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Author Topic: Health Insurance and MTB Injuries?  (Read 3693 times)

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Offline Alan

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Health Insurance and MTB Injuries?
« on: September 03, 2008, 06:26:49 PM »
The thread on Gary got the wheels in my head spinning.  I work in auto insurance and know the issues that come to people who damage their vehicles during "gray area" motorsports such as autocrossing.  The auto insurance industry generally regards this as a formal racing event and can deny the claim.  Why?  Because, in theory, someone who goes out on a weekend race has a higher risk of a large property damage or physical injury exposure. 

What does this have to do with moutain biking?  Theoretically, a person who mountain bikes has a higher probability of serious physical injury over someone who doesn't participate in the sport.  Given my insurance background, this is a potential risk that could be a coverage issue, right?

So this thread is for those who have been injured and had to turn to health insurance.  Is this situation something the health insurance companies frown upon?  If I go out and break my wrist on the trail, do I run the risk of a claims denial if I spill the beans and tell them what I was doing?  Has anyone had any experiences with health insurance claims involving mountain biking and/or mountain bike racing?

Offline Jim DeLuca

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Re: Health Insurance and MTB Injuries?
« Reply #1 on: September 03, 2008, 07:08:11 PM »
I asked my wife who has handled health claims for many years.  She says in general if your out mountain biking for recreation it would not be an issue, however, if you are injured in a racing event your claim would be denied.   She encourages everyone to check their insurance policy exclusions to ensure you are covered if you are injured while riding, as every policy is different. 

Offline treadlight

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Re: Health Insurance and MTB Injuries?
« Reply #2 on: September 03, 2008, 07:34:57 PM »
Help...Gregg is our "in-house" insurance agent and he has the mtb insurance from IMBA.

Offline FACTORe

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Re: Health Insurance and MTB Injuries?
« Reply #3 on: September 03, 2008, 07:53:09 PM »
i got hurt mtbing and my supplimental paid me a check for my broken rib

Offline singletrackmind

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Re: Health Insurance and MTB Injuries?
« Reply #4 on: September 03, 2008, 08:34:09 PM »
I've had several injuries from fractured rib, to broken elbow, and have never had an issue with my insurance covering the bills. Thats even with them(ER staff) asking me how/where i got the injury. The thought has crossed my mind before that an insurance company may be able to drop someone if they put themselves into a higher risk of injury.
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Offline Gregg

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Re: Health Insurance and MTB Injuries?
« Reply #5 on: September 03, 2008, 09:22:36 PM »
As it would happen.....

After my injury 19 months ago, I made career change. I became a licensed insurance agent that specializes in accident insurance. I probably don't let enough people in this community know it.

I could not work for more than four months, and had very expensive surgery and physical therapy for almost 8 months. So i have personally experienced this.

Most health insurance will not exclude any claims regarding recreational mountain biking. In order for a claim to be denied (in most cases) you would have to be considered a professional racer in other words racing for money as a way to earn a living. That would not include a race such as the one that many of you were just in. That is an amateur  race.

What most people don't realize is that not all health insurance is created equally. When we look at our benefits package at work most of us by nature look at the plan that has the lowest copay for regular doctor visits or the lowest premium. This is understandable because each and every year they get more and more expensive.

You NEED to look closer. The major medical side of the policy is what can bankrupt you. Over 80% of all personal bankruptcies in this country are due to being underinsured in the event of a serious illness or injury. Most people just don't keep enough savings on hand.

The fact there are deductables and copays that add up and up and up. In addition, you might not be able to work. The emergency room copay, the hospitalization deductable, surgery copay.....etc.....

I actually have 2 supplemental accident policies and my health insurance. The IMBA policy which is a coordinated policy, and the policy that I sell (Allstate) plus my wife's Blue Cross/Blue Shield. There were lots of holes in the Blue Cross policy, and we get it through Pasco County. (plus it costs a fortune!)

I urge you all to look closely at what you have. Find out if they offer supplemental insurance at work, if they do, get it. If not look at the IMBA policy. I will be glad to show you the Allstate policy. Which ever works best for you. Believe me, if you ever have to make a claim, you will be surprised how much benefit you will get. As with all insurance, I hope you never need it, but we engage in an activity that by it's nature puts us at some risk. That is half of the fun.

Feel free to pm me if you have any questions.

Offline FACTORe

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Re: Health Insurance and MTB Injuries?
« Reply #6 on: September 03, 2008, 09:49:57 PM »
I made money off my wreck....yayyy

Offline MBruns

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Re: Health Insurance and MTB Injuries?
« Reply #7 on: September 03, 2008, 11:01:38 PM »
Gregg, I sent you a PM
Mike Bruns
A 'good' ride is one that you can walk away. A'great' ride is one after which you can use the bike again.

Offline chisel

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Re: Health Insurance and MTB Injuries?
« Reply #8 on: September 04, 2008, 08:04:27 AM »
I was injured jumping bikes and told them that  at  the ER and my insurance covered me with no questions asked. 8)

Offline Redriderpro

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Re: Health Insurance and MTB Injuries?
« Reply #9 on: September 04, 2008, 08:51:53 AM »
o confirm what Greg said, over the 20 years of racing Moto and 25 years of MTB riding, I've had way to much experience with insurance claims. Some of these claims involved hospital stays and surgery.

Thru all of this I've had a lot of different insurance companies, some were HMO,some were PPO and some were company self insured.(I've been at the same job/company for 31 years, they shop insurance companies each year)

In every case I asked up-front, if Moto racing/riding or MTB racing/riding had any exclusions.
The answer was the same each time. If it is not for INCOME or a Professional race then it's all covered.

The KEY is go find out now, don't wait till you're at the ER and they won't take you in and treat you.

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Offline FACTORe

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Re: Health Insurance and MTB Injuries?
« Reply #10 on: September 04, 2008, 09:03:22 AM »
I pay an extra $4 a week for accident insurance on top of my regular insurance and they send you checks on top of having the bills paid.  If you are going to ride mtb, it is crazy to not get accident insurance and if you don't have regular health insurance and are not independantly wealthy...it is a timebomb waiting to explode.

Offline Alan

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Re: Health Insurance and MTB Injuries?
« Reply #11 on: September 04, 2008, 06:00:01 PM »
Excellent information.  I'm definately going to look into supplemental coverage (I've actually been meaning to look into supplemental disability coverages since my work provides less than stellar health and disability benefits). 

Those IMBA policies looked more like group liability policies for MTB clubs, parks, etc.  Did I miss something on IMBA's website?  Do many of these supplemental health insurance policies throw in additional disability benefits too, or is that something separate like AFLAC?

Offline Gregg

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Re: Health Insurance and MTB Injuries?
« Reply #12 on: September 04, 2008, 08:35:06 PM »
Excellent information.  I'm definately going to look into supplemental coverage (I've actually been meaning to look into supplemental disability coverages since my work provides less than stellar health and disability benefits). 

Those IMBA policies looked more like group liability policies for MTB clubs, parks, etc.  Did I miss something on IMBA's website?  Do many of these supplemental health insurance policies throw in additional disability benefits too, or is that something separate like AFLAC?


I just sent you a p.m. I will be happy to explain.

Offline Slowy

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Re: Health Insurance and MTB Injuries?
« Reply #13 on: September 05, 2008, 08:06:07 PM »
interesting topic
Joe


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Offline PinkRoses31

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Re: Health Insurance and MTB Injuries?
« Reply #14 on: September 22, 2009, 04:08:09 AM »
Went out for our Tuesday evening MTB ride and 15min. into the woods, my buddy Brian crashes on a technical rock descent.

Dislocated his shoulder.... Walked him out as the only person that drove to the trails went to get his vehicle. Me, my wife and Brian walked to the road. The three of us had ridden to the trails...so Jeff brought him to the hospital.

Sucks for Brian, but he will be OK. I hear it takes months for that to heal though...

So what kind of MTB riding injury stories do you all have? I have broken a hand once, broke an arm once.



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