This is actually the same in the UK. If you have private health insurance, it normally does not cover dangerous activities. But that just means you get standard NHS coverage. Here in the UK private health insurance is a top-up to the NHS. It means you get seen faster, get better hospital rooms, and so on. But you’ll still take second place to an emergency.
Bah, ninjaed by Doctor Jackson.
dude, in the UK you don’t even need paperwork, and that’s because … you need treatment - that is the criteria. Crazee system bankrupting the country at 8% GDP.
Even with helicopters.
To be honest, the question doesn’t even make sense in the UK. Regardless of the activity you are doing you get treated, and transported (or rescued) for free. No questions asked (other than perhaps a “how did you do this?” followed by a rolling of the eyes)
The only experience I have with anything like that is when my sons were in high school, playing football. There was added insurance we were required to buy, but it provided a payout in case of death or disability. You got so much for a leg and so much for an eye. it was a direct payout, not health insurance.
I guess you could use the payout for medical bills, but you weren’t required to.
Back when I was actively flying as a general aviation pilot I used to read the full insurance policies provided by my employers as benefits. Some did, indeed, have interesting exclusions in their policies. In one case, one of my co-workers discovered that high school and college competitive gymnastics were not covered - after his daughter injured herself. Sometimes my activities as a pilot were covered, sometimes not. The sky-divers I knew had similar issues.
How do they find out? Usually via attempts at sub-rogation, or policy holders being honest.
We find a reasonable middle ground. We treat you, but every single person you meet in the process gets to tell you how stupid you were for getting hurt like that.
Okay, no, not really.
In Japan, any injuries are covered by the national health insurance, but helicopter rescues can be additional charges. We were encouraged to have private insurance for that.
It’s not that they won’t pay, it’s that you’re rated higher; & therefore, your insurance costs more because you’re more likely to die sooner, same is if you’re a smoker, or have a chronic illness, or are older. If they find that you lied on the application, that’s a material defect & they may not have to pay out. Going for a plane ride when you’re on vacation is not nearly the same as being a pilot & flying regularly.
If you’re a healthy, athletic, non-smoking 20 yo, the actuarial expectation is they have ≈ 60 years to collect premiums before they need to payout. If you’re a 45 yo GA pilot who smokes & has diabetes, the actuarial risk may only be 15 years so you’re premium would be 4 times as much as the 20yo’s for the same amount of life insurance payout.
This is a simple calculation; excluding PV of money, etc.
Yeah, I shouldn’t have said it the way I did. My recollection (from 10+ years ago) was that they asked if I engaged in such activities, and when I said no, the policy was priced accordingly, and I was made to understand that the policy would not pay out if I died while doing those things. If I had admitted at the outset to engaging in such risky activities, my policy would have been priced higher, and then yes, the policy would have paid out if I died doing one of those things.
I’d think we can look at activities that ARE customarily covered and that are also high injury risk, and deduce that even if it’s legally permissible, most US policies either don’t have that sort of stuff, or don’t enforce it.
I mean, if the insurance companies were serious about it, they’d want to discontinue coverage on most youth sports, especially contact ones like football or hockey or martial arts like karate, tae kwon do and judo. But I’ve never heard of a high school football player’s injuries not being covered because they are “high risk”. Same for cheerleading, or any other youth sport.
Furthermore, I suspect if that was the case, we’d see dramatic reductions in the number of players, and we don’t see that either.
I’m not convinced that it’s an issue in the US, and it’s pretty clear that it’s not an issue elsewhere either.
I broke my neck while skydiving and my insurance paid without ever even raising an eyebrow. That was in 1990, but still I don’t recall seeing these exclusions.
I broke a couple of ribs earlier this year while mountain biking and it was covered (at least they applied the bills towards my deductible).
In the UK if injured your rescue, transport to hospital and health care would not cost you (tax payer) anything.
Insurance might come into play if you elected for private care.
Note that many rescue services - the RNLI, mountain rescue, etc - are charities, not just the air ambulance that Filbert mentioned.
This applies to many places; the Red Cross is one of the charities that’s got ambulances in many locations. And in Spain, the Armed Forces are another possible source of transportation, both through use of their regular vehicles and through their Red Cross program.
This kind of thing should be applied to drunk driving. If someone drives drunk, they should pay their own way for medical bills.
In New Zealand there is ACC, Accident Compensation Corporation. Our no-fault scheme covers everyone in New Zealand if you’re injured in an accident. The scheme covers children, beneficiaries, students, if you’re working, unemployed or retired. It also includes visitors to New Zealand if they’re injured while they’re here. It is paid for by wage earner levies of about 1.0-1.5 %, a levy on petrol and on vehicle registration fees as well as other levies on employer payrolls. It doesn’t matter what the accident was, whether you were getting a cup of tea and tripped over the cat or trying BASE jumping off the Sky Tower in Auckland, you’re covered. ACC pays for the ambulance costs too, whether it’s a minute down the road from the ED or helicopter rescue from the slopes of Mt Cook/Aoraki. As well as paying treatment costs, they pay for rehabilitation, physiotherapy, prosthetics, wheelchairs, vehicle conversions for legless operation or wheelchair lifts. They also pay for home alterations if necessary to allow disabled access, walk-in or wheel-in showers and so on. You get the picture - any costs associated with accidents from transporting you to hospital, through surgery, recovery and ongoing living space adjustments are covered.
Yes, you’re right. I forgot to specify that I was talking about the UK.
If you are seriously injured in an accident or critically ill here in Australia, you will be transported to the closest hospital that specialises in your injury/illness. That is provided you are an Aus citizen, or on some sort of permanent residency visa. Your treatment and rehab will not cost you anything out of pocket, UNLESS you opt to be treated as a Private Patient, in which case you and the hospital/rehab will be charged by your insurance company.
Which is why most folks with private insurance opt to be treated as a public patient when they have suffered serious injuries/illnesses.
IOW, if you are engaging in extreme sports and get hurt, you will be covered 100% by the Aus health system for your initial treatment and your rehab later.
Oh, I wasn’t trying to correct you, just to point out that what you’d said for the UK is valid in many other locations as well. These conversations always bring to the forefront how many things we take for granted simply because it’s what we’re used to, when they actually happen to change by location.