Does Health Insurance Cover Sports & Gym Injuries?

What are some Common Sports Injuries?

Any person engaging in sports or fitness activities can easily suffer sports injuries. Without a doubt, this can cost you significantly depending upon the injury and treatment procedure. Take a look at some common gym and sports injuries:

Ligament tears
Muscle sprains
Muscle Pulls
Dislocated joints and bones
Abrasions
Knee injuries
Tendon injuries

All of these injuries are very painful, need a lot of time and care to heal and can significantly affect your quality of life if ignored. What's worse, some of these injuries need a long treatment often involving surgeries and necessary rehab programs that cost significantly.

Is there any Coverage for Sports Injuries Under Health Insurance?

Anyone who has an active lifestyle can get injured. Be it due to gym, strength training, cycling, swimming or while playing tennis, these sports injuries are very much possible.

However, the additional cost can cause considerable financial expenses and you may even find it difficult to continue with your fitness journey while fighting these expenses. This should not discourage you or anyone else to forget their fitness goals.

Luckily, many mediclaim insurance plans cover such sports and fitness-related injuries. Thanks to standardised definitions and clear exclusions, you can easily claim coverage for many of these injuries. However, knowing the exclusions of your health insurance policy is very important.

What Sports Injuries Are Covered by Health Insurance?

Most health insurance companies don't cover any injuries due to hazardous or very dangerous activities such as scuba diving, racing, or mountaineering. Since regular people like us don't fall under this category, most sports or gym injuries will be covered by health insurance.

One thing to remember here is that OPD or outpatient costs are not covered by most health insurance companies. Gym injuries are usually minor injuries in muscle and ligaments that are paid out-of-pocket and usually not covered by a health insurance policy.

Therefore, ligament tears, physiotherapy, fractures and minor strains are not covered under the health insurance policy. The only time these costs are covered is when you've been hospitalised or these OPD costs are part of the recovery process post-hospitalisation.

Are There Any Health Insurance Plans for Gym and Sports Injuries?

There are several health insurance companies in India offering cover for sports injuries if you're hospitalised. Even several personal accident insurances or critical illness insurance will cover some sports-related injuries.

There are also some specific health insurance plans that only cover injuries caused due to sports or gym activities. These plans cover several injuries including ligament tears, bone fractures, and other complications depending on their policy wording.

Similarly, many travel health insurance plans offer optional coverage for adventure sports while you're abroad. However, the coverage varies from insurer to insurer and you should know what kind of injuries are covered during these sports.

Things to Remember before Raising a Claim for Sports/Gym Injuries

Before buying any health insurance policy, you should always read their policy wordings carefully. Before raising a claim, make sure to remember the following:

Sports injuries caused due to intoxication or other illegal substances are not covered
Common routine injuries such as sprains are not covered by most insurers
Sports like motorsports, cliff diving, hunting, and adrenaline air sports are not covered by several health insurance plans
Several insurers don’t cover injuries sustained in an illegal or non-registered fitness centre
Injuries during intramural sports events and tournaments are covered by a specific sports insurance policy, not regular mediclaim insurance
Injuries that occur due to an illegal activity won't be covered
Most health insurance companies don't cover any procedure that falls under the category of cosmetic treatment

Over to You,

An increase in health awareness has made many regular people into fitness enthusiasts who actively work out at gyms or play sports. However, this fear should not stop you from leading a fit and active lifestyle. With a comprehensive health insurance policy, you can easily claim benefits for sports-related injuries so that you can focus better on your fitness journey!