Archive for the ‘Accident Insurance’ Category

Swimming outings source of liability claims

Safety first at team pool parties

The swimming outing in a coach’s backyard or at a motel pool during a tournament is commonly the source of drowning or near-drowning incidents.

Drowning among youth baseball and softball players seems to be a prevalent problem in youth sports leagues. Of course, this is not isolated to just the baseball/softball arena, but more common most likely because of spring and summer activity.

An 8-year-old boy nearly drowned during his football team pool party in Arizona. His parents were in attendance but distracted for just long enough. Fortunately, the child was rescued by another alert parent.  Unfortunately, most cases that we read about do not have such happy endings.

Sport-related injuriesVigilance is the key

Drowning is the second highest cause of accidental death in children under the age of 15, according to the Center for Disease Control.. Approximately 750 children will drown next year, 375 of whom will be within 25 yards of an adult.

Accidents cannot always be prevented. It’s critical, however, to be vigilant when dealing with children in youth sports organizations. Most of the time, not every one of the children has a parent or guardian with them, especially when the team travels.  These parents trust that the coaches and volunteers that they leave their children with will be monitoring their safety and bringing them back home in one piece.

Steps toward prevention

Simple precautions can be taken to lessen the risk of drowning.

  • Participation requires passing a swim test.

  • Instill in team members “the buddy system” so they’re accountable for each other.

  • Have at least one CPR-trained adult in attendance.

  • Prohibit alcohol consumption by adults at all youth parties.

  • Adults should not be involved in any distracting activity (such as grilling, reading, talking on phone)

  • Hire a certified lifeguard and require them to provide proof of adequate General Liability insurance.

The avoidance alternative

A number of Sadler Sports insurance clients have been sued for drowning or near drowning incidents resulting in very costly settlements. I’ve personally witnessed a number of incidents around pools where parents get caught up in conversations and lose their concentration for just a split second, and that’s all it takes.

In my opinion, the risks of serious injury and resulting lawsuits are so significant with swimming parties that such activities should be avoided as their risks outweigh their benefits. Avoidance of high risk activities is sports risk management 101 and I put swimming parties right up there with the use of 15 passenger vans (tip-over risks) and sleepovers (sex abuse and molestation risk).

You can find further information on pool safety on the American Red Cross website. If you have questions, please contact us.

Reducing Facial Injuries in Youth Baseball

Batter face guards improve injury statistics

A study of youth baseball Accident Insurance claims from 1994 to 2008 revealed that the batter’s face guard was effective in eliminating a significant percentage of facial injuries. Baseball facial InjuryThe study consisted of Accident claim data provided by Sadler Sports Insurance on behalf of Dixie Youth Baseball and Dixie Boys Baseball, which was analyzed by the USA Baseball Medical And Safety Advisory Committee.

Batter’s face guards were effective in reducing the number of facial injuries to batters being struck in the face by pitched balls and base runners being stuck in the face by thrown balls. The number of injuries dropped from about three percent in leagues where use of face guards was voluntary to less than half of one percent of all claims in leagues where their use was mandatory.

Even though the reduction in facial injuries was impressive, the USA Baseball Medical And Safety Advisory Committee noted that the batter’s face guard does not need to be required in youth baseball as a result of the overall low risk of facial injuries due to pitched balls. However, the use of the batter’s face guard should be encouraged and does not appear to pose an increased risk of injury to the batter, base runner, or to other players on the field.

See the full study.

Insurance Requirements for Rec Facility Users

Reduce liability exposure with proper collection of certificates of insurance

Facility user groups such as teams, leagues, tournament hosts, camps, instructors, and special event operators must carry adequate insurance. In addition to providing the proper coverage, Sadler Sports Insurance can assist you in reducing your liability by:

    • setting minimum insurance limits and coverage standards that adequately protect the recreation department
    • providing a simple free checklist tool to assist in verifying insurance compliance
    • referring uninsured facility users to a specific web page where they can get an instant quote,  instantly pay, and bind coverage  without any delays or hassles. Their delays and hassles become your delays and hassles.
    • setting your recreation department up in our system so that the certificates of insurance meet your special wording requirements every time, which cuts down on your frustration over certificates that don’t meet your requirements.

The video below walks you through the process in more detail.

Swim Club Tragedy

Freak accident highlights need for Accident and General Liability Insurance

An accident can happen anywhere at any time. Recently, 11-year-old Lauren Cecil of North Carolina was electrocuted when an electric surge from a downed power line passed through the pool in which she and two teammates were practicing.

The swim club president witnessed the wire fall and land in a parking lot. When she heard a “popping” noise and saw a puff of smoke, she sent lifeguards to stand guard around the pool and encourage swimmers to exit.  While Cecil’s teammates were able to safely jump out of the pool, she attempted to leave using a ladder. Unfortunately, the metal ladder served as a conductor that sent a shock through her body.

Lifeguards were unable to retrieve her from the pool immediately because the water continued to transmit electric shocks. They eventually used a body board and kickboard to remove Cecil from the pool and begin CPR. Their attempts to resuscitate her were unsuccessful and she was later pronounced dead at a local hospital.

In the insurance industry, we are in the business of expecting the unexpected. Crazy things happen every day. Tragedies such as the one that befell Lauren Cecil are not unheard of, so it is important to protect your swim club or fitness facility in the event of an accident. General Liability and Accident insurance are the best forms of protection for ensuring that your organization and its administrators, staff, and participants do not suffer a serious financial loss as the result of unforeseen circumstances.

Source: 11-year-old North Carolina Girl Electrocuted While Swimming in Pool

American Youth Football and American Youth Cheer Insurance

The Gold Standard

The risky world of youth tackle and cheer

In the high risk world of youth tackle football, flag, & cheer, risk is everywhere in the form of concussions, spinal injuries, cheer stunts, sex abuse and molestation, lack of supervision, lack of instruction, premises problems, equipment problems, etc. In this world, administrators and staff (volunteer and paid) are putting their personal assets on the chopping block every day should an unfortunate mishap occur and result in a lawsuit. This is especially true if the insurance that was purchased to protect against this risk is inadequate.

Competitors often offer inadequate coverage to AYF/AYC

What is inadequate insurance? It could be that the limits are not high enough, but the more common situation occurs when the coverage within the limits includes unacceptable coverage exclusions or loopholes. And these unacceptable coverage exclusions are much more common than you may think, and can even exist if the program is another national association program. Sadler Sports Insurance has fought the battle against these unacceptable exclusions for many years by both educating the public and our competitors. We bring a problem area to the attention of our clients and offer a custom solution Then, within the next year or two, our competitors adopt it and act like it was their idea all along.

But competitors who merely attempt to copy the industry leader are not innovators and will always lag behind.

As for inadequate limits, many organizations no longer feel comfortable with an Each Occurrence Limit of only $1 million. After all, youth tackle football and cheer is more risky compared to some other popular sports. Therefore, an Each Occurrence limit of $2 million or $5 million should be strongly considered. The Each Occurrence limit applies to the amount that is available to respond to any single lawsuit.

The General Aggregate limit is a whole different issue. The General Aggregate is the amount that is available to respond to multiple lawsuits during the policy year. Many competitors offer a General Liability Each Occurrence Limit of $1 million and a General Aggregate limit of $2 million. A General Aggregate limit of at least $5 million may be necessary in the event that multiple lawsuits are filed during the same policy year. One recent concern in this area is the possibility of class action lawsuits by players over brain damage caused by sub-concussive impacts YOUTH FOOTBALL(CTE) from helmet-to-helmet hits. The jury is still very much out on this issue and hopefully such talk is just media hype. However, the possibility does exist.

AYF is leading the way with coach training in the area of concussions and the endorsed insurance program is structured in such a way as to offer superior protection to that of most competing programs.

Examples of common unacceptable exclusions under a General Liability policy include but are not limited to:

  • volunteer vs volunteer
  • participant vs participant
  • player vs player
  • cheer stunts and pyramiding
  • bleacher collapse
  • contractual liability limitation
  • sexual abuse and molestation
  • warranty of waiver/release, warranty of concussion training
  • punitive damages
  • assault and battery
  • athletic participant

We provide a checklist that can be used to analyze a competitor’s program against the AYF/AYC endorsed program, which is especially instructive in terms of revealing unacceptable exclusions.  Sadler Sports Insurance would be glad to assist in the comparison process if you can provide a copy of the competitor’s actual policy forms (Accident and General Liability). Unfortunately, you really don’t know much if you are relying on a competitor’s certificate of insurance or proposal as those documents are not required to include information on the policy exclusions.

Beware of competitor claims that seem too good to be true

A certain amount of self promotion and puffery is expected when advertising any product or service. However, some competitors may claim to have the best and lowest priced insurance product in the market as an attention grabber but that may not be the case after the dust settles. Whenever a claim or offer sounds too good to be true, it always is too good to be true in my experience. The incredible, attractive offer usually does not hold up due to the following reasons:Football Cheerleader

  1. The coverage is not comparable in terms of policies offered (Accident policy not included in price), policy limits are too low, or it includes unacceptable exclusions from coverage.
  2. The initial quote provided ends up being much lower than the final proposal because it was based on a suppressed number of teams or participants. In the meantime, you have wasted hours of time in providing information just to get the final proposal.

Other advantages of the endorsed AYF/AYC insurance program

Only the endorsed AYF/AYC program offers an instant online proposal, payment, binding of coverage, and issuance of proof of coverage documents and certificates of insurance for field owners in real time. This entire process can take days or weeks with our competitors and can be very frustrating when not having a certificate of insurance is keeping you off the practice field.

All of the Accident claims data from the endorsed program is compiled in a special software program that crunches the numbers in a way to produce meaningful information about how injuries can be prevented and how the game can be modified, if necessary, to promote safety. This data has already been used to illustrate that age only divisions in youth tackle football are no more risky than age/weight divisions. When you participate in the endorsed program, your loss data is used in a meaningful way to improve the safety of the game.

We offer free best-in-industry risk management content including articles, forms, risk management program templates, and training videos on general safety and sex abuse/molestation protection in the risk management section of our website.

The AYF/AYC endorsed insurance program is the industry leader and offers the best protection now and in the future for the players, volunteers, administrators, and youth football industry.

Ice Hockey Face Visors

Should sports disability carrier mandate use?

Sports insurance carriers are often pressured by advocates to require certain safety rules or safety equipment as a prerequisite of coverage.  The latest incident of this occurred in the sports disability insurance market for NHL professional hockey players.  Personal Disability insurance covers loss of income as a result of certain career ending injuries. One specialty Accident carrier decided to mandate the use of face visors as a precondition of extending coverage.  However, Disability broker, Greg Sutton of Sutton Special Risk in Toronto argues that it is not the role of sports insurance carriers to affect change as such. These changes, he said, should be left up to NHL players.

Sutton cites the following reasons for not mandating the face visor as a precondition of Personal Disability coverage:

  • The last career-ending injury that a face visor may have prevented occurred in the 2000 season when Bryan Berard lost most of the vision in one eye after being struck by a stick.  The Disability carrier actually paid a lump sum, which he paid back when he decided to continue his career in 2001-2002.  Therefore, mandating the face visor would not make a significant impact on reducing claim payouts.
  • Concussions are a much larger issue in NHL than injuries that could be prevented by face visors.
  • Sutton personally favors the use of face visors and thinks that the insurance industry should consider discounts for their use. However, the policies are already highly discounted.
  • Currently 73% of the NHL’s 740 players voluntarily wear face visors and the players union may consent to mandatory use with older players being grandfathered in.

In my opinion:

In my experience, sports Accident and General Liability carriers only mandate certain safety rules or safety equipment when their use would prevent catastrophic injuries.  As regards discounts, most don’t want to give up front discounts, as discounts will be provided on the back end when claim reductions work their way into the loss history of an account.

Source: David Shoalts, “Player Safety: Onus for Visor Use Must Stem From Players, Insurance Magnate Says.” 24 Mar. 2015.

Accident Insurance and Baseball

Spectator injuries not covered by Little League policy

New Jersey’s Elizabeth Lloyd, is suing for more than $150,000 in damages after being hit in the face by a baseball. Although Matthew Migliaccio was only 11 years old at the time of the incident, the lawsuit filed in April claims that Migliaccio’s overthrow from the bullpen was deliberate and reckless.

Lloyd is filing suit to cover for medical costs and pain and suffering, while her husband is suing for the loss of “services, society and consortium.”

The count alleging Migliaccio’s negligence is covered by the family’s Homeowner’s policy, but the other counts are not. Little League has denied any coverage, due to their accident policy only covering staff or players; spectators are not included.

In my opinion:

Little League is correct that spectator injuries are not covered by an Accident policy. However, “Accident like” benefits for spectator injuries up to a limit of $5,000 can be covered if the General Liability policy includes premises medical payments. Otherwise, if damages are greater than $5,000, the only recourse for an injured spectator is to sue. Such lawsuits would be covered under a General Liability policy under the Each Occurrence section. This case is similar to one that one of our league clients had about ten years ago when a spectator was hit in the jaw by an overthrow ball during pre game warm-ups. It was alleged that the league and coaches were negligent in allowing the players to form two lines for warm-ups where one line was too close to an unfenced spectator area. The carrier settled the case for around $300,000 but the damages were extensive.

-John Sadler

Source: Insurance Journal, June 26, 2012

Weight Limits in Youth Tackle Football

Are they necessary for protecting lighter players?

A study of injuries occurring from 2009 to 2011 in American Youth Football, Inc. indicates that the risks of injuries to lighter players is about the same in the weighted (age groups and maximum weights for all players), modified (age groups and maximum weights for ball carriers only), and unlimited (age groups only) divisions. This is the most recent study to shed light on the hotly debated topic within the youth tackle football community on the pros and cons of weighted vs. unlimited divisions.

A prior Mayo Clinic Study concluded that the number one predictor of injuries in youth tackle football is age and that weight groups would not appear to protect players. The study found that the risk of injury to an eighth grader was four times the risk of injury to a fourth grader. Therefore, the higher the age, the higher the chance of injury, and as a result, correct age groupings are critical to limiting injuries.

The American Youth Football, Inc. study tracked the progression of injuries to players of various weight categories through the weighted, modified, and unlimited divisions. The percentage of total injuries to lighter players (both below average and significantly below average) was about the same regardless of the division in which they participated. The percentage of total injuries to below average weight players ranged from 9.25% (weighted) to 11.50% (modified) to 8.96% (unlimited). The percentage of total injuries to significantly below average weight players ranged from 0.00% (weighted) to .30% (modified) to .71% (unlimited).

Most scientists and doctors who have studied the issue speculate that older players are injured more frequently because they run faster, hit harder, and are more aggressive. However, youth players who are larger don’t necessarily impact with more force if they aren’t fast and strong.

American Youth Football, Inc. and Sadler Sports Insurance are dedicated to giving back to the youth football and cheer community with critical studies on safety issues that impact the quality of the sports experience. All participants in the endorsed AYF Accident/General Liability insurance plan contribute data to these important studies.

See the full version of American Youth Football study on injuries to lighter players in weighted vs modified vs unlimited divisions. And you can read our earlier article debating weighted vs unlimited and a link to the Mayo Clinic study.

Source: John Sadler; Sadler Sports Insurance; American Youth Football, Inc. Accident Insurance Claim Database

Accident Insurance Overview for Sports/Recreation

Understanding your policy

Accident insurance is commonly purchased by sports and recreation organizations and is a requirement of most General Liability insurance carriers. Accident insurance is also commonly referred to as medical expense insurance.

Accident insurance pays covered medical expenses on behalf of participants who are injured during covered activities. Coverage is normally designed tobe “excess” or Sports accident insurance“secondary” so that it only pays after existing family health insurance has already responded to a claim. Excess Accident coverage is more affordable than Primary Accident coverage since it does not duplicate benefits.

The first line of defense

Accident insurance has two primary purposes in the sports context:

  1. It satisfies a moral obligation the sports organization has to make sure that injured participants get quality medical treatment; and
  2. It meets the required General Liability carrier pre-condition for covering a participant injury lawsuit claim.

From the insurance carrier’s point of view, an Accident policy is the first line of defense against lawsuits resulting from participant injury. If there is no Accident insurance in force and if the injured party is uninsured (no family health insurance) or inadequately insured (high deductible, coinsurance, or unfavorable exclusions under family health insurance), significant medical bills will likely be incurred. After receiving collection notices and phone calls from unpaid medical services providers, the injured participant or his/her parents will likely consult an attorney who will recommend a negligence-based lawsuit against the sports organization and its administrators and staff. On the other hand, if the Accident policy guarantees that the injured participant or parent will not incur significant out-of-pocket medical expenses, it takes away much of the incentive for them to file a lawsuit against the sports organization as a “deep pocket.”

Recommended minimum coverage standards

  • Medical Limit: The medical limit should be at least $25,000 per person per accident. A policy with a lower medical limit won’t be enough to cover even a moderate injury. For example, ACL injuries, which are common in sports, can easily exceed $20,000 after surgery and rehabilitation. Furthermore, most General Liability carriers require an Accident policy with a medical limit of at least $25,000 as a pre-condition of covering a participant injury lawsuit claim. Higher limits such as $100,000 or $250,000 should be strongly considered due to the additional protection offered at rate that can be surprisingly affordable.
  • No Internal Payout Limitations:– Many Accident policies have internal payout limitations, which are also known as sublimits or allocations.  Examples include limits on certain categories of medical expenses such as surgeon’s fees, daily hospital room and board, doctor’s visits, physiotherapy, etc. Some plans include so many internal payout limitations that it would be impossible for the policy to ever get close to paying even 50% of the overall medical limit. Plan designs that result in significant unpaid medical bills increase the chances of litigation against the sports organization in an effort to find a “deep pocket.” Better Accident plans don’t have these internal payout limitations (with the common exception of dental benefits).
  • Excess vs. Primary: Excess Accident insurance requires other collectible insurance, such as family health insurance, to respond first. There are three scenarios that can arise with high quality Excess Accident coverage: 1) if the existing family health insurance pays 100% of the bills, the Excess Accident policy will not respond to the claim, 2) if the existing family health insurance only pays 80% of the bills (due to its own deductible or coinsurance), the Excess Accident policy should pay the remaining 20% less any deductible, 3) if there is no existing insurance, the Excess Accident policy becomes primary and pays for 100% of the bills, less any deductible.

Primary Accident insurance can be purchased that will pay without regard to other collectible insurance. However, in order to make it affordable, most carriers will “water down” the benefits by inserting an oppressive schedule of internal payout limitations (see section above). If such internal payout limitations are present, they can result in extreme dissatisfaction if the payout does not come close to covering the medical bills.

Therefore, in most cases, high quality Excess Accident insurance is superior to Primary Accident insurance since high quality Excess Accident insurance will guarantee that the injured participant (or parent) does not incur significant out of pocket medical expenses. The fact that the payout is excess to any existing family health insurance does not diminish the important role that is played by Excess Accident insurance.

  • Mandatory vs. Optional Participation: Participation in an Accident plan should always be mandatory instead of optional. Mandatory plans require coverage for all participants and a premium to be paid on behalf of all participants by the sports organization. On the other hand, optional plans allow individual participants to choose whether or not they want to pay to be covered. Optional participation plans are unacceptable for two reasons:
    • Not every participant who needs coverage will purchase it. As a result, some will be uninsured; and
    • The General Liability policy will likely have a warranty provision that requires Accident insurance to be carried on an injured participant as a pre-condition of coverage for a resulting lawsuit.
  • Deductibles: Deductibles commonly range from $0 to $1000. Deductibles can result in significant premium savings. For example, increasing a deductible from $0 to $100 may result in a premium savings of 20%. From the point of view of the injured participant (and parent), deductibles in excess of $500 may result in financial hardship. However, sports organizations that only carry Accident insurance to satisfy the requirements of the General Liability carrier (and don’t perceive it as a member benefit) may want to investigate higher deductibles such as $1,000 or $2,500.
  • Corridor vs. Disappearing Deductibles: A disappearing deductible is more favorable to the claimant as compared to a corridor deductible. A disappearing deductible is satisfied by payments made by other primary collectible insurance, such as family health insurance. On the other hand, a corridor deductible is not satisfied by the payment of other primary collectible insurance.
  • Payout Period: The payout period is the time period for which incurred medical bills will be paid from the date of the injury. The payout period should always be at least one year. However, in cases where the medical limit is $100,000 or more, the payout period should be extended to two or three years. The insurance carrier will require a small additional premium for this enhancement. Any injury that approaches $100,000 in medical bills will likely result in the performance of medical services after one year.
  • Covered Activities: The Accident policy should cover all sports organization approved and adult supervised activities including tryouts, practices, games, tournaments, non-sport outings, and travel to and from. In youth sports, many of the more serious claims arise from non-sport outings such as awards banquets, backyard cookouts, swimming parities, and celebration trips to restaurants, etc. As a result, coverage should extend to these activities unless they are not approved by the sports organization’s policies and procedures. As concerns coverage for travel to and from, some Accident policies cover only supervised group travel to and from whereas others cover individual travel to and from that is provided by a licensed driver.
  • Covered Persons: All players and staff (paid and volunteer) should be covered. Staff normally includes but is not limited to coaches, assistant coaches, managers, umpires, referees, scorekeepers, concession workers, field maintenance workers, and administrators such as directors and officers. The definition of covered persons under the Accident policy should always be at least as broad as the General Liability carrier’s requirement to cover certain persons under an Accident policy.

Other Accident Coverages

  • Accidental Death & Dismemberment (AD&D): AD&D offers a death benefit commonly ranging from $5000 to $25,000 payable in the event of accidental death. It also provides a dismemberment principle sum limit that matches the accidental death limit in the event of certain paralysis or loss-of-use accidents. The payout for these types of accidents is based on a percentage of the principle sum, depending on the severity of the loss.
  • Disability/Loss of Wages: Some Accident policies offer a limited disability limit to reimburse certain compensated staff members, such as umpires, in the event that a covered accident results in loss of compensation.

Notable Accident Insurance Exclusions

All Accident policies contain a long list of expected exclusions, such as injuries suffered while committing a felony, under the influence of drugs, etc. However, some exclusions are notable because they can be removed for an additional premium.

  • Heart & Circulatory Malfunction: Heart attacks and strokes are generally considered sicknesses instead of accidents.
  • Heat Illness: Some insurance carriers consider heat illness or heat stroke to be a sickness, whereas others consider it to be a covered accident.
  • Previously Existing Injuries:  Some Accident policy forms exclude previously existing injuries, whereas others do not.

Sadler Sports & Recreation insurance has many existing Accident Insurance programs with pre-published rates that are listed on our program webpages. We can also customize an Accident insurance program for any organization.

8-Year Old Sues Over Hard Softball

The eight-year-old claimant had joined a softball team for girls of her age group. While playing the infield, she was struck in the face by a ball thrown by a teammate, resulting in a fractured nose. The claimant’s parents filed suit against the softball league, the coach and the child who threw the ball. The main allegation in the suit was that the plaintiff and her parents were deceived by the defendants because the softball wasn’t soft and actually was quite hard.

Source: Liable to Laugh, Copyright 2004 American Specialty Companies, Inc.