Distance Runners Are a Paradox For Insurers

Jennifer Frighetto is not a marathoner, but it is not for lack of trying. Had she crossed the finish line at this year's race in Chicago, it would have been her first successful attempt at the 26.2-mile distance. But just as at the 2008 and 2009 Chicago Marathons, Frighetto was unable to finish because of injury.

Frighetto, a self-described former couch potato, said that since she first decided to run a marathon in late 2006, she has seen doctors for a stress fracture in her foot, plantar fasciitis and iliotibial band syndrome. The activity that promised to make her healthier was actually increasing the frequency of her doctor visits, a fact that makes amateur athletes like her a problematic group of people for health insurance companies to insure. And as more and more people become marathoners -- the 2011 Boston Marathon sold out in eight hours -- distance runners are becoming a hard group to ignore.

''Insurance companies love runners because they're healthy people,'' said Nathan Nicholas, the president of Nicholas Hill Group, a Colorado-based insurance brokerage firm that works with USA Triathlon. ''Many of them are younger and have disposable incomes. They're a great demographic.''

But, he added, because they train so hard, they have injuries and accidents that can sometimes make them difficult to insure.

Distance running, in particular, has a documented history of injury: a 2007 study published in The British Journal of Sports Medicine found rates of injury to the lower extremities were as high as 79 percent in long-distance runners.

Another study published in 2008 in The Scandinavian Journal of Medicine and Science in Sports found that 28 percent of 694 male runners polled sustained a lower-extremity injury while running in a marathon or in the month before it.

''Athletes are going to have more injuries than a couch potato,'' said Kevin Luss, the founder of New York-based insurance services company the Luss Group. ''But their height-weight ratio and cholesterol will be better than a couch potato's. Their physiological age will be younger.''

Nicholas said benefits like those made ''insurance companies view athletes very favorably from a health standpoint,'' but that those benefits did not prevent companies from denying coverage to injured athletes.

''States have come up with regulations under the best intentions that had unintended consequences,'' Nicholas said.

For example, insurance companies in California are no longer allowed to exclude pre-existing injuries from treatment. So if a healthy 25-year-old marathoner with a broken leg were shopping for individual health insurance, instead of being accepted and receiving coverage for everything except the leg, insurance companies could deny her coverage. In 2014, provisions of the new health care law passed in March will go into effect, restricting insurance companies from denying coverage based on pre-existing conditions.

In New York, where such provisions already exist through state law, Luss said, ''it doesn't matter if you're an athlete or a person participating in organized athletic events at almost any level.''

He added, ''You'll pay the same amount as someone who is overweight and unhealthy.''

This fact upsets New York-based runners like Barbara Gubbins. A 50-year-old Southampton resident, Gubbins has been running since high school and placed second out of 895 women in the Hamptons Half Marathon in October. She says the injuries associated with endurance running are minor compared with the benefits to health and wants insurance companies to consider her identity as a runner when calculating her premium, not just her age and gender.

''The fact that you're an active runner or a triathlete doesn't factor in at all, which is very counterproductive,'' Gubbins said. ''But for the insurance companies, it's a bonus because they're getting a big pool of healthy applicants.''

New York-based health insurance companies like Group Health Incorporated work hard to cultivate this ideal pool of applicants -- without the injury risk posed by endurance athletics -- by focusing sponsorship on events like tennis tournaments rather than distance running.

''What we're promoting is a healthy lifestyle,'' said Karen Chaikin, Group Health Incorporated's director of public affairs.

But with marathon participation in the United States at a record high of about 467,000 finishers in 2009, according to Running USA, a nonprofit organization that tracks running trends, insurance providers like Connecticut-based Aetna do not shy away from promoting their products to distance runners.

''We do believe running events can help people make healthier lifestyle choices,'' said Floyd Green, the head of community relations and urban marketing for Aetna. Although Aetna ''tends to focus more on the 5-kilometer to 10-kilometer events,'' he said, ''we sponsor events like the marathon because it's an opportunity for people who are into that kind of race to remain healthy.''

When it comes to health insurance and marathoners, particularly in New York, the risk of injury should be more of a consideration for the applicant than for the insurance company, according to Luss.

''A lot of athletes feel invincible and don't buy the insurance that they should,'' he said.

For recreational athletes who do not earn income from competition, Luss said a health insurance plan was all that was necessary to cover potential injuries.

However, if that passion for running turns into a zeal for triathlon, Nicholas recommends supplemental accident insurance to cover potential bicycle crashes. To serve this athlete demographic, Nicholas founded Adventure Advocates, a nonprofit organization that provides members accident insurance.

For Frighetto, a 40-year-old working mother who has health insurance through her employer, the marathon remains the ultimate athletic goal.

''Even if I've been injured and haven't reached my goal of completing the marathon, there have been tremendous benefits,'' she said. ''Training got me off of the couch, and a couple of friends from work started running after listening to me talk about training all of the time.''

Green says Aetna is happy to work with runners like Frighetto.

''We will work with athletes to provide the resources and services they need to live healthy lives and also to run healthier,'' he said.

October 25, 2010, Monday    Late Edition - Final
Section: D    Page: 1    Column: 0    Desk: Sports Desk    Length: 1065 words