Beware if you are injured while committing a crime or doing something the law says not to do. Your health insurance policy may not cover your treatment. But what is "illegal activity"? Sometimes illegal activity is what the insurance company says that it is.
Health insurance policies have included clauses like this for many years, on the theory that it is not right to reward illegal behavior in any way. If you were driving dangerously and were using an unregistered car when you got into an accident, your insurance company may tell you that it is your tough luck. Insurance policies may exclude problems that stem from drug or alcohol use, injuries while committing a felony, self-inflicted trauma, hazardous activities, or other activities.
Often, an insurance company will make the decision as a way to get out of very expensive care, according to an article in the New York Times. Whether it decides to cover care may also have nothing to do with whether or not you were charged with a crime. The article gave the example of Monroe Bird III, who was shot and paralyzed by a security guard while sitting in a car outside an apartment building. The guard fired shots as Bird was driving away. Bird was never charged with any crime, but his insurance company declined to cover his large medical bills. Lack of insurance meant that he was sent home as a quadriplegic rather than to a rehabilitation center and he died of preventable complications from his paralysis.
Some states have laws against insurance exclusions for illegal activities but these may not apply to health plans administered under the federal Employee Retirement Income Security Act, which sets standards for many private pension and health plans.
