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Source of injury exclusion...

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Old 10-11-2008, 04:02 PM
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Default Source of injury exclusion...

Since we are trying to stray away type of threads.

I been looking for more informative material. I know injury is a subject that we all hate to hear. But its reality, right?
After taking my small harmless spill yesterday. It had me thinking. Would my insurance take care of me is something MAJOR happened? Probably not...

But the Motorcycle Rider Foundation is doing their part on changing insurance guidelines...

Check it out...

The United States House of Representatives Committee on Energy and Commerce today passed legislation that would make it illegal for insurance providers to exploit what is known as the "source of injury exclusion" loophole, the Motorcycle Riders Foundation (MRF) reports.

Under current law, insurance providers can refuse to pay for treatment of an injury based solely on the source of the injury, with no prior notice of denial of benefits for that source of injury simply by pointing to the “source of injury” law that exists today.

Some sources of injury that can be used as a reason by insurance providers to refuse payment of medical bills are motorcycling, snow skiing, ATVs and horse back riding.

This new legislation, HR 6809, known as the Health Insurance Source of Injury Clarification Act, does not entirely replace HR 1076. Where HR 1076 makes it illegal to deny benefits for any injury that occurs during legal transportation or recreation, this bill does allow for limitations of payment if the provider follows some rules.

According to HR 6809, 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. [ul][*] "Make such limitations and restrictions explicit and clear;"[/ul] [ul][*]"If part of a group plan, must be disclosed to plan sponsor in advance of the point of sale of plan;" [/ul] [ul][*]"The plan sponsor and issuer of health insurance coverage provide a description that is easily understandable to the participant prior to enrollment."[/ul] 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.

"HR 6908 is not a touchdown, but it's moving the ball a good way down the field”, said Jeff Hennie, Vice President of Government Relations for the Motorcycle Riders Foundation. "Considering the fact that the Federal government just bailed out one of the giants in the insurance world to the tune of $85 billion, I don't think Congress is in any mood to mandate insurance to cover anything, even transportation."
"I do believe this is a very positive step forward on this issue and one for which the motorcycle rights community should be very proud", he added.

MRF Vice President, Michael Kerr had this to say when hearing the news: "The MRF applauds Dr. Burgess' efforts to bring honest disclosure and openness in the wording of major medical insurance policies. We also thank Chairman Dingell for his leadership in guiding this legislation through his committee. That being said, the MRF remains firmly committed to the passage of HR 1076. We will continue to advocate for closing the HIPAA loophole, once and for all. We stand fast in fighting discrimination by insurance companies against anyone engaged in a legal form or transportation, such as motorcycling."

The bill's primary sponsor, US Representative Michael Burgess, had this to say: "Congress is charged with making laws to protect people and when they have the opposite effect, we also have a responsibility to work together to fix them. The time has come to fix this loophole in the HIPAA law and this bi-partisan bill does just that."

Closing the loophole entirely and mandating that insurance companies must cover all injuries from legal motorcycle use has always been a lofty goal. It is still the goal, and it is still lofty, but HR 6908 at least backs insurance into a corner and doesn't allow them to hide behind regulation, rather than being honest up front and that's a good start.

This committee hurdle is the first of many. There are still two other House committees that have some jurisdiction over this bill and they need to vote the bill or waive jurisdiction. Then, onto the House Rules Committee and the House floor. The bill must then navigate the Senate committee and floor process and ultimately the President will sign into law. That's a lot of ground to cover before Congress adjourns in the next few weeks.
 
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