A city firefighter in an off-duty motorcycle accident in June, involved health insurance was denied for his injuries because the city required him to wear a helmet insurance. Lt. James Baker waited to see if the City Council would accept a negotiated settlement that would pay a reduced amount that night. The Sebring City Council will meet at 6:30 p. m clock today at 368 S. Commerce Ave. vote on these and many other issues. Baker suffered injuries from a motorcycle accident on U.S. 27, came to the right to medical about $ 86,000. He was at the Tampa General Hospital Trauma Center is flown. “I was a little less than two months,” said Baker. “I returned to full duty at the beginning of August 2009.” Baker’s insurance claim was initially denied because a clause added to exclude the city health insurance in 2005 for “activities of a dangerous nature”, from the cover motorcycle accident without a helmet. Baker said he would have hurt, regardless of whether he was wearing a helmet, and thus the claim should be paid. He suffered most abdominal injuries and no head injuries, he said on Monday. In 1998, when he was hired, Baker said he received a copy of his insurance policy, and not at the time of the exclusion clause was there. He had no recollection informed that she was accepted, he added. Had he known of the exclusion, he would have worn a helmet, he said. In a city health committee meeting, said City Clerk Kathy Haley she was not sure whether the announcement of the exclusion list were added to transfer employees of the city, showing the minutes of the meeting. Mayor George Hensley said a committee or an employee of activities might consider “dangerous.” City Administrator Scott agreed Noethlichs, but the question how to define “dangerous.” Representatives of the city health insurance administrator, Anchor Benefit, negotiated a settlement of $ 46,750, which they will have to pay. At a special meeting held Feb. 25, the Committee recommended that the Council’s Benefit Anchor negotiated discount with the understanding that Baker’s remaining out-of-pocket maximum pay for the year to accept the $ 734. 74 and to negotiate a $ 745 fee for the claims. The tentative agreement further concluded that the basis of the recommendation was that Baker was no head injury and that he had been injured, even if he was wearing a helmet at the time of the crash. However, it remains up to the City Council to approve the deal. Hensley on Monday that representatives of Anchor Benefit Consulting had noted that this exclusion is not usually found in insurance policies, and believed that the city Hensley would probably take a closer look. Baker has since stopped riding motorcycles, citing his love for his wife and five children. He said his wife told him while he was still in Tampa General Hospital that she knew how much he loved riding motorcycles and would not ask him to stop. “This was a hobby,” said Baker. “I was ready to abandon it in order not to make my family through that again.” 1 July 2000, Florida adult motorcycle and moped riders to wear helmets, free, if $ 10 000 in medical insurance, according to Andreas Muller, in the April 2004 American Journal of Public Health. Since then, Florida Statutes have required motorcyclists younger than 21 years wear helmets. The statute was signed into law by former Governor Jeb Bush. Previously, a Florida helmet law that all drivers had called on the Security Helmet.
Tags: City, Health, Insurance, Negotiates, Snag
