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A Car Hits You While You Are On A Club Ride – What you Need to Know About Medical Bills
A Car Hits You While You Are On A Club Ride – What you Need to Know About Medical Bills
You are on a Club ride and a car hits you. One thing is for sure: you will need to get medical treatment and to pay for it. That, and nothing else, is the subject of this article1. And although I am an attorney licensed in the State of New Jersey, this article is not intended as legal advice and should not be taken as such. My purpose in writing is to help you navigate the system intelligently by knowing who is supposed to pay what.
I write on the assumption that you are covered by a New Jersey auto insurance policy for a passenger vehicle2. If this is not so, this article is irrelevant to you.
First Important Fact: in New Jersey, your own auto insurer is primarily responsible for paying for your injuries from auto accidents. Your auto insurer. Not your medical/Medicare insurer. Not the “at fault” party’s insurer; New Jersey is a “no-fault” auto insurance state. Thus, if you are covered by a New Jersey auto insurance policy and you are injured in an auto accident, you should first look to your auto insurance carrier.
Second Important Fact: some New Jersey physicians will not treat auto accident victims. This is because those doctors do not accept the compensation set by the “Personal Injury Protection (PIP)” coverage that an auto accident victim gets from his or her auto insurance. (The New Jersey Department of Banking and Insurance promulgates a PIP fee schedule that specifies what a doctor gets paid for specified medical services rendered to a patient who has been in an auto accident. As you may imagine, this schedule is not particularly generous.) If you are making an appointment with a doctor to address post-auto accident medical care, make sure the office knows that an auto accident was the cause! If you accept treatment from that doctor and the doctor’s office has not made appropriate arrangements with your auto insurance carrier, the carrier may refuse to pay and you will be on the hook3.
Third Important Fact: your medical insurance carrier, or Medicare, is secondarily liable for paying what your auto carrier is not required to pay. If – as will usually be the case – you end up with a balance due even after your auto carrier has paid the appropriate amount to your doctor, you should submit that balance to your medical insurance carrier. When you do this, you will need to provide evidence of what your doctor did and charged for and what your auto insurance carrier paid the doctor. Your medical insurance carrier/Medicare will pay benefits in accordance with its contractual/statutory obligations to you.
On this issue, you need to know that some providers of medical services don’t play by these rules. In my case, I was taken to Morristown Hospital by an ambulance service, and you would think that an ambulance service would have the experience to know that it should bill my auto insurance carrier first. It didn’t. It billed my medical insurance carrier, which paid, and it then came after me to pay the unpaid balance of its charges. I told the service that it had made a mistake, and it ignored me. (I am used to this!) I got my auto insurance carrier involved, and the claims manager said this happens all the time. She took the matter on, and I have not heard further.
Fourth Important Fact: you are covered by the Club’s insurance policy! When you report your accident to the Club’s Safety Coordinator (currently Drew Thrain) he will provide you with a claim form. You provide the information they request and they process your claim.
Summary: in all likelihood, if you are unfortunate enough to be struck by a car while you are on a Club ride, you will be covered by three different insurance programs. Deal with them in the correct order – and get better!
Mark Jay (recorder.dulcian@gmail.com)
- If you want to know about fixing/replacing your bike, getting compensation for your injuries, and getting compensation for wages you lost while you were out of work, talk to a lawyer. But not me. ↩︎
- If you are hit by a dune buggy or a motorcycle, PIP benefits do not apply. And special rules apply to pickup trucks, vans, panel trucks, etc. I don’t discuss these here. ↩︎
- If you are treated in a hospital, you won’t have this problem. All New Jersey hospitals accept PIP coverage. ↩︎
Oregon Trail Gravel Grinder
Oregon Trail Gravel Grinder
I (Brian Cap) recently did a 5 day gravel bike ride in Oregon.
5 days, 320 miles, 28,000 feet of climbing. Brutal and beautiful.
The Oregon Trail Gravel Grinder’s website is:
https://oregontrailgravelgrinder.com/
Their contact is:
Chad Sperry 541-980-2338,
chad@breakawaypro.com
PO Box 112 Redmond, Oregon 97756
Message from the President: July 12th
July, for cyclists, traditionally means the Tour de France. And this year it also brings our own Revolutionary Ramble. The Ramble organizers have been hard at work, and still need a few volunteers to help out, whether in the days leading up to the event, or on Ramble Day (July 24th). If you can share in the work, check out the Ramble website and select a volunteer spot: https://rambleride.org/volunteer-signup/
Our MAF Team store is now open until July 23rd. You have just a few more days to order MAF jerseys, shorts, jackets, and other items. You can find the link to the MAF Store from the club homepage. Look sharp in your MAF attire!
Two of our club members, Steve Davis and Joe Reo, took the initiative to contact the town of Bernardsville and get some large potholes patched on Hardscrabble Road. Please follow their lead and contact the responsible community about road hazards. This is especially effective if you live in the community in question; they try to keep the taxpayers happy!
As always, thanks to our ride leaders for keeping our ride schedule busy and varied. Ride safely and wear your sunscreen!
Liz Jennison
MAF President
The light at the end of the tunnel (June 9th, 2021)
Greetings to all MAF members. The light at the end of the tunnel was not a train after all! On Monday the MAF Board met and decided that, in alignment with CDC and NJ guidelines, the club will eliminate the mandatory cap on riders on club rides. Ride leaders will have the discretion of capping their ride (as at present) or allowing unlimited riders. This will be easily visible on the website. If a ride is capped, you must sign up in advance; no walk ins, no guests. If a ride is not capped, you can walk in and guests will be allowed.
Thanks to all of the new ride leaders who stepped forward in the recent months. We hope that you will continue to be a ride leader. And thanks to all who chose new start locations and destinations. We also hope that this will continue. Please remember that our Ride Leaders are all VOLUNTEERS who have agreed to accept a level of responsibility for the MAF members on their ride. Attend rides that are appropriate for your pace and ability. And even if there is no rider limit, if you have signed up and do not plan to attend the ride, please remove yourself from the ride list. And please do not come on a MAF ride if you are not feeling well. COVID is still out there.
While we are on the topic of volunteering, please consider volunteering for the Revolutionary Ramble, sponsored by our Morris Area Freewheelers Foundation. The Ramble will be on Saturday, July 24th, and over 300 riders have registered already. Volunteer positions range from route marking, sign making, rest stops, and others. Here is the link to volunteer: https://rambleride.org/volunteer-signup/
And last but not least, please be good stewards on the roads. As summer traffic increases, we need to remember to ride single file (or single up immediately if you hear “car back”). Jim Hunt, our Bicycle Advocacy leader, tells us that NJ is close to having a 4 Foot Safe Passing Rule, something that has been in the works for almost 12 years. We need to do our share of “sharing the road”.
Ramble On…..
Liz Jennison
MAF President
April 2021: Changes to Rider Limit and Gap between scheduled rides
At the April MAF Board of Director’s meeting, the Board voted to expand the number of riders allowed on MAF rides to 15, and to reduce the required gap between rides from the same start point to 15 minutes. These decisions did not come easily for us, and Board member opinion was divided on all issues. I expect that the diversity of Board opinion on the matter reflects that of the MAF membership at large. Ride leaders and individual riders need to make good decisions about what they feel comfortable with for their personal situation AND make sure they are protecting other members as well.
RIDE LEADERS: While ride leaders may have up to 15 total participants on a ride, they still have the ability to cap the number of riders at a lower number. This is the ride leader’s choice, please respect it. Ride leaders should continue to remind riders to practice social distancing (6 feet apart from others) and wear masks in the parking lots before and after rides and at rest stops. We continue to require everyone to sign up for rides in advance, and no guests.
RIDERS: If you feel uncomfortable with larger ride groups, do not sign up for a ride with a larger participant cap. You can determine the ride cap by looking at the number of people already signed up and the number of spots remaining. Make sure you maintain social distancing (6 feet away from others) and wear a mask at all times while not riding (or actively eating/drinking); this is especially important at rest stops and in the parking lots before and after rides. And please sign up for rides of YOUR PACE. Remember that no one rides alone, and that includes the ride leader. When you sign up for a ride, it is assumed that YOU would be willing to ride with the ride leader, at their pace, if it appears the ride leader will be left alone.
While we all would like to think that COVID is in the rearview mirror, that is not the case. New Jersey has the second highest COVID cases rate in the country. The level of cases is below the post-holiday peak experience in January, but is not declining, and may be on the rise again. While vaccinations continue in the state, we are not anywhere near the point where the rate of vaccinations can impact the case rate.
Allowing more riders and a shorter gap between rides from the same start point places more responsibility on ALL of us to maintain the proper precautions, even if we have been vaccinated. And first, and foremost, do NOT come to a ride if you have been exposed to anyone who may have COVID in the past 2 weeks, or if you feel ill in any way. We all need to look out for ourselves and each other.
I hope that before too long we really can say that COVID is in our rearview mirror, and enjoy all of the club events and gatherings we miss so much. In the meantime, ride safely!
MAFF Meeting 02-09-2021
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