My son went down over the summer at an MX track. Ended up with a broken nose and a broken wrist. Insurance sent a questionnaire which we threw in the trash. Now receiving emails like this. Its not the rider or the people filing.
Response Required to Anthem Questionnaire
Dear ,
Anthem has notified the Benefits Service Center that a response has not been received to a request that was mailed to you. A questionnaire was sent to you because a claim or claims for medical service was submitted to Anthem with a diagnosis or treatment frequently found to be related to an accident.
Health Plan requires that you assist Anthem in determining whether the claim(s) submitted are work related or caused by another person or entity that may be responsible for these health care costs (e.g. auto accident, accidental injury on another person’s property).
Prompt completion and return of this questionnaire is important to you in the following ways: 1) your benefit plan may be credited with direct recoveries; and, 2) this may help to control the cost you and/or the Company pay for health care benefits.
If you still have the questionnaire, you can return it in the envelope that was enclosed with the letter. Anthem provides the opportunity to respond as well.
If you have questions or no longer have the letter, you can call the Anthem Subrogation Department at. Your reference/file number is . You may be asked to provide this when speaking with an Anthem representative.
Thank you,
Sounds like they may give you more or better coverage if you tell them your son was in an accident. Are they asking what type of accident? They may think it's a car accident where someone else may have been at fault who they can go after for payment
They basically want to bill the tracks insurance or the track....
I've always gotten hurt from crashing in the desert or from falling off of a ladder....
They want to understand whether or not another party is responsible for the medical expenses they paid out for your son's injury. If it's not someone else's fault, tell them he fell out of a tree. You wouldn't believe how many trees I've fallen out of over the years. :/
The Shop
Free shipping: VITALMX
Luxon 4-Post Bar Mounts
$189.95 - $239.95
These MF’s just want to recoup their “losses” by squeezing someone else or their insurance for it.
This is only tangentially related, but I thought it might be interesting to some.
I just applied for an AMA insurance policy for an upcoming event. They are using a new carrier this year. The carrier sent me a questionnaire asking about how the event will be organized. The majority of the questions are about how spectators, flaggers and course officials will be barricaded from the track.
Based on that, it sounds like one of their biggest concerns, is not from injuries to riders, but injuries to bystanders.
Whenever I end up in an ER from a dirt bike accident, I always fill out the paperwork and say I fell off my bike. Never had them follow up to ask what kind of bike it was.
It differs state to state but ..once an Ins. Company pays out on a claim, they have legal recourse to try and recoup monies from any party that may be fully or partially responsible…I am getting the same notices from my Health Ins. Company from injuries/ Emergency room services, after I crashed at a track last year.I went straight from the track to ER via ambulance so I don’t think the old “ I hurt myself playing basketball” is going to work….I”m not responding to them, if they cancel our family coverage, I will file a complaint with the state insurance dept. and we can have a hearing about how much $ I have paid them over the last 25 years….
Mountain biking solo in the national forest. Always mountain biking on public land, stick to the story. 👍
Yes Mtn biking or ladder.
MTB'n over a ladder at the Moosrun.
Had this happen to me before. It’s because when you went to the er the nurse filing the report wrote down that your son was in a “motorcycle accident”. They don’t understand a dirtbike doesn’t have a insurance policy like a Streetbike. So they are looking to go after a auto insurance policy to cover there expenses. I had to tell them like 50 times that it was a dirtbike crash on my own property not a motorcycle crash on the roadway. All because one thing a nurse or dr writes down. The person handling the claim probably is from India and doesn’t understand the difference. It got straightened out but your definitely gonna have to talk to someone.
We have had probably 17-18 motocross accidents over the last ten years. . We always get those. Just fill it out. We’ve never blamed the track. Nothing happened that was the tracks fault. . One hospital bill was over 1.5 mil. Insurance never went after track.
Just take the blame on yourself. You crashed, nobody else had anything to do with it. It was your fault, you were out of control.
Is there a box where you can blame a 4yr old on a Stacyc bike to stay consistent with the AMA’s fantasy?
I crashed at a new local track at the end of the year breaking my eye socket which resulted in a small plate in my face. Got a few questionnaires like above which I answered vaguely until I started receiving phone calls demanding I tell them the property I hurt myself on. Told them I was on the Sam Houston National Forrest, never heard another word from em.
The United Healthcare murder back in November showed health insurance is all about profit and CEO bonus compensation!
Subrogation claims are very real, there are law firms with entire departments that handle nothing but subrogation cases on behalf of insurers.
No insurer is going to go through the trouble of a subrogation case over a broken nose and wrist, but they could. Even if you don't wish to file suit or participate in the litigation they can and do file suit and your name is listed as the Plaintiff. Public records will reflect that you are suing the track.
Pit Row
Pretty much my point for the thread..
This thread is for the riders that are trying to do just what you stated, when an Ins. Company pays out a claim, they have legal recourse to recoup those paid out amounts, “IF” being the big factor….IF they can show/ determine your injuries are the result of someones…in this case a track, negligence….now even if the subrogation dept. gets 25% of a paid out claim back, that is a win compared to nothing back….
I get that I wasn't responding to your post. Just clearing up some misconceptions that have been posted.
I have been through this as well….multiple times explaining to the rep it was an off road motorcycle with no license plate, registration or Insurance…. They are more concerned with denying a “ No Fault ” claim for medical benefits, which in NYS does not apply to road motorcycle accident injuries…..trying to explain dirt bike racing/ accident to someone who has no clue is painful.
I’ll echo this - I crashed my road bicycle and they put down motorcycle in the intake form when I told the nurse “road bike”. They chased me down like this and there were numerous times ( like 10-15 ) I had to tell them “that was written wrong it wasn’t a motorcycle it was a bicycle” because they were trying to pass it on to someone’s auto policy liability
When Kaiser reached out a couple year ago after I broke a few bones at a local track they couldn’t hang up fast enough when I said motocross track. I (probably naively) thought there was no reason to not be straight up since they had signed waiver from me.
Yup. Most of us do the same. It depends on the extent of the injury though, if you need paramedics or an ambulance, the hospital/insurance will know.
This is what i put on the one i received from united healthcare when i broke my Scaphoid at LACR last year… I tripped and fell to an out stretched hand… never heard anything else back.
I don't think the murder showed that. We already knew that before he got murdered.
I had a compression fracture in my lower back from casing a jump, I told the hospital and insurance i fell out of my truck
Yeah makes sense down vote a guy that works in the insurance industry. Lying will just cause problems.
Yeah you aren't teaching me anything I don't know about subro I literally used to do it. Not in health insurance that stuff is horrible but with auto between companies. Health insurance is an absolute ripoff. I hate it. Especially Cigna worst I've ever had.
Post a reply to: Insurance, Accidents, and Lawsuits