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Old 11-11-2009, 09:49 AM   #21
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Candie, sucks to hear. I agree with Pachuco that you should talk with someone who knows the ins and outs of the insurance biz before you call them.

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Old 11-11-2009, 09:51 AM   #22
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Quote:
Originally Posted by bubby View Post
We are on the same plan and have never had any trouble before. i don't think the initial denial has anything to do with it being bike/track related but we will find out.
with my numerous claims made in the last few years, not once did I tell them I was doing anything other than riding a dirt bike in the woods. Had I told them I was racing, it would probably have been denied.

Each claim made has been a hassle though, because I was on a motorized vehicle, they kept insisting that I claim on my vehicle insurance, to which I told them repeatedly that I was on a dirt bike, riding in the woods. After a few months, and some stern phone calls, they accepted my explanation.
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Old 11-11-2009, 09:56 AM   #23
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Honestly, you are treading on dangerous ground by talking about it on a public forum. They have teams that dig thru EVERYTHING to deny you.
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Old 11-11-2009, 10:14 AM   #24
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A certain person should delete this thread to protect the folks!!!
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Old 11-11-2009, 10:21 AM   #25
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sorry about your troubles. i had a very similar situation earlier this year. hope yours turns out better than mine did.
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Old 11-11-2009, 10:34 AM   #26
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Quote:
Originally Posted by Godsuki View Post
with my numerous claims made in the last few years, not once did I tell them I was doing anything other than riding a dirt bike in the woods. Had I told them I was racing, it would probably have been denied.

Each claim made has been a hassle though, because I was on a motorized vehicle, they kept insisting that I claim on my vehicle insurance, to which I told them repeatedly that I was on a dirt bike, riding in the woods. After a few months, and some stern phone calls, they accepted my explanation.
so you were stern about your ins fraud.........nice.
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Old 11-11-2009, 10:43 AM   #27
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Quote:
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Honestly, you are treading on dangerous ground by talking about it on a public forum. They have teams that dig thru EVERYTHING to deny you.
I am not going to lie about what I was doing. Besides a year later and several doctors, physical therapist all know who I got my injury. It is a little late to try and change my story.
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Old 11-11-2009, 11:01 AM   #28
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I just went through all my medical bills/claims for my surgery. From what I can tell there is a 1400 balance for an assistant to the surgeon that my insurance deemed unnecessary and that is what was denied. So if that is all it is I am ok. I will know for sure tomorrow. But now that I have thought about it I will go through my health insureace policy and make sure there are no exclusions for racing, since I will be doing that next year.
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Old 11-11-2009, 11:45 AM   #29
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Quote:
Originally Posted by Candie View Post
I just went through all my medical bills/claims for my surgery. From what I can tell there is a 1400 balance for an assistant to the surgeon that my insurance deemed unnecessary and that is what was denied. So if that is all it is I am ok. I will know for sure tomorrow. But now that I have thought about it I will go through my health insureace policy and make sure there are no exclusions for racing, since I will be doing that next year.
Try to make 'em pay that too.
Who are they to determine if that asst. was necessary? If the asst. was truly unecessary then the surgeon/hosp. should not have billed you.
In which case it should be between the insurance co. and the surgeon or hospital.

My wife had a minor surgical procedure done a few years ago, the hospital tried to bill us for part of it. My wife called the insurance and they said they had already paid the entire bill.
She then called the hosp. and after a long conversation got the lady to admit that they often send out letters insisting on payment even though money is not due!
Obviously if the patient just shrugs and pays then they got free money, if they fight then the hosp. just drops it.

I know this isn't exactly the situation but the point I'm making is that the whole medical and insurance industries are full of quasi legal scams to shake down the customer, so fight for what you believe is right!
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Old 11-11-2009, 12:16 PM   #30
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I really didn't have any problems except they didn't want to pay for a second CT scan and a second MRI. After a couple of phone calls it was fine.

I was shocked at the cost though, $15k and I didn't break anything and no surgery, crutches, slings, braces etc. 2 years later and I still have some aches and pains from it though.
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Old 11-11-2009, 04:54 PM   #31
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Candie I would call my agent to get that clarified. I don't think you will find an employee sponsored policy that will include coverage while in a sanctioned closed course event. This brings to light what a lot of folks overlook when it comes to racing. The what if's....
One only need look a few threads over to see the story of Zac and all the complications involved in a worst case scenario. Roadracing World had a good article on it last month. Basic coverage is one thing, how many racers do you know who carry thier own long term disability? Most( if any) never really consider the worst case and how it would affect families and loved ones should you become incapacitated. I know I am responsible for child support even if I die!!
It takes some real soul searching to continue to race year after year. For 99.99% it is nothing more and will be nothing more than a VERY EXPENSIVE hobby. Every time you grid up, you should understand that through no fault of your own you could be hurt badly and your way of life could change in a big way. Props to you and Bubby for taking a good look at your policies, good luck and let us know what you find. The "closed course" is a very broad disclaimer for the insurance community, school or race.
Even trackday riders should consider the consequences of a good bell ringing that the paramedics deem worthy of a helicopter ride. It can add up faster than most can believe.
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Last edited by Buck Beasley; 11-11-2009 at 04:57 PM.
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