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Can You Claim Health Insurance for Sports and Gym Injuries?

By Juhi Walia
23 August 2022, 4:37 PM

In a time of sedentary lives and irregular eating habits, physical and mental diseases are more widespread than ever. Silent killers such as cardiovascular illnesses, stroke, diabetes, and hypertension are progressively claiming many lives. One cannot overlook the importance of physical fitness in such an unhealthy environment to stay in good shape. While some quickly come up with excuses to avoid exercise, others believe in taking time to work out regularly or involving themselves in a sport to keep their body ticking. Bear in mind that as we get older, the physical demands of our bodies keep changing, thereby increasing the risk of a severe sports injury or one inflicted at the gym. 

An active lifestyle has become the need of the hour. Your goal should be to get at least 30 minutes of daily workout for a healthy body and mind. It's half the battle won if you love playing sports or breaking a sweat at the gym. But are you covered for the medical expenses that might arise from any unwanted injury? A standard health insurance policy may provide you cover, but that does not mean that it is the optimal plan covering you for all your extracurricular activities. Hence, reading the fine print for inclusions and exclusions under your specific cover plan is essential. Some injuries can be drastic and need long-term medical care or even hospitalisation. 

Does Health Insurance Cover Sports and Gym Injuries?

Health insurance has several terms and restrictions, particularly for sports injuries, just like any other insurance product you buy. Health insurance does not cover adventure sports and gym injuries that thrill-seekers indulge in, such as rock climbing, skydiving, bungee jumping, and so on.

What are the Common Sports and Gym Injuries?

Every sport is unique; hence, it carries its share of specific injuries that may harm different parts of the body. Below are some common injuries that can affect people who actively participate in sports or go to the gym regularly. 

  • Muscle sprains
  • Bone fractures
  • Ligament tears
  • Knee injuries
  • Hamstring injuries
  • Tennis elbow
  • Running injuries
  • Dislocated bones and joints
  • Achilles tendon injuries
  • Rotator cuff injuries

List of Some of the Most Excluded High-risk Sports

  • High-speed motorsports such as bike rallying, car races, go-karting
  • Scuba diving below 30 metres
  • Bike mountaineering or cliff diving
  • Sports involving the usage of weapons like hunting and archery
  • Rock climbing or trekking above 2,500 metres altitude 
  • Boat-related activities involving a speed of 30+ knots  
  • High adrenaline air sports like skydiving, bungee jumping, parachuting, etc.

No two policies are the same. While one policy may not necessarily cover a specific injury or condition, another plan may. Be sure to go through the exclusions list mentioned under the table of benefits. You may also contact your health insurance provider and enquire about the same. 

Exclusions Offered Concerning Sports Injuries are as Follows

  • Sports injury claims are not eligible for policyholders under the age of 18.
  • Sprains and other common everyday sports injuries that are self-inflicted.
  • Sports-related injuries abroad.
  • Injuries caused by risky extreme sports, including scuba diving, mountaineering, and racing.
  • Out-patient expenses (OPD) 
  • Sports injuries that occur under the influence of drugs and other unlawful substances. 
  • Procedures classified as "cosmetic treatments."


Simply put, a majority of health insurance policies do not cover gym and sports related injuries. Although professional and other organised athletic events have their own health insurance schemes. As a precautionary measure, you must confirm whether the gym you register for has a valid licence. If you use a gym with a valid licence, your health insurance provider will most likely reimburse your health insurance claim if you meet with a mishap requiring hospitalisation. It is advisable to do a thorough research and discuss with your current provider about customising your policy so as to avoid some of the exclusions or still better, switch to a new insurance policy that better fits your requirements. Go ahead and play the sport you fancy, but ensure to prepare yourself for all the scenarios. 

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1. What are the most common sports-related injuries?

Mild sprains, muscle pulls, ligament tears and abrasions are people's most common sports-related injuries. 

2. What if my health insurance does not cover sports-related injuries?

Speak with your current health insurance provider about customising your plan to avoid some of the exclusions, or look for a new policy or even company that better fits your needs. To get insurance coverage that meets your needs, you have to spend a little bit more upfront, but this choice could save you a lot of money over time.

3. What does extreme sports mean?

Extreme sports, usually referred to as action sports or alternative sports, are competitive sports that involve significant risk and speed. Adrenaline-rush activities, including skateboarding, snowboarding, freestyle skiing, in-line skating, street luging, BMX, and mountain biking, are the sports that are most frequently included in this category.

4. How many sports-related or gym-related injury claims am I eligible to file each year?

You need to check with your insurance provider for the same. It differs from company to company.

5. Outpatient (OPD) costs are not covered in the policy — what does this mean?

It implies that even with health insurance, you will still be responsible for foot fractures, minor ligament tears, and physiotherapy. The only exception is if you pay for physiotherapy or outpatient care before or after being hospitalised as part of your recovery. In some circumstances, the health insurance provider will cover the cost of OPD or physiotherapy.

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