Overseas Health Care Discrimination Lacking
Rights Groups Say Their Members Are Covered
By Jim Witters
As we detailed in the May issue of American Motorcyclist (“Coverage Denied”), the new federal Patient Protection and Affordable Care Act does nothing to prevent employers and insurers from refusing to pay for injuries sustained off-duty, if the insured individual was engaged in certain insurer-defined “risky” activities.
The continued reluctance of state and federal governments to prevent health-insurance discrimination against motorcyclists and all-terrain-vehicle riders leaves U.S. citizens vulnerable.
In short, the law allows discrimination based on how the injury happened.
Only Colorado specifically forbids health-care policies from limiting coverage to off-duty activities pre-approved by your employer and insurance provider.
Following that article, we received inquiries from members about how things are handled overseas.
A survey of motorcycle-rights organizations in Europe, Canada and Australia revealed that the United States might be the only country in the Western world where this issue persists.
Here is a sampling of the responses:
Source: David White, chief executive officer, Motorcycling Australia
In Australia there is a public health system called Medicare. Basically that means for any Australian citizen or a person with permanent residency status will receive free public hospital treatment including the cost of the bed, medical treatment and medicines required for the treatment.
There is a waiting list for non-emergency treatment, i.e. a hip replacement where the joint has just worn out.
However a motorcyclist who was admitted to hospital following a racing accident would receive immediate free service for the treatment of his/her injuries.
Similarly a road-riding motorcyclist would receive free medical service if admitted to hospital as a result of a road accident.
The free service provided in these emergency situations is first class.
A person can take out private health coverage, whereby you will be covered for your medical treatment in a private system for what would be termed non-emergency treatments.
In addition, Motorcycling Australia has a personal accident policy for its competition riders. This is a basic cover for death, paraplegia/quadriplegia and full/partial loss of use of limbs. In addition the policy covers what is referred to as non-Medicare services, such as physiotherapy. The policy also allows for a parents’ inconvenience allowance whereby the parent of a minor may have to drive that person on regular trips for medical services or have accommodation where the minor maybe hospitalized some distance from the family home.
Source: Marilynn Bastedo, executive director, the Canadian Motorcycle Association
In Canada, even though our health care system is a national one, the jurisdiction for health care is at the provincial level, which provides an opportunity for small differences in coverage to exist.
However, in no case does our system permit exclusion from coverage of injuries, however they are sustained. The exclusions that do exist are for certain medical procedures, such as cosmetic surgery.
I have never heard of a case of an employer being able to exclude coverage under any private plan they may have in place for their employees, and no provincial government, to my knowledge, is involved in approving insurance policies and exclusions.
The individual insurer, in the case of a private plan, may have established a list of exclusions. But it seems to be increasingly rare to find “risky behavior” as part of it. They are paying more attention to whether the individual can be deemed to be a professional or an amateur rider.
Source: Hans Henrik Jørgensen, governing member, Danish Motorcycle Council
In Denmark every citizen is covered by the national health care system, no matter what activities you are involved in. Many people also have a private insurance for quick access to a private hospital.
Source: Juha Lieslinna, member, Finland Bikers Association (SMOTO)
We have a similar system here in Finland to what they have in Sweden. Normal health care and mandatory vehicle insurance takes care of normal situations but we can take extra insurance, too, and that covers nearly everything you can imagine.
Source: Eric Thollier, managing director, Fédération Française des Motards en Colère
In France, the social security always takes care of most of the medical bill, but may ask the party responsible for some refund under a subrogation principle.
Motorcycling is not a factor in exclusion.
Some clauses may exist for extreme sports (like parachuting) in the case of specific insurance, for example a real estate loan, but the general answer is no, in France, the health care systems do not exclude “risky activities” from medical insurance.
Source: Harald Eisenmenger, media representative, The Biker Union
In Germany, we have both: a national insurance system and a parallel private insurance system. There are some rules on when you can go into which of the systems, and it is difficult to change, especially from private back to the national system.
But I am not aware that any insurance does not cover motorcycling.
However, there are always discussions coming from several interested parties to have extra fees, such as for smokers, overweight people etc. that could also include motorcycling, bungee jumping and other activities.
But nothing got even close to being seriously discussed to a level of agreement.
During work or on the way to and from work, employees are covered by the employer in a “trade association” (Berufsgenossenschaft) health insurance policy. They pay for the consequences of accidents at work and on the way there.
Source: Gazoulis Theodoros, member, Motorcycle Federation of Greece (MOTOE)
In Greece, there is a national health care system for everybody, but it is in a very bad financial situation. So, in fact, you have to pay. This is worse now, due to economical crisis and the memorandum [agreement] with Troika (the European Commission, International Monetary Fund and European Central Bank).
Source: Njall Gunlaugsson, member, Icelandic Motorcyclists’ Association (BLS)
In Iceland, you are always covered by the health care system, no matter what you are driving/riding.
Source: Dolf Willigers, member, Motorcycle Action Group Netherlands
In the Netherlands these days, we have a mandatory private health Insurance system: the insurance companies are privately owned, and everybody has to insure himself for health care.
The insurance companies have to accept everyone, regardless health situation, lifestyle etc. People who don’t smoke or drink, eat vegetarian, etc., often get a discount.
Not everything is covered by this system, so you can voluntarily insure yourself for extra costs, like extended dental care.
In this system it doesn’t matter if you are a motorcyclist, skier, cyclist or practice other dangerous activities—when you get into an accident, the health costs are covered.
Source: Morten Hansen, member, Norwegian Motorcycle Union
In Norway, there is free public health care for everybody—motorcyclists injured by their own risky behavior included.
Source: D. Emilio López López, board member, Asosiaçion Mutua Motera
In Spain, we have the National Health System, which is supported by the tax of the citizens, and it covers all citizens. So, any car driver or motorcyclist is covered by this system.
Of course, in an accident, the insurance company of the guilty vehicle have to pay for all damages, even the personal injuries. But if a motorcyclist has an accident on his own, the National Health System will cover him/her.
Apart from this system, any citizen can have private insurance in parallel for quick treatment. I do not know if private insurance companies increase the price for motorcyclists. I suppose that it would depend on each company.
Source: Maria Nordqvist and Jesper Christensen, members, Swedish Motorcyclists Association
Sweden is a country where health care is covered through the tax for all who are living here.
We have extra insurance, like in Germany, to and from work and at work.
But, money is being saved on health care, and it’s becoming more and more common for employers to have an extra insurance for passing along the cost of operations, seeing a specialist, etc.
UNITED KINGDOM/GREAT BRITAIN
Source: Chris Hodder, former British Motorcyclists Federation government relations executive, now in public affairs for the UK motorcycle industry
As a keen rugby player and motorcyclist, I can say with complete confidence that the UK’s National Health Service does not charge patients who get injured taking part in dangerous activities.
This is not to say that having a free-at-the-point-of-use, publicly funded system does not have its drawbacks. The medical profession is frequently lobbying for curbs on personal freedoms, such as taxes on sugary food and drinks, but to be even-handed, that happens elsewhere as well.
However, discretionary private medical insurance policies do often exclude “hazardous activities” or will simply charge more.
In the United Kingdom, private medical companies almost never deal with emergency care, but they do often deal with recovery. Sometimes this is funded by motor insurance (i.e. the liable driver’s insurer pays or the rider’s insurer if they are at fault). Sometimes this is funded by the individual on a non-insured basis (e.g. they want to get back to work quicker, so pay for a non-urgent operation).
Other insurance policies also exclude hazardous activities. Of particular relevance here are travel insurance policies. Most policies (but not all) restrict winter sports, motorcycling and other high-risk activities.
There is also an issue with travel insurance policies and where they overlap with motor insurance. If I rent a scooter in Greece and crash it, it is unlikely that the local insurer will cover the cost of repatriation; the travel insurer normally would (much as if you fell ill), but not if they exclude hazardous activities.
As an example, BUPA is probably the most well known of private medical insurance companies operating in the UK. Their policy does not exclude motorcycling from the normal medical insurance bit, but does for their travel and emergency medical care policy.
Workplace sports competitions are quite popular here, particularly five-a-side soccer (as you call it) leagues. A few years ago, underwriters were found liable for injuries sustained in these competitions as they took place whilst the employee was “under work rules.”
The consequence was that many underwriters started explicitly excluding hazardous activities from employer liability policies. Motorcycling became collateral damage to this, and many employers started banning cycling and motorcycling to work “for insurance reasons.”
There was a debate about whether the employers’ liability extended to the commute, as this would be covered by the motor insurance, and now it is quite rare to find an employer who bans motorcycling.
Also of interest is that access to medical treatment is shared across the European Union, so that I can access the emergency care that is available to locals in all 27 member states—provided I have my European medical card with me.