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MTBA / CA Insurance - What exactly are we covered for ?
After some recent bad luck with injuries to some of the SXC Racing boys, and hearing Craig's (Fatboy) delimna's at the recent Willo, i thought I would do a bit of research into what the MTBA / CA Insurance actually covers us for.
I am glad I did, and the short answer is not much - but I thought i would share the basics of the policy
http://cycling.org.au/LinkClick.aspx?fileticket=...
There are other components that can be found in the PDS but I thought I would call out these couple of key items that are relevant to most of us.
Firstly - Scope of the Personal Accident Cover
The scope of cover for the CA and MTBA personal accident policy is as follows; For registered members, benefits are applicable
to injury occurring during any and all bike riding activities 24hrs a day, unless an Insured Person(s) is competing in an event/ race that is not conducted under the endorsed protocols of an affiliated entity of CA or MTBA.
This is important - we are only covered when competing for CA ot MTBA sanctioned events. This was recently found out by one of the SXC Racing boys when injuring themselves at the recent Capital Punishment event. Not being a sanctioned MTBA event he found out that the MTBA coverage was not applicable.
Secondly - Benefits for exepenses not incurred by Medicare
Reimbursement up to 85% of Non-Medicare medical costs, up to a maximum of $5,000 per injury.
Basically not much !! If you require any specialists or orthapedics or private hospital the $4250 will be used up very quickly !
Thirdly - Coverage for Loss of Income
85% of your income up to a maximum of $500 per week whichever is the lesser.
Again NOT MUCH. For those who live in Sydney with families and a mortgage - coverage of upto $500 per week wont go very far.
So in summary, this is not about criticising what MTBA / CA provide or dont provide - as with anything you get what you pay for ! The key is to ensure we are all aware and if our circumstances require more coverage due to lifestyle / family commitments / mortgage etc for the risk you have in riding / cycling then you need to ensure that you have suitable coverage to cater for this risk and these commitments.
STAY SAFE !!
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Thanks Dicko. Thats really useful info and after reading lots of horror stories recently something thats caught my attention. I'd be interested in hearing about other people's solutions to the insurance dilemna.
Good summary and highlight of some important questions. Besides the Personal Accident cover noted, the other very important element of the CA/MTBA insurance policy is the Public Liability cover.
It is very inexpensive to sign up for MTBA membership to gain the insurance benefits, and even cheaper now with the inclusion of the recreational membership category in addition to the competitive membership category.
Given my situation I did have a look at this the other day but in my case I'm not expecting any hospital bills that my Private Health or Medicare haven't taken care of (maybe it's in the mail?). At best the insurance will cover my out of pocket physio which is only $18/visit for me thanks to the level of Private Health cover I have so maybe not worth the effort...
2 things I did do a long time ago when I got into the sport were to set up my own life insurance, disability and income protection. While not an extreme sport, the chances of injury are a lot greater than that of a tennis player I would assume so in my case I have peace of mind that my family are catered for if I'm not earning an income.
I did exactly the same thing. My life insurance even had an injury insurance which actually paid out on time spent under the care if a registered nurse and also a monetary value on each bone broken. Which in my case, was quite a few.
If you have quite a severe injury, then it's worth looking at income protection etc. Mind you, most only start to pay out AFTER you are 90 days off from work. Again, even in my case I never used this. I did use up 4 years of sick leave and 2 weeks of annual leave though...
At the very least, get ambulance cover. The cost of an ambulance to take you from manly dam to Mona vale hospital is around $850.
A helicopter from St. Albans to westmead hospital was substantially more...
And save some money for a present for your partner if any of the above occurs, they go through their own trauma...
Sounds like the MTBA insurance coverage is a lot like the Confederation of Australian Motorsport (CAMS)coverage I used to get with my annual license fee. Taking a decidedly cynical view, it was more about covering CAMS arse with regard to public liability than it was about providing drivers with financial support/compensation should the worst happen. Still, it didn't cost a lot and it's better than nothing.
If you do take out personal cover make sure that it is worthwhile. Be careful of the potentially long list of exclusions that may be found in cheap or generic policies. I spent some time with a financial planner (mate of mine for 20 years) crafting bespoke policies for Life, Trauma and Income Protection to ensure I had the right level of cover and there were no nasty surprises. Unfortunately the insurer did insist on an exclusion for motorsport, which I was heavily into at the time. The irony that the activity most likely to kill or severely injure me would not be covered was not lost on me.
Also be aware that good coverage can be expensive. Life insurance and Trauma insurance not so much, but Income protection can be a doozy if you want to cover a reasonable salary or work in what the insurer deems to be a high risk occupation. It also helps to take out these insurances before you are diagnosed with any significant or potentially excludable illness otherwise you may be denied insurance or they may charge you a ridiculous premium. Fortunately I was healthy at the time and continue to be today.
On top of Life, Trauma and Income Protection I also have a fairly high level of private health insurance just in case and that includes ambulance cover up to a given value each year. My girlfriend also has the same. Long ago we made the joint decision that neither would leave the other in debt should the worst happen. The result is that everything is geared towards paying off the mortgage at a minimum.
Also read the policies for any other insurances you already have and even for your credit cards, etc. You may be surprised to find that there is a payout figure in there that you may have a right to access depending on the relationship of the policy to the activity that caused your injury, or you were participating in at the time.
This is an interesting and very useful thread. Definitely a topic worthy of discussion.
I'm insured under this but a recent busted wrist and avulsion fracture didn't get me over the excess. Went to Manly Hospital in the first instance and X-Rays and CT were covered publicly. Follow up at ortho surgeon only cost a few hundred bucks so I didn't have anything to claim for.
So what companies do income protection for mountain bike riding/racing. I tried to get cover through my super but they wouldn't cover me on the mtb
Brian, I recently went through the exercise as my previous ensurer Colonial cocked up and closed my account so I went to Macquarie Life where I had to go through the whole process again - medicals etc. In the questionnaire they were quite specific on do you do parachuting, motor sport etc? There were no questions re mountain biking! I am covered for anything except for the exclusion detailed which include pre existing injuries.
No exclusions on my Colonial income protection policy related to mtb. But I've had it for 25 years, ever since we took out our first mortgage. Death cover is provided by my Super.
Unfortunately it ceases at 55. Not that far away
Disclosure: I work for a related company, although the cover was first taken out a long time before joining my current employer.
I have a OnePath income protection policy. Potentially relevant information in the exclusions section:
"we will not pay a claim arising directly or indirectly from:"
...
"your participation in, or training for, professional sports or
speed contests"
I recently changed jobs and it prompted me to look into my life/disability/trauma insurance. I met with a few advisers and one guy stood out for differentiating his advice and making me feel that it was indeed my interests he was looking after.
If anyone is interested then feel free to PM me and I will pass on his details.
Just to be clear, I had never met him or heard of him prior to this and have no connection to him whatsoever.
I would read that as meaning that amateur participation is fine. Bottom line: don't accept cash prizes.
That makes road cycling with cash primes tricky.
... any race is a speed contest. Not sure that amateur status gets you out of that?
I got $100 from the Real Insurance XCM series a couple of years back, so I guess I'm stuffed either way.....
I read "professional" as applying to both sport or speed contest.
But I'd get them to confirm over the phone your understanding, that amateur cycling events are covered and record the conversation, noting date, time, and full name of person spoken to.
Insurance companies are snakes. Leave them no room to squirm out of their obligations.
I'm just extending my insurances with MLC and the question they ask is:
Do you now or do you intend to engage in any of the following activities? *
Aviation activities other than as a fare paying passenger
Motor racing
Underwater diving
Mountaineering
Caving, Potholing or Canyoning
Parachuting, Skydiving, Paragliding, Parasailing or Hang gliding
Australian Rules Football, Rugby League, Rugby Union or American Football
Other hazardous pursuits (eg body contact sports, downhill mountain biking)
I take that to mean that XC events are fine (apparently downhill=bad) and I don't need to declare them which is good.
Hmm might just mean your not covered if you ride a mountain bike down a hill, tell it to the judge son. Mine is with my super, First State Super, seems to cover MTB and Skateboarding, which is more likely to get me time off work. I've had insurance through AMP previously but it really seemed more like a pyramid scheme than an insurer, nice long residuals for the sales broker. They really hassled me when I changed insurers, but couldn't get anyone to talk to about changing the details.
When ever I've entered a non MTBA event (Three Ring, and Highland Fling) I've just taken out the optional extra insurance was only about $20, likely not to amount to much if I have a big off, but better than nothing.
I thought I'd give my feedback on the insurance provided by MTBA as I now have most of my expenses behind me since my crash at The Willo that @dicko refers to.
Firstly they were quick to approve my claims. I had to fill out some paperwork and get my Doctor to confirm my list of injuries then once I submitted it was approved within a few days. I received an email from Corporate Services Network who act on behalf of QBE and they basically said just keep emailing my receipts as they occur and they will process them. I find on average from the time I email receipts to the time money is in my bank would be about 3-4 days and they follow this up with an email confirming what they have just paid. I've never had any issues.
As to what is covered, they don't pay for anything that is covered or part covered by Medicare. For example I had a number of long visits to my GP and was billed about $120 for each of these sessions. Medicare covered a bit more than half so I was out of pocket for the balance.
I have top private cover so was covered for most non Medicare expenses but the MTBA insurance would pick up what the Private Insurance didn't cover. For example I have weekly physio at about $80. My Private covers about $60 of this so the MTBA then covers 85% of the remaining $20.
I've also had some expenses for pathology that neither Medicare or my Private cover so the insurance pays 85% of those expenses.
So from my experience the insurance was only required for a small portion of my total costs which so far have amounted to about $15,000 but each time they are required the experience with them is very good. If I don't submit any receipts for a while they chase me to see if I have any more or if they can close the case. I always reply "chill, I won't be fixed any time soon..."
All up I'm only out of pocket by about $500 of the $15,000 in medical expenses.
Now had I insured the bike I'd be about $3,000 better off right now...