Posts
963
Joined
12/22/2009
Location
una
AZ
Edited Date/Time
1/27/2012 6:13pm
Seem's like there is a serious insurance problem with people who ride dirt bikes. Question for any of you MX Mom and Dad's - how could you justify sending your kid out on the track knowing he doesn't have sufficient disability insurance and/or sufficient medial insurance?
Is it irresponsible to take such HUGE LIFE CHANGING risks knowing your not properly insured?
Is it irresponsible to take such HUGE LIFE CHANGING risks knowing your not properly insured?
The Shop
Its my understanding policies that cover 80% of the cost leaving the policyholder the remaining 20% are a culprit. People do not realize that 20% can still be a very large dollar amount, especially for a young person who has no significant savings built up yet.
It's not easy in CA to qualify for an individual policy (vs a policy offered thru an employer which is very easy to get). An individual disability for a motocross racer is even more difficult to qualify for.
Of course, the same applies if the rider isn't a minor. But I think it's everyone's responsibility to be adequately insured before riding. I sat out two events earlier this year because I knew I wasn't covered. (My ex left a job and new coverage hadn't kicked in yet.)
My guess is that there might be some other pitfalls here. Anyone else?
I thought I had heard once, if you fall off a atv you are covered, but if you fall off a dirtbike it opens up a new book. Also events might have a different effect also. IDK for sure.
Just my opinions
I also have insurance through my bank that covers lost income in case of injury. Thats not free though.
Pit Row
I was lucky i only had a few days to go, put up with it until i got home and got it checked into then.
Otherwise man up and take responsibility for your own choices to participate in your chosen past time and buy your own insurance and keep your hand out of my families pockets and expect someone else to take care of you and your own stupidity!!!
OK ill get off my soapbox… carry on!!!
Also, with free insurance (Canada) you also get crappy doctors. Don't believe me? Talk to someone that came to the States from there to see a specialist.
Finally, I love bvm111. Preach on, brother.
Guys are on here saying they can get new 09 450's for $4,000 - I saw an 09 CRF450 for $9,300 @ Riverside this weekend.
And, to my US friends...yeah, our health care is "free" but you wait a loooong time if you need anything major done. Plus, you can't pay and move to the front of the line here like you guys can. Not sure which system is better, but if I get real sick I'll be paying to get treated in the US anyway instead of waiting in line until I am dead.
I am covered by a private policy that I have been paying for since I quit the film union I worked for. I have Regence Blue Cross Blue shield out of Portland ,Oregon. I pay close to $900 per month for my wife ,myself and our three kids.
Some of you guys know I was injured at Elsinore three years ago this Dec 30th I took a digger and ended up with a broken femur (two places), ascetabulum, pelvis and humerus. I had three major surgeries at Riverside County med center and spent 15 days in that lovely establishment.
My first problem was that I was "out of network" and usually this is covered by the fact that the service's were of an emergency nature which usually requalifies you as" in network" even though you are out. One small problem was that I was initially taken to the med clinic in Murrieta near the track which had no business treating someone with the extensive injuries I sustained. So they stabilize me and then transfer me to a trauma team at riverside to handle the injuries. This is the part that my beloved insurance company used to remove the emergency nature of my situation therefore disqualifying my "in network" coverage. I then rang up a hospital bill to the tune of $185,000 (at Riverside) and Blue Cross used this as their way to deny paying for my claim. Leaving me with about $70,000 in out of pocket expenses. They denied all of my appeals pretty much saying tough luck buddy. So now I pay for the next 30+ years for that fateful day at Elsinore.
One of the things I learned was that if I had been a California resident I would have qualified for MediCal which would have then kicked in and covered the outstanding balances. This is one thing for Christian to check into if he is a resident of Cali (if that's where he was injured) it sounds like a good program.
I also learned that in the sport of motocross you are probably better off if you also have AFLAC or some other supplemental coverage to cover what your policy doesn't cover. In my case the out of network clause left me responsible for 40% of my bills. Luckily I was able to transfer myself back to Oregon to have the rest of my surgeries and recovery where I was back in network and covered 100%
I agree with Guy B don't ride without insurance, it's irresponsible and in America you can be ruined finacially for the rest of your life if you don't have adequate insurance. If I had done major spinal or head injury my out of pocket could have easily been upwards of $500,000 not to mention the ongoing cost of extended treatment.
Good luck and read the fine print on your policy, the insurance companies don't make their money by paying claims, they make it by collecting premiums and denying claims. It's sad but true, I unfortunately learned this the hard way but I still feel lucky that I can walk and enjoy my family and believe it or not still ride, but I only ride in area's where I am "in network"
When I see guys complaining about how much rebuilding a four-stroke costs (and that would be a minor thing compared to any serious injury), it makes me wonder how many of them are skimping on insurance.
I hate insurance but you've gotta have it. Necessary evil.
here are a few counters too their dis-allowances and exclusions.
when they pull the out of network crap... read your fine print. The language they use, if its simular to mine, they are talking about primary care physicians and seeing specialist out of state when its not under direct referral with approval from them(translation, you cant just up and goto the Mayo Clininc on a whim, but I have yet to hear BC/BS not authorise a specialist, but firs time for everything). They cant legally use location, as long as the claim happened in the usa, as an excuse to disallow. There is no, as far as I was told by my lawyer, state, county, city only coverage , you dont and they cant limit coverage by location. They will tell you that, have a lawyer write one letter and they usually wont mention it again.
secondly... ask the hospital to SUE you. You can NOT sue your own insurance to get them to pay someone else. Ask about it. You cant. BUT, if YOU get sued, and you have paid your premiums and are covered... if the hospital sues YOU, you CAN bring your own insurance in as a co-defendant VERY successfully. Worst case, you still owe what you owe and its on your credit as a judgement. Bright side, they cant charge you over 5% interest, and you can appeal to the court to waive that, plus they will generally be instructed by the court to accept a settlement amount. Thats the bad side. Good side. you never goto court, you get sued, goto an attorney, he files BC/BS as a co-defendent. you sit back, they pay what they are supposed to. Let their lawyers fight about it, thats why they retain them. The above is FACT, not imo. I literally had to do this. Mine was a bit weird though... got married. My wife was under the EXACT same BC/BS policy I had. We filed within 30 days of being married to move her from her dads to mine. BC/BS considers this a policy change for her. 1 year before you can make a maternity claim. We get married in Dec 05. Nov 11, 1996, little girl arrives.... had to pay for it ALL they said. 22,000. Yes I know that makes a difference, price vs how much to goto court ect. But my dad, had a 152,000 bill. 15 days in ICU, hospital for another 20 days. they claimed the specialist that was brought in for dad was out of coverage. Mom went to the attorney, 2 or 3 letters, got served, named BC/BS as co-defendent... they suddenly paid. So it has legs.
For the record, this is 2 cases out of 40 years of my dad having a shit ton of claims and they paid better than expected... dad had 23 back and neck surgeries. Degenerative disk disease. BC/BS even paid 100% of the costs for dad to have a $45,000 morphine pump implanted and ported into his spine... that bill was over 100k. So, there are instances, but I wouldnt goto anyone else.
Again, this isnt some IMO. This is from a lawyer that is versed in medical malpractice, and liability. He might be an ambulance chaser, but hes a damn good one around here.
Also, personal tip that works, you just have to go high enough up the hospitals chain of command in the accounts receivable department. Ask them if they would accept from you, the same amount they would accept from your insurance if you were at 100% dedectable. its typically between 40~60% off! FACT! you just gotta find someone that can ok it at the hospital.
lastly... i dont know where the hell some of you stating things get yoru insurance, but if you have insurance thats 80% 20% from 1 dollar until you hit your cap... you have shit insurance. You ask around, the med bills and crisis most get into isnt because of some 80-20 deal, its because they cap their insurance out! Why is Blue Cross, good blue cross, so expensive, relatively speaking? I pay the first 800 out of pocket. it applies to my deductable, plus just because I have insurance, most providers waive 40 to 60% of the charge.
Secondly, once I pay 800, i then have to pay 20% of all charges until i hit $2000 total paid out (including the original 800) after that, I go %100 covered. Also, any charges I pay in the last 90 days of a calendar year, carry over to the next year.
I have a 15$ co-pay for general physician visits, but the best part, i have NO cap. 100,000, 200,000,000. There is NO cap. As long as I pay the deductable, ($602 a month for me, 38, wife 37, kids 13, and 10) they cant drop me.
Look it up. BlueCross Blue Shield is generally one of the best you can get, but no matter what, there are always stories out there and they WILL, if they think they can, try to loophole you. just do it back.
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