May 20, 2016
Sports Injuries: Who Pays for What?
by Hattie James
When it comes to sports injuries, insurance liabilities aren’t nearly as black and white as you might think.
When an athlete gets hurt on the field, there’s often a lot of finger pointing. The athlete might point the finger at the opposing player who hit her. The opposing player might point back. Then coaches get involved. After all the finger-pointing, though, who’s ultimately responsible for the medical care that might be needed for the injury? Is it the athletic program? Certainly, insurance has been factored into that program’s budget, but it might not be the kind of insurance that helps its athletes. And what about youth sports injuries or those sustained by professional athletes?
When it comes to sports injuries, insurance liabilities aren’t as black and white as you might think. While insurance policies are mandatory for nearly every athlete, it may surprise you who pays for what, especially for medical care after the end of an athlete’s career.
With more than 30 million children participating in sports, it’s no wonder about 10% of them, aged 14 and under, end up in emergency rooms for injuries related to those sports. The most telling aspect of these injuries is that the majority of them occur during practices rather than games (nearly 62 %).
In the game of who pays for what, it’s difficult to determine when an injury occurs during practice rather than competition. One Seattle-area high school’s student athlete handbook simply states that participants may be covered by the school district’s insurance or by a plan that is its equivalent or better. There is no mention of coverage based on practice versus competition, and the stipulation that students can be covered by a better plan puts the onus on parents to pay for the insurance, even though the students are representing the high school.
Parents and guardians, of course, should be responsible in general for health insurance for their kids, but is it going too far to ask them to provide sports health insurance? Most regular health insurance plans will cover the basics of a child’s sports participation, but once a child becomes highly competitive, separate coverage for sports may be necessary. It can also be argued that more specialized coverage is becoming necessary as youth sports are attracting bigger, more powerful players.
Once an athlete graduates to the college level, insurance liabilities don’t change much. While the NCAA requires all athletes be covered by insurance, it doesn’t require that all colleges pay for that insurance.
In some cases, as sports medicine specialist Dr. David Geier points out, colleges and universities have limited budgets and cannot afford to fully cover athletes. While many institutions provide basic on-field care for their student athletes, the buck stops when those athletes get injured.
Geier writes about the difference between the University of Alabama and Auburn, a large- and small-market team in the same state. While Alabama covers everything from basic medical and dental for its athletes to their rehabilitation for injuries sustained during an official team activity, Auburn only pays for expenses not covered by a family’s insurance. If an athlete’s family doesn’t have insurance, the school with then cover that athlete.
Covering college athletes’ insurance expenses doesn’t come cheap for any school; Alabama paid nearly $2 million five years ago, Auburn nearly $900,000. Yet with so many college athletes suffering catastrophic injuries, does it behoove the NCAA and its member colleges to provide more comprehensive care?
If an athlete can make it to the big leagues, insurance coverage becomes a different game, literally. Professional athletes who play individual sports such as golf or tennis must pay for their own insurance.
Team athletes, however, are covered by multiple policies. Leagues such as the NBA and the NHL have plans that blanket many of their players. For a league like the NHL, where injuries are prolific, this tactic is smart. These types of policies are based on a modest percentage of the players’ salaries. The NBA’s policy is only obligatory for a team’s top five players, essentially the starting line-up.
Insurance for professional athletes has to do as much with financial losses for a club as it does with physical pain endured for an injury. Policies typically won’t kick in until an athlete has been unavailable for at least a few months. Athletes sidelined for an entire season (think: Peyton Manning) cost their teams and insurers millions of dollars.
However, because athletes of the highest caliber carry private insurance, they themselves are covering their medical expenses and covering potential income losses. After Manning’s neck surgery, the Denver Broncos guaranteed the first two years of his contract; after that, his salary could have been voided if he hurt his neck again.
Now that Manning is retired, he is likely paying a disability policy. He famously stated that he expects to have debilitating medical problems as he ages, simply because of his playing days. Should the NFL or the Broncos pay for his treatment? As with any other employer-employee relationship, it can be argued that Manning is now responsible for his own medical care. With the continued research into post-career injuries, the responsibility for covering them will likely evolve.