© 2007 mcgraw-hill higher education. all rights reserved. chapter 3: legal liability and insurance

© 2007 McGraw-Hill Higher Education. All rights reserved.

Chapter 3: Legal Liability and Insurance


Define the following from Chapter 3

Make 4 columnsWord -- Book Def. -- Def. in own words -- Example

• Liability• Negligence• Standard of reasonable care• Duty of care• Torts• Nonfeasance/Act of

Omission

• Malfeasance/Act of Commission

• Misfeasance• Good Samaritan Law• Statute of limitation• Assumption of risk


Legal Concerns

• Negligence suits involving coaches, athletic trainers, school officials and physicians have increased in frequency and in the amount of damages awarded

• Liability – Being legally responsible for the harm one causes

another person– Must be certain you are aware of all rules and

regulations of being a healthcare provider


Standard of Reasonable CareAssumes the healthcare provider is a person of

ordinary and reasonable prudence

•Will use common sense and do what most other healthcare providers of the same level would do•Must not do more or less that what he/she has been trained to do

Duty of CareWhen an individual has a responsibility

to care for an injured person

•Taking care of injuries is part of the job


Torts•Legal wrongs committed against a person

•Can be caused by:–Nonfeasance /Act of Omission

–fail to perform legal duty, i.e. fail to refer athlete to MD

–Malfeasance /Act of Commission–perform action that is not his/hers to legally perform, i.e. perform advanced treatment leading to complications

–Misfeasance–Perform an action that is allowed, but do it wrong

•With a partner come up with 3 examples of each


NegligenceThe failure to use ordinary or

reasonable care

•Care giver does something a reasonably prudent individual would not.

•Care giver fails to do something a reasonably prudent individual would not.

•Athletic trainer has a duty or obligation to provide coverage to athletes


Person making complaint must show 3 things to establish negligence

1. That a duty of care existed between the person injured and the healthcare provider

2. Conduct of the healthcare provider fell short of that duty of care and the standard of reasonable care

3. The conduct directly caused the injury or damages


• People with a higher level of training will possess a higher level of competence or ability

• Once an individual assumes the duty of caring for an athlete that person has an obligation to provide appropriate care

• Provides limited legal protection for the care giver should something go wrong

Good Samaritan Law


Statutes of Limitation

•Specific length of time an individual can sue for injury resulting from negligence.

•Generally ranges from 1 to 3 years

•Clock begins at the time the negligent act results in suit or from the time injury is discovered following negligent act

•Minors generally have an extension


Assumption of Risk•Athlete is made aware of inherent risks involved in sport and voluntarily decides to continue participating

•Expressed in written waiver or implied from conduct of athlete once participation begins

•Can be used as defense against an athlete’s negligence suit – but doesn’t not prevent an athlete from filing a suit


Product Liability

• Liability of any or all parties involved in a manufactured product for damages caused by product– Includes manufacturer, assemblers, wholesaler,

and retail store owner

• Products with inherent defects are subject to liability suits


• Manufacturer of equipment has duty to design and produce equipment that will not cause injury

• Express warranty– Manufacturer’s written guarantee – product safety

• Equipment warning labels– Informs athlete of possible dangers inherent with

product use


National Operating Committee on Standards for Athletic Equipment

(NOCSAE)• Organization that sets minimum safety

standards for equipment

• It does not work for the manufacturer

• Not all equipment gets the NOCSAE stamp of approval


Insurance• Cost of insurance has increased

• Huge increase in number of lawsuits

• Medical insurance is a contract between the company and

policyholder

• Company agrees to pay portion of medical bills following payment

of a deductible

• Insurance you have through your parents or you job is your primary

insurance

• School athletic insurance is usually secondary


General Health Insurance• Primary policy covers illnesses, hospitalization and

emergency care

• Sometimes offered through the school for athletes – Wake Co. offers limited secondary coverage

• Secondary insurance – – additional coverage that pays all or part of what primary

insurance doesn’t pay for

• Schools and universities must ensure that athletes have primary insurance coverage


Reimbursement

• Primary payment for medical care in the US

• Insurance company reimburses the health care providers for services rendered to the patient


Health Maintenance Organization (HMO)

• Provide preventive measures and basic regular care• Must go to a specific doctor – on approved list• HMO will usually pay 100% if you go to approved

doctor• HMO may not pay anything if go to someone else

• Why must ATs know the limits and restrictions of an HMO? – discuss with neighbor


Accident Insurance• Low cost plan for students that covers accidents on

school property– Wake Co. $10 for At School coverage for all year

• Helps pay for medical cost instead of student paying all out of pocket

• Provides for additional protection for institution above regular policy

• Will cover costs associated with hospital care, surgery, and catastrophic injuries


Insurance to Protect the Professional

• Protect against damages that may arise from injuries occurring on school property

• Liability insurance – covers against claims of negligence

• Must be protected especially because of the increase in lawsuits

• Will cover negligence in civil case – not criminal complaint


Catastrophic Insurance

• Catastrophic injuries include:– death, brain damage, other life long conditions

• Organizations provide additional coverage to deal with lifetime extensive care– NCAA: National Collegiate Athletic Association– NAIA: Nat. Assoc. of Intercollegiate Athletics– NFSHSA: Nat. Federation of State High School Assoc.


Insurance Billing

• Must file claims immediately and correctly

• Get athlete insurance information at beginning of year

• Letters should be sent home to explain the coverage available and necessary procedures

© 2007 mcgraw-hill higher education. all rights reserved. chapter 3: legal liability and insurance

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