Risky sports get even riskier under some insurance plans
Outdoor recreation groups are alarmed because some carriers refuse to pay medical bills for injuries suffered in high-risk activities. Health insurance coverage may be denied if you’re injured while participating in horseback riding, snowmobiling, motorcycle and all-terrain-vehicle riding, skiing and other outdoor pursuits. A very large loophole in the Health Insurance Portability and Accountability Act, or HIPAA, remains open. It’s being called health care discrimination. HIPAA was enacted to protect those involved in legal transportation and recreational activities, but according to outdoor recreation groups, its language can deny coverage because the way an injury occurred. For instance, if you break a bone tripping over a little boy’s scooter, the medical bills are covered. If the same bone is broken in a skiing accident, coverage may be denied. “I’m sure there are lots of horseback riders and snowmobilers who have no clue this is out there,” says Pam Gluck, executive director of American Trails, a Redding, Calif. based national, nonprofit organization. “If people who pay premium dollars are being denied coverage, it defeats the intent of HIPAA,” says Carla Varriale, a partner in the New York law firm Havkins Rosenfeld Ritzert & Varriale. “From a policy point of view, you could debate both sides, but it’s definitely something worth watching.” Varriale, who has done extensive insurance coverage litigation, enjoys horseback riding and motorcycling during leisure hours. “It flies in the face of the intent of the act,” she said. “These are otherwise legal activities and it seems heavy-handed in our private lives. And I’m a bit uncomfortable about who defines ‘risky.’ ” Outdoor-recreation groups have found sympathetic supporters in Congress. Bipartisan legislation to close the so-called HIPAA loophole is in committee while the Senate and House address the war in Iraq and other issues. While understandable, the delay is unsettling to outdoor enthusiasts.
