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Why are fans paying medical bills for world-class skier Sarah Burke?

Competitors at the Winter X Games in Aspen, Colo. adorned themselves with items in rememberance of Canadian skier Sarah Burke who died from injuries she sustained in a training accident in Park City, Utah in January.

Updated at 6:20 p.m. ET: A spokesman for Monster Beverage Co. said skier Sarah Burke, one of the athletes it sponsors, did not receive insurance coverage from the company before her fatal accident in Utah.

"Sponsors in general do not provide insurance for the athletes, who are independent contractors. In many contracts if not most, the athletes sign an agreement saying they understand that it is a dangerous sport and that they are responsible for their own well-being," said Roger Pondel, from the public relations company PondelWilkinson in Los Angeles. "That is fairly standard throughout the industry."

"The company is continuing to support (Burke's) family," Pondell said, but he declined to give details, "in deference to the privacy of the family."

Original post: On Monday, msnbc.com published a story on a fund drive that had raised more than $300,000 to cover the medical costs for Sarah Burke, a 29-year-old professional skier from Canada who died after a training accident in Park City, Utah.

The story pointed out that Burke’s family was facing a disaster familiar to uninsured Americans — a mountain of medical expenses on top of personal tragedy. As a number of readers pointed out, the story raises a question: Why was a professional skier with corporate sponsors not covered by insurance?

Because Burke was Canadian, wouldn’t she have been covered by Canada’s universal health care system? The answer is yes — and no.

Had the accident occurred in Canada, Burke, who lived near the western Canadian ski mecca of Whistler, British Columbia, would have been covered for 100 percent of her medical care through public health insurance, according to Ryan Jabs, manager of media relations for the Ministry of Health in British Columbia.

That national health insurance policy applies outside the country too, he said, but only pays for what the services would have cost in Canada — typically only a fraction of what the services cost in the United States.

“If someone is traveling outside Canada, we encourage them to get third-party insurance” to cover the difference, said Jabs.

Burke’s husband has not pursued insurance claims from the government so far, Jabs said, adding that he still has the option to do so. He said the University of Utah hospital where Burke was cared for had been in contact with the health ministry but he could not disclose details.

Daniel Dal Zennaro / EPA

Canada's Sarah Burke celebrating on the podium after winning the women's halfpipe freestyle FIS World Cup Grand Finals in Chiesa Valmalenc, Italy in 2008.

Burke also had $5 million in medical coverage through the Canadian Freestyle Ski Association, a largely government-funded body that fields Olympic competitors in the sport.

"It’s a really good policy — one used by most athletic associations in Canada," said Kelley Korbin, media relations manager for the association. But she said that the policy covers only sanctioned events and training where association coaches are present. “This was a private sponsored event, so none of our certified trained coaches were there."

Burke’s event — half-pipe skiing — was added as an Olympic event just last spring, said Korbin, so top half-pipe athletes like Burke had a history of performing in commercially sponsored events. Half-pipe skiers compete in a half-cylinder-shaped course dug deep into the hill. With speed gained on the slope, skiers come up over the rim of the pipe and perform acrobatic aerial tricks, winning by executing the most difficult tricks with the best form. Burke was defending champion for the women's halfpipe in the annual Winter X Games.

The Jan. 10 accident that took Burke’s life occurred during training at Park City Mountain Resort in Utah, as part of a freeskiing team sponsored by the U.S.-based Monster Energy drink company. She was rushed to the University of Utah Hospital and treated for a ruptured vertebral artery — one of four that supply blood to the brain. Surgery and subsequent care ultimately failed to save her. She died Jan. 19 because of a lack of oxygen to the brain.

Why no insurance?
The biggest unanswered question is why Monster or Burke’s agent, Michael Spencer, apparently had not arranged for insurance coverage for Burke.

"It’s hard to believe Park City would allow someone to come and do an event without proving that you have liability insurance,” said Korbin, of the Canada’s freestyle association. "For sure at Whistler (ski resort in Canada), we have to prove that each competitor there has Canadian freestyle insurance. Otherwise they don’t want to take on their liability on their hill."

California-based Monster Beverage company did not respond to phone calls about insurance coverage for Burke, who the company was sponsoring for the Winter X Games. Michael Spencer, Burke’s agent, who set up the donations page to help the family with medical costs, also did not respond to queries from msnbc.com by phone and email.  

Park City Mountain Resort had not yet responded to queries from msnbc.com about its policy on insurance coverage for events as of the writing of this article.

Patterson notes that it’s difficult to get policy underwriting for medical coverage on some sports, like mixed martial arts, for instance, where injury is virtually certain.

"To me it’s unfathomable that she wouldn’t have had someone covering this, especially competing at that level," said Derek Patterson, owner of eGlobalHealth Insurances Agency, in Springfield, Missouri, which provides specialized coverage for athletes, war-zone contractors and other clients in hazardous conditions. “Sometimes people have the assumption that they are covered, but then find out it is not the case."

"Someone didn’t put (coverage) in place," said Greg Sutton of Sutton Special Risk, a specialized insurance broker in Toronto. "The broker or the agent — someone should have recognized that there would have been a gap because the event was unsanctioned."

Addendum: In our previous story, we noted that uninsured Americans are frequently pushed to bankruptcy by the cost of medical care for catastrophic illness or accident. An email from GiveForward, a donation appeals site mentioned in the story, said that the site currently has about 1,500 pages posted by people who were struggling to raise money for health care costs.

Press reports initially estimated the cost of Burke's intensive medical care at about $500,000, though later it was revised downward, to about $200,000. A fundraising page on GiveForward.com shows that donors have contributed $305,483 to help the family cover the costs.

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