Mopeds Tampa

Town Negotiates Capture Health Insurance

A city firefighter involved in a motorcycle accident in June out of service was denied health insurance coverage for their injuries, because the city health insurance forced him to wear a helmet.

Lieutenant James Baker waited to see if the City accepts a negotiated solution this evening to pay a reduced amount.

The Sebring City Council will meet at 6:30 pm today at 368 S. Commerce Ave. to vote on this and other various issues.

Baker was injured in a motorcycle accident in the U.S. 27 for medical demand rose to about $ 86,000. He was taken to a trauma center Tampa General Hospital.

"I was out for a little less than two months," said Baker. "I came back with right around the first of August 2009. "

Baker's insurance claim was initially denied by a clause added to the policy of the city health insurance in 2005 in "activities of a dangerous character, "excluded coverage for motorcycle accidents without a helmet.

Baker said he would have been injured whether they had a helmet, and therefore demand to be paid. He suffered abdominal injuries and especially without head injuries, said Monday.

In 1998, when he was hired, Baker said it had received a copy of your insurance policy, and in time of the exclusion clause was not there. He had no recollection of having been notified was added, he said.

If I had known of the exclusion would have been wearing a helmet, he said.

In a town meeting Health Insurance the Committee, the City Clerk Kathy Haley said he was not sure if the announcement added exclusions were given to city employees, the record of this meeting.

Mayor George Hensley said a committee or an employee may consider trying different activities "dangerous."
City Manager Scott Noethlich agreed, but asked How do you define a "dangerous."

The representatives of the city manager of health insurance, benefits Anchorage, negotiated a $ 46,750, they will pay.

In a special meeting held on 25 February, the committee recommended that the Council accept Anchor negotiated discount benefits in the understanding that Baker pays its maximum stay out of pocket for the year of $ 734.74 and a fee $ 745 to negotiate the claims.

The tentative agreement further concluded that the basis of the recommendation was that Baker did not receive injuries head and that would have been injured, although wearing a helmet at the time of the accident.

However, it remains until the City Council to approve the deal.

Hensley said on Monday that representatives from benefits consulting anchor had advised that this exclusion is not normally found in insurance policies, and Hensley believes the city is likely to take a closer look the same.

Baker has since stopped on a motorcycle, citing his love for his wife and five children.

He said his wife told him that while he was still at Tampa General Hospital that she knew how much he loved to ride a motorcycle and she was not asked to leave.

"That was a pastime," said Baker. "I was willing to give it up, not put my family through that again."

1 July 2000, Florida exempted adult motorcyclists and moped helmets provided they have $ 10,000 in health insurance, according to Andreas Muller, in April 2004 American Journal of Public Health.

Since then, the Florida statutes have required riders under 21 to wear helmets.

The law was enacted by former Gov. Jeb Bush.

Before the Florida helmet law had required all riders to wear helmets.

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