we talk about it more and more becoming a rich man's sport.

Sorry to be a downer, riding motorcycles is fun, these issues are not.

truck
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Louisville, KY, USA
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11/1/2023 3:14pm

Yes it's two separate issues. Insurance denying a claim based on mechanism of injury or having it as part of policy that injuries from certain activities are not covered I do not believe is a real concern for most when it comes to moto. 

Insurance making sure there aren't other policies that should be covering some costs is a real issue but ultimately is a fight for insurance companies to have with each other. If tracks and their insurance companies are regularly losing this fight or being dropped by policies when the time comes, then their insurance company either didn't know what they were doing when they issued the policy or isn't doing their job in defending their client. Trying to claim negligence without the cooperation of the person actually injured is not an easy task. These stories we hear about tracks being sued by an insurance company at the objection of the injured rider are quite suspect.....

1
early
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11/1/2023 3:31pm
truck wrote:
Yes it's two separate issues. Insurance denying a claim based on mechanism of injury or having it as part of policy that injuries from certain activities...

Yes it's two separate issues. Insurance denying a claim based on mechanism of injury or having it as part of policy that injuries from certain activities are not covered I do not believe is a real concern for most when it comes to moto. 

Insurance making sure there aren't other policies that should be covering some costs is a real issue but ultimately is a fight for insurance companies to have with each other. If tracks and their insurance companies are regularly losing this fight or being dropped by policies when the time comes, then their insurance company either didn't know what they were doing when they issued the policy or isn't doing their job in defending their client. Trying to claim negligence without the cooperation of the person actually injured is not an easy task. These stories we hear about tracks being sued by an insurance company at the objection of the injured rider are quite suspect.....

If you have your own property you gotta really think about if you want to have people ride there, same with trespassers that might ride without your permission. It's not just tracks that have explicit policies for the activity that can get into a sticky situation with this. 

Also like I said earlier, denial of claims for pre-existing conditions determined by insurance companies or other factors and lifetime caps aren't as much of an issue right now, but they can be in the future if laws were to change. 

1
kage173
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USA
11/2/2023 8:48am
truck wrote:
ER visit and follow up for an ACL or broken bone are peanuts compared to one big get off with liver laceration and dropped lung and...

ER visit and follow up for an ACL or broken bone are peanuts compared to one big get off with liver laceration and dropped lung and a trip or two to the OR and several days in ICU after the helicopter ride from the track. There are very few other activities that expose the body to the kind of velocity and impacts that moto does.

I do tend to believe the fear that people have about moto not being covered or this being some big secret that insurance companies don't know about are very overblown, and I'll tell you why. They still cover street bike injuries and those are more brutal and far far more frequent. Riding on the street is also entirely elective, lot of states don't have helmet laws, and health insurance still pays when drunk uncle Larry can't hold the curve on his Harley and bounces his head off the guardrail and never lives a normal life again. Moto isn't really even a blip on their radar as far as it being worth excluding. The stuff we're talking about in this thread is just about trying to get some other insurance company to chip in. 

Yeah I have to say that Ive never seen Motocross racing listed as excluded on an explanation of benefits. Im curious to kniw from those who have been denied if it was on their EOB

1

The Shop

Chuck_Nice
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Indianapolis, IN, USA
12/8/2023 4:41am

I have also gotten the form for a MTB crash. Had to explain I was on a bicycle, not motorcycle. I was also on city park land, so go sue the city! Injuries were a concussion and deep abrasion on knee.

1
12/8/2023 4:53am
motofool wrote:
I have always said I was riding my bike but never state weather it's motorized or not. My parents always had me do this growing up...

I have always said I was riding my bike but never state weather it's motorized or not. My parents always had me do this growing up also. Broke my leg from falling off my bike. Never seem to have any issues and Docs never pressed for more information.

This is what I did.  Fell off my bike.  No other vehicles or people involved.  Case closed.

1
Splat03
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Kiowa, CO, USA
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12/9/2023 10:03am
truck wrote:
Yes it's two separate issues. Insurance denying a claim based on mechanism of injury or having it as part of policy that injuries from certain activities...

Yes it's two separate issues. Insurance denying a claim based on mechanism of injury or having it as part of policy that injuries from certain activities are not covered I do not believe is a real concern for most when it comes to moto. 

Insurance making sure there aren't other policies that should be covering some costs is a real issue but ultimately is a fight for insurance companies to have with each other. If tracks and their insurance companies are regularly losing this fight or being dropped by policies when the time comes, then their insurance company either didn't know what they were doing when they issued the policy or isn't doing their job in defending their client. Trying to claim negligence without the cooperation of the person actually injured is not an easy task. These stories we hear about tracks being sued by an insurance company at the objection of the injured rider are quite suspect.....

They are probably infrequent but it does happen. My dad’s girlfriend was helping him back and hook to his camper when the ball hit the hitch that was set too low. Camper moved and somehow cut her leg necessitating a ED visit with stitches. It was not life threatening, no plastic surgery needed, no admit to the hospital. Her medical insurance sued my dad’s homeowners insurance despite her repeated objections. It seemed pretty silly to us. It was a relatively low cost claim and we didn’t see the point. I’m not saying that my dad’s insurance shouldn’t have been the responsible party. The girlfriend and my dad just gave her medical insurance when they got to the hospital, not considering it should be different. 

Electromoran
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Edinboro, PA, USA
12/9/2023 7:59pm

Following 

Ake89
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Argyle, TX, USA
12/9/2023 8:02pm

They are also making sure your injury is not a workman’s comp case

2
rdbs505
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Conroe, TX, USA
12/9/2023 9:33pm
motofool wrote:
I have always said I was riding my bike but never state weather it's motorized or not. My parents always had me do this growing up...

I have always said I was riding my bike but never state weather it's motorized or not. My parents always had me do this growing up also. Broke my leg from falling off my bike. Never seem to have any issues and Docs never pressed for more information.

This is what I did.  Fell off my bike.  No other vehicles or people involved.  Case closed.

I appreciate all the replies and input.

We shall see what comes from this approach.

Apparently all previously paid bills can be reversed, and all pending or future payments for any coverage can be suspended until the questionaire is filled out and sent back. Atleast that is what was threatened. 

cwtoyota
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Tacoma, WA, USA
12/10/2023 8:47pm Edited Date/Time 12/10/2023 8:50pm
rdbs505 wrote:
Wondering..have any of you ever been out riding (not racing) and gotten injured, went to hospital/urgent care for said dirtbike related injury and then several weeks...

Wondering..have any of you ever been out riding (not racing) and gotten injured, went to hospital/urgent care for said dirtbike related injury and then several weeks later received a questionnaire from your insurance company's legal/subrogation department? 

Seems like they are gathering info to get out of paying if they can but I am unsure.. The questionaire asks if it was a sports injury, motor vehicle related, on school property, product liability related.ect. 

Just curious how one might go about filling out the form honestly, but avoiding any potential pitfalls? I know you are not legal advice just never crossed this road before and am curious about others experiences with this. Thanks!

I had the same thing happen a few years back with an injury.  That spooked me big time!  Be careful with what you say, but I wouldn't be so stressed today as I was in the moment.
After looking through my coverage booklet and the terms of the insurance I called them and sniffed around the topic.

In my case the medical report said motorcycle incident, so they were thinking (hoping?) it was on the street and could be covered by my auto insurance or someone else's auto insurance.

Since then I changed up my insurance plan and in the one injury I've had I never mentioned motocross or racing.  I said I was out "riding my bike", they assume bicycle...  That's fine with me.
 

12/11/2023 9:43am

I wrecked on my "bicycle". 

rbm33
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Duncan, OK, USA
Fantasy
12/11/2023 10:11am

I have never been to the ER because of a motorcycle crash, however I have fallen off of my porch 17 times and fell off a ladder 6 times.

2
kijen
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1245
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Location
Jacksonville, FL, USA
12/26/2023 4:23pm
This just sums up how fucked your medical system is over there. actually one of the private hospitals where I live you get a discount on...

This just sums up how fucked your medical system is over there.

actually one of the private hospitals where I live you get a discount on sporting injuries if it’s club affiliated or you can use the public system for free 

Not agruing, but i doubt anything in any country is "Free" somebody is paying.

3
12/26/2023 5:43pm

Talk to a lawyer before you do anything.

I have worked in the motorcycle industry for over 20 years, and my insurance companies know this.  In that time I have had to sue my insurance companies several times.  Insurance companies play dirty, you have to stay ahead of them with trusted legal counsel.

earthmx
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Location
Riverside, CA, USA
12/26/2023 5:57pm

Whenever I have had to go to the doctor over moto related issues even if I have my gear on, I tell them I tripped and fell. If they comment about dirt and mud on my pants or jersey I tell them I was catching butterflies or painting murals or something.

olds cool
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Claremont, NC, USA
12/26/2023 9:21pm

One time I got hurt from falling off a ladder when I had my riding gear on…😎

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