Hurt on motorcycle. Who should pay the ER bill?

by John
(New York)

I was riding my motorcycle and it was very cold. I went down at 10mph around a turn. a couple days later I went to the ER to have my leg examined to make sure it wasnt fractured because I had a little pain while walking. It ended only being soft tissue damage and all is better. I received a claim denial from my HMO.

Their stating its up to my auto insurance to pay this. The ER bill is $300 dollars.

If I contact my auto insurance they will surely drop me as its my first year having cycle ins. with them.

Even if they dont drop my coverage they'll pay my bill but both of the policies I have with them will likely go up. So I'll end up paying either way. Is it worth calling my motor insurance about this?

Or will calling them just bite me in the end?

I have heard that my situation is the same as sitting at a stop light and getting hurt from the bike falling on me from slipping on gravel.

Where I'll end up going back and forth with both insurance companies.

What if i was working on my car or bike in my driveway and it fell and hurt me, who would have to pay the bill? Auto or Health?


Answer:

Hello John,

You have an interesting situation here. You motorcycle policy would be in effect here (not your auto policy), if the happening (injury) occurred directly related to an accident. Was this an accident? A coverage investigation must ensue here.

Your problem will be showing that this was indeed a motorcycle accident and not some other kind of condition (broke leg playing soccer, for example). If you fall down, you can show damage to the bike and maybe even a police report of the fall (accident). It will be difficult to argue that this is an accident.

At any rate, you have the paper work from the HMO so you can forward that to the motorcycle insurance company and have them do a coverage investigation.

Will this affect your rates? Probably will (particularly with motorcycles).

See our discussion about rates and claims.

If you are only looking at $300 worth of medical bills, you might want to bite the bullet, however, if you are looking at more medical treatment, you might want to file a claim. The bottom line is this, either it is an accident or it is covered under the motorcycle policy. Have both insurance company talk to each other and determine this.

Good Luck,
http://www.auto-insurance-claim-advice.com/