By Alan Prendergast
By Michael Roberts
By Michael Roberts
By Amber Taufen
By Patricia Calhoun
By William Breathes
By Michael Roberts
By Melanie Asmar
Put plainly, insurance companies aren't allowed to ban bikers from group health plans, but provisions may legally nix payments to anyone injured while motorcycling.
In response, AMA and the Washington, D.C.-based Motorcycle Riders Foundation, arguably the motorcycle community's most powerful lobbying organization, asked the U.S. Department of Health and Human Services to review the decision. But despite the MRF's friendly relationship with new HHS Secretary Tommy Thompson, a former governor of Wisconsin and himself a motorcyclist, and letters of support written by approximately 100 members of Congress, the department reported in May that it couldn't find legal justification to guarantee benefits to motorcyclists.
"The bottom line is, the 1996 law has a loophole in it," says Tom Wyld, MRF's vice president for government relations. "Which is an earth-shattering development. We were hopeful that common sense would prevail -- that licensed users of American highways driving registered motor vehicles would not be summarily denied health-benefit coverage in the case of an accident. But that's what we're facing."
He adds that Coloradans who think they won't feel the effects of the decree because the state passed a law in 1997 making it illegal for insurance companies to deny health-care benefits to motorcyclists may find out otherwise. "The federal government commands the field on group health," says Wyld. "That means that for every insurance program the state runs and regulates, the Colorado guarantee is golden. But people from Colorado who have group health plans may very well suffer."
Of course, not every employer-provided health plan will immediately move to deny benefits to injured motorcycles. But in the event of an accident, even those insurance companies that still represent motorcyclists can be counted on to try to recoup their expenditures. And the process of doing so is seldom pretty.
January 8, 1995. Back then, Bill Head, a forty-year-old independent contractor, lived in a north Boulder mobile-home park with his wife, his four-year-old stepson, Jason, and his 1981 Harley-Davidson -- a classic "wide glide" model. There'd been a hard freeze the night before, and Bill wanted to warm up the battery on his bike by taking it on a six-block spin around the neighborhood. But his journey ended up taking considerably longer than he figured.
A couple blocks from home, Bill, clad in riding gear and jeans but no helmet, was heading west on Yarmouth Avenue behind a 1968 Volkswagen bus driven by Esta Kirschner. According to Bill and two witnesses on the scene, Kirschner, who couldn't be reached for comment, veered onto the right shoulder of Yarmouth approaching Lemon Place, leading Bill to conclude that she intended either to turn right or park on the right shoulder of the road. Bill accelerated in order to pass the VW on the left. But in the midst of his maneuver, Kirschner suddenly stopped veering rightward and turned left instead, swinging her vehicle directly into Bill's path. A fraction of a second later, the Harley's front tire hit the front wheel well on the driver's side of the bus, and Bill's body hit the door. "I looked her straight in the eye as I went over the car," Bill says. "That's the first time she saw me."
Both Bill and the Harley somersaulted through the air, with Bill landing in a ditch around 150 feet away. He was knocked unconscious briefly, and when he snapped out of it, he saw that his legs were crisscrossed beneath him in an extremely unnatural position. He knew in that instant that his injuries were bad, but not until he was taken to what was then Boulder Memorial Hospital did he learn how bad -- and how many of them there were. The list was long. Two compound fractures of his right femur. A shattered left hip plate. A blown left hip socket. Three cracks in his pelvis. First-, second- and third-degree chemical burns between his waist and his knees from exposure to gasoline, which wound up gushing onto Bill after his knee ripped open the fuel tank. A skull fracture with a concussion. A broken jaw. An inch-and-a-half tear in his esophagus, torn from the inside by his renegade jaw bone. And finally, for good measure, eighteen broken teeth that went from his mouth to the pavement, never to return.
Unsurprisingly, a good many doctors spent a great deal of time putting Bill back together again. At first physicians thought his right leg might have to be amputated, but a surgeon at University Hospital in Denver managed to reconstruct him with the assistance of screws, rods and other hardware. After that, he stayed first in the convalescent wing at Longmont United Hospital, then in a Longmont nursing home. By the time he was released, it was four months later, and winter had given way to spring.
The care Bill received didn't come cheap: He estimates that the total topped out in the vicinity of $350,000. Luckily, the previous October, Bill had invested in health insurance for himself and his family through USA for Healthcare, a Texas outfit specializing in insurance for the self-employed. (Because of the expense involved, Bill had called to cancel in December; a company representative talked him out of it.) But payments for which Bill was responsible came to about $18,000, and other debts mounted because he wasn't cleared to work for over a year. He received some money from Progressive Insurance, his motorcycle-insurance carrier, to replace his mangled Harley, as well as public assistance from Boulder County, but it wasn't nearly enough. So he looked into suing Nationwide Mutual Insurance, the Ohio corporation that represented Kirschner. Her policy limit was $100,000, which certainly would have helped Bill and his family.