Yep, this is what it's come down to. The insurance company basically is asking whether you might have a reason to seek money from some source for being a cause of your accident. If you had a reason to sue somebody, such as the bike mfr or the helmet mfr, the HMO would have the right to seek compensation from you for any costs that they had as a result of your accident. This would only be the case if you sued successfully or reached some settlement with the companies.
When I settled with the driver who opened his car door and hit me, I had to repay some portions of my health insurance costs to Aetna. For some reason, I was the victim and they can come after my settlement. It was, after all, the sole fault of the driver. Why didn't they sue him for those costs? Because that's the way the laws governing this sort of thing work. Take care and heal fast! Joe Joe Bartoe Synaptic Cycles Bicycle Rentals, Inc. email: j...@synapticcycles.com website: www.synapticcycles.com Twitter: @synapticcycles phone: 949-374-6079 > Date: Fri, 6 May 2011 18:55:39 -0700 > Subject: [RBW] Odd Investigation by HMO > From: r.sh...@sbcglobal.net > To: rbw-owners-bunch@googlegroups.com > > Last January, I crashed on a fast downgrade with a 90 degree turn at > the bottom. I was obviously going too fast for conditions. I collided > with a guard rail and the roadway, which was newly paved and in > pristine condition. The result was a slight concussion and a broken > collar bone that required surgery to plate and screw it back together. > Rehab has been on-going, and I still lack full range of motion in the > effected shoulder. I have returned to cycling and commute to work by > bike. I don't yet ride a bike with drop bars, however. > > Fortunately, I have health insurance, although I did opt for a higher > co-pay to reduce the cost.. But, yesterday I received a phone call > from an investigator working for the insurance company. She wanted to > know about the bike I was riding. Who made it, sold it, who maintained > it, what type of components did it have, was I wearing a helmet, what > manufacturer of the helmet and the components on the bike. Have I > resumed cycling? I started to get a little annoyed and asked what this > was all about. She told me it was a routine follow up typical of > bicycle collisions. I have crashed other bicyles and motorcycles, have > been transported and hospitalized as a result, and was never asked > about the equipment I was riding. > > I assured her that the collision was a result of not heeding the > conditions of the roadway and not slowing in time (and the report > backed me up). I assured her that there was nothing wrong with the > bike (a 6-year old Canti-Rom) -- even following the crash. It > suffered only cosmetic damage. I was careful not to use the > manufacturer's name, and referred to it as a CantiRom make. I guess > she bought that because she probed no deeper into the maker or where I > bought it. > > If any of you have had a similar experience, I'd like to know. It's > never happened to me before. Is this something new that insurance > companies do. Incidentally, there was an official report made of the > collision. Her introduction did say the investigation was to determine > if there was a negligent party or entity that would be partially > responsible for some of the costs associated with the claim. This is > a nationally recognized health insurance provider, HMO. I'd rather > not give the name. > > -- > You received this message because you are subscribed to the Google Groups > "RBW Owners Bunch" group. > To post to this group, send email to rbw-owners-bunch@googlegroups.com. > To unsubscribe from this group, send email to > rbw-owners-bunch+unsubscr...@googlegroups.com. > For more options, visit this group at > http://groups.google.com/group/rbw-owners-bunch?hl=en. > -- You received this message because you are subscribed to the Google Groups "RBW Owners Bunch" group. To post to this group, send email to rbw-owners-bunch@googlegroups.com. To unsubscribe from this group, send email to rbw-owners-bunch+unsubscr...@googlegroups.com. For more options, visit this group at http://groups.google.com/group/rbw-owners-bunch?hl=en.
