the most common, the most expensive, the most unexpected insurance claims and how to prevent them

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The Most Common, The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM. The Most Common Insurance Claims. THE TOP FIVE. Knee Leg Arm Ankle Head. Looking at It Another Way. Fractures account for 35% of Claims And, 30% of Total Amounts Paid - PowerPoint PPT Presentation

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Page 1: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM
Page 2: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

The Most Common, The Most Expensive,

The Most Unexpected

INSURANCE CLAIMSand

HOW TO PREVENT THEM

Page 3: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

The Most CommonInsurance Claims

Page 4: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

THE TOP FIVE1.Knee2.Leg3.Arm4.Ankle5.Head

Page 5: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Looking at It Another Way• Fractures account for 35% of Claims• And, 30% of Total Amounts Paid

• Sprains/strains account for 23% of Claims• And, 19% of Total Amounts Paid

• ACL injuries account for 12% of the Claims• And, 22% of Total Amounts Paid

Page 6: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Looking at It Another WayWhen combined, KNEE, LEG and ANKLE Injuries account for:

70% of all claims dollars

52% of all claims submitted

Page 7: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Looking at It Another Way• 65% of claims involving Sprains/Strains/ACL are

attributed to female athletes.• 53% of these claims occurred in the 12-15 age group

with 37% in the 16-19 age group.

• 60% of claims involving fractures are attributed to male athletes.• 24% of fractures occurred in the U12 age group, 57% in

the 12-15 age group and 19% in the 16-19 age group.

Page 8: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Head Injuries• We’re doing it right.• Attention to concussions is getting youth players off the

field and making sure they’re cleared to return.• Head injuries are not making a major impact on

our insurance rates.• In general, these are low cost claims. The player sees a

doctor, may have an X-ray, CT scan or MRI. Once diagnosis is made, most likely treatment is rest until deemed medically ready to play.

Page 9: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?• Promote proper stretching

• Promote core, hamstring and quad strengthening for our female athletes

• Promote agility drills

• Pay attention to field conditions – including indoor facilities.

Page 10: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?Look into, talk about, explore….

FIFA 11+Developed for amateur players and players U14 and older, this warm-up’s effectiveness has been proven

in Switzerland with a 30% to 50% reduction in injuries when used by teams at least twice-a-week.

Page 11: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?FIFA 11+

•Structured with 3 parts and a total of 15 exercises to be performed in sequence

•Key points are the use of proper techniques, good posture and good body control.

•Includes straight leg alignment, knee-over-toe position and soft landings

Page 12: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?FIFA 11+

•Part 1: Running exercises at slow speed combined with active stretching and controlled partner contacts•Part 2: Six sets of exercises focusing on core and leg strength, balance and plyometric/agility•Part 3: Running exercises at moderate/high speeds combined with planting/cutting movements

Page 13: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

The Most ExpensiveInsurance Claims

Page 14: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Goal Post Injuries

Sexual Molestation

Page 15: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

GOAL POST INJURIESA Look Back at Top 20 Most Expensive Claims

Injuries from Falling Goal Posts•#2 -- $ 2,400,000 •#6 -- $ 640,000•#8 -- $ 570,000•#14 -- $ 253,244•#18 -- $ 158,680•#20 -- $ 120,000,

Page 16: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

GOAL POST INJURIES

These Claims ContinueOne of the top claims for the past year is $1,000,000 paid when a six-year-old climbing around goal equipment was struck by an unsecured goal. Child had a craniotomy for a subdural hematoma and has lost almost all vision in the left eye.

Page 17: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

“It is astounding that soccer goal injuries continue to be the leading cause of high-

limit claims.”

(Bollinger Insurance)

Page 18: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

“Unsecured portable goals…are ‘under the radar’

by sports underwriters.”

(Pullen Insurance)

Page 19: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?Preventing Goal Injuries

EDUCATE! There are numerous sites with good information on how to secure goals.

Consumer Protection Safety Commission: www.cpsc.gov/cpscpub/pubs/soccer.pdf

KWIK Goal Website:http://www.kwikgoalsafety.com

Page 20: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?Preventing Goal Injuries

EDUCATE – to all levels!•Stress that goals should be inspected every time a coach takes the field for a game or practice. Players should never be placed in an area with an unsafe goal or asked to move or help move a goal.

Page 21: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?Preventing Goal Injuries

EDUCATE – to all levels!•State Association•Leagues•Clubs•Teams•Coaches, Parents, Admins and Players

Page 22: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?Preventing Goal Injuries

Label Your Goals with Safety Stickers•Labels may come with goals from the manufacturer

•Label examples are also available at http://www.cpsc.gov/cpscpub/pubs/soccer.pdf

Page 23: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?Preventing Goal Injuries

Label Your Goals with Safety Stickers•Labels include warnings like:• Unanchored goals may cause death and

serious injury• Never hang or climb goals

Page 24: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?Limit Your Liability

Take Common Sense Steps•Buy goals from reputable manufacturers with liability insurance.•Don’t use homemade goals.•Know who owns and is responsible for goals.•When possible, give your goals to the municipality, school, etc. where they are located.

Page 25: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?Preventing Goal Injuries

Take Common Sense Steps•Encourage the State Associations, leagues and clubs to establish routine, scheduled inspection of goals.

•Talk to your Referee Association and ask that they report any potential goal safety problems.

Page 26: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?Preventing Goal Injuries

Create a Card-Carrying Coach: The following has been created as a file the size of a player card and can be laminated and included with the cards.

Page 27: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?Preventing Goal Injuries

GOAL AND FIELD SAFETYCheck goals before every practice and game. Make sure they are properly

anchored, have no sharp edges and any bolts are tight.Never have players move or help move a goal. Only authorized adults should

move a goal.Check field for holes, ruts, foreign objects, etc.

PERSONAL SAFETYAvoid being alone with a child. Have an assistant, team parent, etc. at the field

with you. If alone, work in an open area in view of others.Keep clear boundaries between adults and players.

Include parents in communications such as texts, emails, etc.Do not make personal phone calls to players; do not “friend” them in social

media..

Page 28: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Goal Post Injuries

Sexual Molestation

Page 29: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Sexual MolestationA Look Back at Top 20 Most Expensive Claims

Sexual Misconduct Claims

•#3 -- $ 1,374,849•#5 -- $ 769,645•#10 --$ 530,000•#19 --$ 140,000,

Page 30: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

SEXUAL MOLESTATIONThese Claims Continue

Parents of a 16 year-old girl are suing a soccer club on behalf of their daughter who was lured into a sexual relationship with a 40 year-old coach.

Total Claim to Date: $125,000Reserves: $112,000Expense Paid/Reserved: $13,000

,

Page 31: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?Preventing Sexual Misconduct

Keep professional barriers in place:

• Promote professional behavior and communications between adults and youth -- whether by text, cell phone, on the web or through email.

Page 32: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?Preventing Sexual Misconduct

Texting:•Texting lowers the barriers; it’s the way youth communicate with each other. •Texting gives the coach’s cell phone number to everyone who receives the text.•Texts are easily misconstrued and you cannot control the text that comes back to you.•Recommend the use of broadcast texts to the entire team and parents and/or using a texting service. Free texting services are available.

Page 33: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?Preventing Sexual Misconduct

Email:•This is a personal way to communicate. •Once your email address has been given out, you cannot control how it is used or what emails are sent to you.•Emails should be group/team emails including parents – never individual, personal emails

Page 34: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?Preventing Sexual Misconduct

Cell Phones:•Adults should not make or accept personal phone calls to/from youth.•Once a cell phone number is given out, you cannot control how it is used including texting. •Phone communication should include parents.

Page 35: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?Preventing Sexual Misconduct

Social Media:•Adults should not “friend” youth or allow youth to “friend” them.•Tagging photos can lead back to individual youth and their personal social sites.•Practice times, full names, pictures that identify individual players should never be posted to a social media site.

Page 36: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

“Online predators know the ropes of their trade

well and look for opportunities to strike their

unsuspecting targets.”

(Internetsafetyrules.org)

Page 37: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

How Do We Do It?Preventing Sexual Misconduct

Warn:•Don’t be afraid to tell coaches that they are vulnerable.•Let parents know the dangers of posted rosters, public team sites, unmonitored computer/cell phone use.

Page 38: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

How Do We Do It?Preventing Sexual Misconduct

Address the Issue:•Have policies that address our new “wired” world, including policies for misuse of social sites and communications.•Make your policies known to all stakeholders – coaches, admins, players and parents.

Page 39: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

How Do We Do It?Preventing Sexual Misconduct

Monitor:•Google your organization, your leagues and your teams. See what’s out there.•Likewise, do searches on Facebook for your members. See if sites are open to the public.•Create and distribute guidelines for Internet website and Social Media sites.

Page 40: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

How Do We Do It?Preventing Sexual Misconduct

Guidelines can include:•Recommending password-protected or private sites.•A list of things that should not be posted such as pictures with names, practice schedules, anything that can identify individual players.•Any rules for your organization has in place.

Page 41: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Remember -- anything posted online can be easily copied, easily shared, can be reposted to other sites and can be misconstrued.

And, it’savailable forever.

Page 42: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

The Claims You Never Saw Coming

Page 43: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

General liability: Club installed outdoor field lighting system on leased premises. Homeowners Association filed suit against field owner and the club. The field owner defended under policy as an Additional Insured.

Loss amount: $ 500,000Indemnity: $ 150,000

Expense: $ 350,000

Page 44: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Player injury: Claim based on player mismatch. A 13-year-old player broke leg by colliding with another player. Allegations of negligence revolved around U14s playing against U15s. Settled in mediation.

Loss amount: $ 401,864Indemnity: $ 285,000

Expense: $ 116,864

Page 45: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Spectator injury: A 79-year-old female fell over a speed bump in school parking lot while attending a soccer game. She later died of a heart attack caused by an infection from the injury. The school district intended to have their full defense tendered through their indemnification agreement. In mediation, the school district was ordered to pay $242,500 and a smaller amount was awarded to be paid by soccer league.

Loss amount: $ 174,182Indemnity: $ 82,500

Expense: $ 91,682

Page 46: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Unexpected ClaimsThese Claims Continue

Two bounce houses and one inflatable slide went airborne with a gust of wind at a tournament/festival. Twelve players/spectators injured.

Total Claim to Date: $143,000Indemnity Paid/Reserved: $112,000Expense Paid: $ 93,000

,

Page 47: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?Preventing Unexpected Claims•When in doubt – get legal advice.•Know your vendors. If possible, be named as their additional insured.•Take precautions. Do research. Dot your I’s. Cross your T’s. Cross your fingers.

Page 48: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

The Cost of Insurance

Now and in the Future?

Page 49: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Factors Effecting Your Insurance Rates Now

• Liability insurance rates are actually down an average of 40% from 2006.• This reflects a “soft market”.• However, moderate price increases are

now being implemented and will like continue in 2013-14.

Page 50: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Factors Effecting Your Insurance Rates Now

• The reduction in Liability cannot offset the increase in Medical Insurance• Medical costs are rising an average of

10% annually.• Treatment may be more complicated and

more expensive.

Page 51: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Factors Effecting Your Insurance Rates Now

• Claims have increased• Claims presented without additional

insurance (secondary becomes primary) have increased by 20% to 41% since 2008 and the economic downturn.

• Claim counts have increased in four out of the last five years.

Page 52: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Factors Effecting Your Insurance Rates Now

• Higher Primary Deductibles• Employer-sponsored insurance plans may

be offsetting their insurance increases with higher deductibles -- which means your State Association is picking up a greater proportion of a claims “out of pocket” expenses.

Page 53: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Factors Effecting Your Insurance Rates Now

• Interest Rates are Down• “Positive” price adjustments are being

driven by an inadequate rate of return on insurance company’s capital in the current low interest rate environment.

Page 54: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?How States are Handling Increases•Higher-per-claim deductibles

•Co-Insurance and/or high-limit, self-insured (aggregate) deductibles.

2013 Does Not Indicate Relief on AccidentClaims and Their Impact on Rates

Page 55: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Factors Effecting Your Future Insurance Rates

• PPACA Healthcare Legislation (Obamacare)• Possible relief in 2014 by creating more

families with primary insurance.• Could stabilize pricing due to insurance

mandate and implementation of state insurance exchanges.

Page 56: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Factors Effecting Your Future Insurance Rates

• PPACA Healthcare Legislation (Obamacare)• Could mandate sports accident plans to

pay on a primary basis before the national healthcare plan would pay.

Page 57: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Now, What Can We Do?We must all work to keep sports accident insurance affordable.

•Educate to reduce goal injuries.

•Increase sexual abuse awareness to reduce sexual misconduct claims.

Page 58: The Most Common,  The Most Expensive, The Most Unexpected INSURANCE CLAIMS and HOW TO PREVENT THEM

Special thanks to Pullen Insurance and Bollinger Insurance Companies

for their help in preparing this presentation and their on-going

efforts as our partners in keeping insurance affordable for youth

soccer and all youth sports.