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grue

Jumping for a living without insurance?

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USPA provider concluded once he made entry into the water, the skydive was completed, therefore no pay out.

Main stream provider concluded he died 'skydiving', a non covered incident.



(FWIW: I've handled a lot of insurance claims law, on both sides. The following is not legal advice.)

If the main stream policy had language that excluded skydiving, then it did, and that's hard to fight. But to be sure, a lawyer should review every word of the policy from front to back; one should not rely on a layperson, and certainly not on the say-so of an employee of the insurance company.

BUT - and it's possible there are more factual or technical details of which you're not aware - IF the USPA's insurance carrier is claiming the drowning was an event that was technically separate from the skydive, my default reaction, even without reading the policy (though that still must be done) is that's bullshit, and your friend should consult a lawyer with an eye toward fighting it in court.

Of course the cost may be a deterrent. But although taking cases on a contingency-fee basis is usually only done in personal injury type cases, some lawyers do handle certain types of insurance claim cases on contingency, too (though many do not).

Except for the most rural areas with very low population density, almost every county in the US has a local county bar association that provides attorney referral services to the public. And every state has a state bar association that often provides similar services. Your friend should look them up and speak with them, with an eye toward getting at least an initial consultation with a lawyer who handles insurance claims. She just might be able to find one who'd be willing to take her case on either a contingency or a "blended fee" basis (i.e., part hourly, part contingency) that she'd find affordable.

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Andy9o8

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USPA provider concluded once he made entry into the water, the skydive was completed, therefore no pay out.

Main stream provider concluded he died 'skydiving', a non covered incident.



(FWIW: I've handled a lot of insurance claims law, on both sides. The following is not legal advice.)

If the main stream policy had language that excluded skydiving, then it did, and that's hard to fight. But to be sure, a lawyer should review every word of the policy from front to back; one should not rely on a layperson, and certainly not on the say-so of an employee of the insurance company.

BUT - and it's possible there are more factual or technical details of which you're not aware - IF the USPA's insurance carrier is claiming the drowning was an event that was technically separate from the skydive, my default reaction, even without reading the policy (though that still must be done) is that's bullshit, and your friend should consult a lawyer with an eye toward fighting it in court.

Of course the cost may be a deterrent. But although taking cases on a contingency-fee basis is usually only done in personal injury type cases, some lawyers do handle certain types of insurance claim cases on contingency, too (though many do not).

Except for the most rural areas with very low population density, almost every county in the US has a local county bar association that provides attorney referral services to the public. And every state has a state bar association that often provides similar services. Your friend should look them up and speak with them, with an eye toward getting at least an initial consultation with a lawyer who handles insurance claims. She just might be able to find one who'd be willing to take her case on either a contingency or a "blended fee" basis (i.e., part hourly, part contingency) that she'd find affordable.


Thank you for your feedback, Andy.

" USPA's insurance carrier is claiming the drowning was an event that was technically separate from the skydive, my default reaction, even without reading the policy (though that still must be done) is that's bullshit, ..."

This is exactly their position & reason for denying !!!

Like I said she is still extremely devastated by the loss of her husband, but I will definitely suggest to her, what you've pointed out.

Is there a 'timely filing' to appeal denied claims ?

His death was July 9, 2013, so this week is extremely hard for her, but I wouldn't want her to miss any procedural requirements.

She has shut down from pursuing this.

Sometimes you would have to wonder if insurance companies count on this.

She hasn't even been able to move his gear from the spot he had them in their home, nor go into a closet he had clothes, since his death, so it is hard to bring the topic up to make suggestions.

So far all I've really been able to do for her, is listen.
Though no doubt some day, she'll wish she hadn't missed her window.

Thanks again for your input. It's very much appreciated !

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>Most of the poor jumpers I have known in this situation still won't justify it.
>They gladly let it ruin their credit and pay $5 a month to the bill collector for the
>rest of eternity.

Yep. And we wonder why our medical costs are so out of whack . . .

About 20 years back I was jumping at Brown Field and one of the jumpers there had a pile of medical bills. He decided to declare bankruptcy. Just before he started the process he went out and bought a brand new rig - new main, new reserve, AAD, the works. "Well, if I have to declare bankruptcy anyway I might as well get something out of it" was his rationale.

Lots of people think that way.

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Is there a 'timely filing' to appeal denied claims ?
His death was July 9, 2013, so this week is extremely hard for her, but I wouldn't want her to miss any procedural requirements.



Yes! - but the factors that affect the deadline vary from one state to another, and one insurance policy to another, among other things. She should consult with an attorney immediately! (with respect to all insurance policies and any other issues)

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cgriff

***Personal responsibility seems to be a lost virtue.




It's just not very fashionable these days...

They've been saying that since the days of Socrates. Viewed truly objectively, it really doesn't vary much from one generation to another.

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Andy9o8

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Is there a 'timely filing' to appeal denied claims ?
His death was July 9, 2013, so this week is extremely hard for her, but I wouldn't want her to miss any procedural requirements.



Yes! - but the factors that affect the deadline vary from one state to another, and one insurance policy to another, among other things. She should consult with an attorney immediately! (with respect to all insurance policies and any other issues)



Ok -
I will be talking to her later in the week, so in hopes not to come across insensitive, I will attempt to approach the topic & relay this to her.
Thanks again !
* too bad you weren't in her area...a skydiving attorney who has handled both sides of insurance claims legal issues, given the circumstances, would be her best shot !

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skygypsie

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Is there a 'timely filing' to appeal denied claims ?
His death was July 9, 2013, so this week is extremely hard for her, but I wouldn't want her to miss any procedural requirements.



Yes! - but the factors that affect the deadline vary from one state to another, and one insurance policy to another, among other things. She should consult with an attorney immediately! (with respect to all insurance policies and any other issues)


Ok -
I will be talking to her later in the week...

He said "immediately!"

...if not, sooner. :P
Your secrets are the true reflection of who you really are...

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Coreece

******

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Is there a 'timely filing' to appeal denied claims ?
His death was July 9, 2013, so this week is extremely hard for her, but I wouldn't want her to miss any procedural requirements.



Yes! - but the factors that affect the deadline vary from one state to another, and one insurance policy to another, among other things. She should consult with an attorney immediately! (with respect to all insurance policies and any other issues)


Ok -
I will be talking to her later in the week...

He said "immediately!"

...if not, sooner. :P

I wish I could talk to her "immediately", except I just spoke with her exactly one week ago, exactly the one year date since she lost her husband, our close & dear friend.
She, their children & his family (parents & brother) are taking this week together, privately, to celebrate & honor his life.
Not only is she not accessible, but it would be disrespectful to attempt to call her voicemail, etc.
I will get in touch with her when she & her family have had this time together & she is taking calls.
I will honor & respect their wishes & privacy during this much needed time together.
Thank you for pointing out this really needs to be acted on immediately. Your concern is appreciated B|

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if the law said 1 year from date of incident, it's already too late. If its 2+, plenty of time. If it's 1 year from point of decline, then there's more time since they couldn't have answered that quickly. If instead the time interval is in months, who knows.

As soon as you can (tactfully) inquire, the better.

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JohnMitchell

***

She was denied by both.

USPA provider concluded once he made entry into the water, the skydive was completed, therefore no pay out.

Main stream provider concluded he died 'skydiving', a non covered incident. :(:|


[:/][:/]

Could see this same argument used for a pond swooping fatality. :S>:(

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kelpdiver

if the law said 1 year from date of incident, it's already too late. If its 2+, plenty of time. If it's 1 year from point of decline, then there's more time since they couldn't have answered that quickly. If instead the time interval is in months, who knows.

As soon as you can (tactfully) inquire, the better.


Though the date of incident was 1 year ago, she received the denial(s) around November, 4 months later.

It is my understanding they were awaiting investigation results pending, per USPA, autopsy & law enforcement.

So are you saying 1 year from date of occurrence or date of filing claim ?

She has been very open discussing details, emotions, issues....with me, so I will share with her input from those of you have given knowledgeable advice.

Thanks for your feed back !

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skygypsie

***if the law said 1 year from date of incident, it's already too late. If its 2+, plenty of time. If it's 1 year from point of decline, then there's more time since they couldn't have answered that quickly. If instead the time interval is in months, who knows.

As soon as you can (tactfully) inquire, the better.


Though the date of incident was 1 year ago, she received the denial(s) around November, 4 months later.

It is my understanding they were awaiting investigation results pending, per USPA, autopsy & law enforcement.

So are you saying 1 year from date of occurrence or date of filing claim ?

She has been very open discussing details, emotions, issues....with me, so I will share with her input from those of you have given knowledgeable advice.

Thanks for your feed back !

I'm hesitant to say anything that might be construed as legal advice on here. But generally speaking (although this is not legal advice)
- The clock usually starts running as of the date of the occurrence.
- It's not just what the state's law says re: deadline - i.e., the so-called "statute of limitations" for filing a lawsuit (which varies greatly depending on the state and the type of claim). But most insurance policies have specific deadlines for filing suit written into the language of the contract, and they're often shorter, sometimes much shorter, than whatever deadline is in the state law. Blow that contractually-set deadline, and you're possibly (maybe even probably) shit outta luck, no matter what the state-law deadline might be.

That's why she needs to see a lawyer ASAP to advise her.

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Andy9o8

******if the law said 1 year from date of incident, it's already too late. If its 2+, plenty of time. If it's 1 year from point of decline, then there's more time since they couldn't have answered that quickly. If instead the time interval is in months, who knows.

As soon as you can (tactfully) inquire, the better.


Though the date of incident was 1 year ago, she received the denial(s) around November, 4 months later.

It is my understanding they were awaiting investigation results pending, per USPA, autopsy & law enforcement.

So are you saying 1 year from date of occurrence or date of filing claim ?

She has been very open discussing details, emotions, issues....with me, so I will share with her input from those of you have given knowledgeable advice.

Thanks for your feed back !

I'm hesitant to say anything that might be construed as legal advice on here. But generally speaking (although this is not legal advice)
- The clock usually starts running as of the date of the occurrence.
- It's not just what the state's law says re: deadline - i.e., the so-called "statute of limitations" for filing a lawsuit (which varies greatly depending on the state and the type of claim). But most insurance policies have specific deadlines for filing suit written into the language of the contract, and they're often shorter, sometimes much shorter, than whatever deadline is in the state law. Blow that contractually-set deadline, and you're possibly (maybe even probably) shit outta luck, no matter what the state-law deadline might be.

That's why she needs to see a lawyer ASAP to advise her.

No worries about your (nor any others) statements being misconstrued as legal advice, though with that being said, I will contact her IMMEDIATELY -TODAY !

I know she is not only struggling emotionally & physically, but also financially.

Like I said, a major portion of their income was his skydiving, but also a very successful
'built from the ground up' home business, he ran.
He also had his own dz, but was just helping another dz out with tandems, when he died.

No doubt she needs to get on this.

They had an attorney for their business ventures & he was the initial go between with insurance companies after his death, but once claims were denied, she relayed to me there was nothing more to be done.... :|

I will suggest to her she needs to find an aggressive, specializing in insurance cases, attorney - NOW !

Again, thanks to you all for your 'statements' !

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I am a Nurse with a variety of experience. I do volunteer at a free clinic 4 days each month.

What I find in many cases is that people will pay 400-500-600$ dollars a month for a car, but balk at spending as much on their health care insurance.

Sorry, but IDGAF about cars people drive, they do not impress me nor create internal feelings pf jealousy. I drive a 2008 Kia Rio LX I purchased brand new for 8k. Before that my 1994 Toyota Corolla. I prioritize health ins, and now skydiving, over certain material possessions.

People need to learn to prioritize.
Skydiver Survivor; Battling Breast Cancer one jump at a time. DX June 19th 2014
I have been jumping since October 5th 2013.
https://pinkribbonskydiver.wordpress.com/

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It comes down to this. HONESTY. When I bought my policy I was asked if I participated in any "high risk activities." The list is actually quite long and has stuff that I would never consider high risk. I got two quotes. One as if I wasn't involved in any of the activities on the list and the other to cover me as a jumper. Keep in mind that this was a $500K 20 year term life insurance. I'm in my mid-30s, in shape and zero health problems. First quote was just under $30 per month. Second quote was for just over $500 per month.

Here's the point. If you're open and tell them what you're looking for you can get coverage. That said, you will pay for it!

Also, what you need to ask is what their "period of contestability" is. Most insurance companies are two years. This means that when you fill out the application you're giving them what you do or do not do right now as well as for the next two years. If you purchase a policy right now most insurance companies will cover you if you start jumping 3 years from now.

there's a lot of ins, a lot of outs, a lot of what-have-yous
Truth is the distilled meaning of facts, for any truth refuted by a fact becomes a fallacy.

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I am going to check that out! I can see why. 130,002 miles and I have not performed anything other than routine maintenance. Mobile 1 oil change every 5,000 miles, tranny service every 15,000, etc..
I am good to my vehicles.
Skydiver Survivor; Battling Breast Cancer one jump at a time. DX June 19th 2014
I have been jumping since October 5th 2013.
https://pinkribbonskydiver.wordpress.com/

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Hmm, I still carry term life insurance (V's gonna be rich if I go inWink) that doesn't exclude skydiving. But now I think I may have to recheck the super fine print. . .



Since there has been some talk about term life here, I will chime in...

My husband and I both got new/increased term life policies about a year ago. (After we got sticked and pee'd, I received the super-preferred rating and cheapest rate possible for my level of coverage. B| My husband got the next best price.)

W/r/t skydiving: The questions were have you in the past two (or three?) years skydived and do you have plans to in the next two (or three?) years. We both answered honestly, "No." We both may skydive again (after that period of time) once we want to commit the time to jump regularly (it is so hard to leave the beach :$) and thus, we asked several questions beforehand; it was explained to us after that two-year period of time it was not excluded and would be fully covered even if we did so regularly (not as a job). I skimmed through the policy and nothing suggested the contrary, FWIW.

It is important to answer honestly and ask questions.
Paint me in a corner, but my color comes back.

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