Legal Liability and Insurance Chapter 3

Legal Concerns of the Coach and Athletic Trainer In recent years negligence suits against teacher, coaches, athletic trainers, school officials, and physicians arising out of sports injuries have increased both in frequency and in the amount of damages awarded. Liability means being legally responsible for the harm one causes another person.

Legal Concerns of the Coach and Athletic Trainer It is important to reemphasize that it is incumbent upon the coach or the athletic trainer to know the legal limitations of the responsibilities in providing athletic health care as dictated by laws and statutes (staCHo͞ot) in the specific state where that individual is employed.

The Standard of Reasonable Care Negligence is the failure to use ordinary or reasonable care – care that persons would normally exercise to avoid injury to themselves or to others under similar circumstances. Standard of Reasonable Care assumes that an individual is neither exceptionally skillful nor extraordinarily cautious, but is a person of reasonable and ordinary prudence.

The Standard of Reasonable Care Or in other words, it is expected that an individual will bring a commonsense approach to the situation at hand and will exercise due care in its handling, Standard of Reasonable Care requires that a coach or athletic trainer act according to the standard of care of an individual with similar educational background or training.

The Standard of Reasonable Care To establish negligence, an individual making the complaint must establish 3 things: a Duty of Care existed between the person injured and the person responsible for that injury. Conduct of the defendant fell short of that duty of care. Resulting damages.

Torts Torts are legal wrongs committed against the person or property of another. Every person is expected to conduct themselves without injuring others. When they do so, either intentionally or by negligence, they can be required by court to pay money to the injured party so that, ultimately, they will suffer the pain caused by their action.

Torts Such wrongs may be emanate from Nonfeasance (nänˈfēzəns) (also referred to as an act of omission), wherein the individual fails to perform a legal duty; from Malfeasance (malˈfēzəns) (also reffered to as an act of commission), wherein he or she commits an act that is not legally his or hers to perform; or from Misfeasance (misˈfēzəns) wherein an individual improperly does something that they have the legal right to do.

Torts In any instance, if injury results, the person can be held liable. In the case of Nonfeasance, the coach or athletic trainer may fail to refer a seriously injured athlete for the proper medical attention. In the case of Malfeasance, the coach or athletic trainer may perform medical treatment not within his or her legal province and from which serious medical complications develop. In the case of Misfeasance, the coach or athletic trainer incorrectly administers a first aid procedures they have been trained to do.

Negligence When a coach or athletic trainer is sued by an athlete, the complaint typically is for the tort of negligence. Negligence is alleged when an individual: Does something that a reasonably prudent person would not do Fails to do something that a reasonably prudent person would not do under circumstances similar to those shown by evidence.

Negligence An example of negligence that occurs all too often in sports is when a coach or an athletic trainer moves a possibly seriously injured athlete from the field of play to permit competition or practice to continue and does so either in an improper manner or before consulting those qualified to know the proper course of action.

Negligence Once the coach or athletic trainer assumes the duty of caring for an athlete, that person has an obligation to make sure that appropriate care is given. If they choose to become involved as a caregiver for an injured person, they are expected to provide reasonable care consistent with their level of training.

Negligence The Good Samaritan Law provides limited protection to someone who voluntarily chooses to provide first aid. As long as the first aid provider does not overstep the limits of his or her professional training and exercises what would be considered reasonable care in the situation, the provider will not be held liable.

Statute of Limitations A Statute of Limitation sets a specific length of time that individuals may sue for damages from negligence. Plaintiffs have between 1 and 3 years to file suit for negligence.

Assumption of Risk An athlete assumes the risk of participating in an activity when he or she knows of and understands the dangers of that activity, and voluntarily chooses to be exposed to the dangers. An Assumption of Risk can be expressed in the form of a waiver signed by an athlete of his or her parents or guardian, or implied from the conduct of an athlete under the circumstances of his or her participation in an activity.

Product Liability Product Liability refers to the liability of any or all parties along the chain of manufacture of any products for damage caused by that product. Manufactures of all types of athletic and fitness equipment have a duty to design and produce equipment that will not cause injury as long as it is used as intended. Warning labels placed on football helmets inform the player of possible dangers inherent in using the product.

What Types of Insurance are Necessary to Protect the Athlete Managed Care where costs of health care are monitored closely by insurance carriers. Medical Insurance is a contract between an insurance company and a policy holder in which the insurance company agrees to reimburse a portion od the total medical bill after some deductible has been paid by the policy holder.

General Health Insurance Many athletes are covered under some type of family health insurance policy. However, the school must make certain that personal health insurance is arranged for or purchased by athletes not covered under family policies.

Reimbursement Reimbursement is the primary mechanism of payment for medical service in the United States. Health Maintenance Organizations (HMOs) provide preventive measures and limit where the individuals can receive care. With the exception of emergencies, permission must be obtained before the individual can go to another provider. HMOs generally pay 100% of medical costs as long as the care is rendered at an HMO facility.

Reimbursement Preferred Provider Organizations (PPOs) provide discount health care but also limit where a person can o for treatment of an illness. PPOs pay on a fee-for-service basis. Point of Service Plan is a combination of HMO and PPO plans. It is based on HMO structure, yet allows members to go outside the HMO to obtain services. This flexibility is allowed only with certain conditions and under special circumstances.

Reimbursement Indemnity Plan, although not a type of managed care, is the most traditional form of billing for health care, in which the provider charges the patient or the third party payer a fee for services provided. Charges are based on a set fee schedule. Capitation is a form of reimbursement used by managed care providers in which members make a standard payment each month regardless of how much service is rendered to the member by the provider.

Accident Insurance Accident insurance covers accidents on school grounds while the student is in attendance. The purpose of this insurance is to… Protect the student against financial loss from medical or hospital bills Encourage an injured student to receive prompt medical care Encourage prompt reporting of injuries Relieve a school of financial responsibility.

Insurance to Protect the Coach, Athletic Trainer, and Other Personnel Personal Liability Insurance covers claims of negligence. Because of the amount of litigation for alleged negligence, all professionals involved with the sports program must be fully protected by personal liability insurance. Catastrophic Insurance is designed to cover school employees, officers, and the district against suits claiming malpractice, wrongful actions, errors and omissions, and acts of negligence.

Insurance Billing It is essential that Insurance claims be filed immediately and correctly. Parents should submit all bills to their insurance company before submitting the remainder to the school.