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Jammin_joules
| | Posted on Tuesday, March 17, 2009 - 11:42 am: | 
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Think insurance covers you when you go down off that hot Buell wearing a helmet and not speeding while the cell-phone text'g suburbanite in an SUV that runs you down?
Or fall from a carbon-based horsepower?
Better write your elected officials to make sure it does.
In a message dated 3/17/2009 mrfnews@mrf.org writes: HIPAA Update
On March 4, 2009, The United States House of Representatives Committee on Energy & Commerce passed legislation that would make it illegal for insurance providers to exploit what is known as the "source of injury exclusion" loophole; reports the Motorcycle Riders Foundation.
On that day the committee chaired by US Representative Henry Waxman considered 10 bills that had passed the House with bipartisan support in the 110th Congress. Under a motion those bills were ordered favorably reported to the House by unanimous consent.
Under current law, insurance providers can refuse to pay for treatment of an injury based solely on the source of the injury. Simply by pointing to the "source of injury" law, no prior notice of possible denial of benefits for that source of injury is required.
Sources of injury that can be used as a reason by insurance providers to refuse payment of medical bills include motorcycling, snow skiing, ATVs and horseback riding.
According to HR 1253, known as the Health Insurance Source of Injury Clarification Act, if an insurance provider wants to be able to put limitations on payment for an injury from a specific source they must meet the following requirements.
* "Make such limitations and restrictions explicit and clear; "
* "If part of a group plan, must be disclosed to plan sponsor in advance of the point of sale of plan;"
* "The plan sponsor and issuer of health insurance coverage provide a description that is easily understandable to the participant prior to enrollment."
To summarize the legalese, your health insurance provider can limit payment for an injury sustained on a motorcycle so long as it is spelled out to you in simple terms well in advance of you joining the plan.
Closing the loophole entirely and mandating that insurance companies must cover all injuries sustained while operating a legal motorcycle is still the ultimate goal of the MRF. HR 1253 puts Congress on record that this issue needs attention and is willing to work on it. The MRF will continue to keep you updated on this important matter. |
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