Legal Concerns & Insurance Issues

Being legally responsible for the harm one causes another person. (pg. 79) A key responsibility of a certified athletic trainer is to reduce liability. A great deal of care must be taken in following athletic training procedures to reduce the risk of being sued by an athlete and being found liable for negligence. (pg. 79)

assumes that an individual is neither exceptionally skillful nor extraordinarily cautious, but is a person of reasonable and ordinary prudence. (pg. 79) At the core it means you will use common sense and handle the situation carefully and prudently. The standard of reasonable care requires that an athletic trainer will act according to the standard of care of an individual with similar educational background or training. (pg. 79)
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Negligence This is a type of tort. the failure to use ordinary or reasonable care care that person would normally exercise to avoid injury to themselves or to others under similar circumstances. (pg 79) Tort -- legal wrongs committed against the person or property of another. (pg 80)

Nonfeasance (act of omission) -- failure to act Malfeasance (act of commission) committing an act that is not legally his or hers to perform Misfeasance improperly doing something you have the legal right to do

 Duty

part of a job description; must prove the person responsible for the injury had a duty to the injured party. a failure to conform to the standard of care required

of care

Breach

of duty -

Resultant

Damage - actual loss

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resulting from the injury.

Statute of Limitations- fixed certain length of

time in which an athlete can sue the athletic trainer. (varies from state to state) generally, plaintiffs have between 1 to 3 years to file a lawsuit. Comparative negligence-if monetary reimbursement is given it will based only on the % of negligence assigned to the defendant Assumption of risk-the athlete assumes responsibility for injury athlete knows the types & magnitude of the risk for their sport athlete chooses to participate in the sport

Act of God (act of nature)-injury occurred as a

result beyond the control of the defendant. I.E. Being injured by an earthquake during a crosscountry run Good Samaritan Law- (limited) protects health care providers who voluntarily come to the aid of an injured person. [no compensation] (You, as the hired ATC for a school/event, etc, are not covered under the good samaritan law if you are working an event for which you were hired)

Potential liabilities for athletic trainers

failure to provide competent personnel failure to provide instruction failure to provide proper equipment failure to warn failure to supervise improperly treating an injured athlete

Written contract- athletic trainers job/ functions First aid/CPR training- must be current Emergency plan-written form (EAP)
COC's EAP

Obtain informed consent to treat forms

COC's Informed Consent COCs PPE

PPE-Preparticipation physical exam Document all injuries, treatments, & rehab procedures Participate in continuing education Inspections of facilities/equipment Two-way communication-athletes, coaches, and medical personal
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General health insurance covers illness, hospitalization, and emergency care.

Primary billed first; usually athletes personal ins Secondary billed after primary ins benefits have been exhausted **School athletic ins**

Accident Insurance covers accidents that occur on school grounds. Professional liability insurance covers claims of negligence against individuals

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HMO health maintenance organization; provide preventive measures and limit where individual can receive care. PPO preferred provider organization; provide discount health care but also limit where a person can go for tx or illness. POS point of service; combo HMO & PPO. Based on HMO structure but pt can go outside HMO to obtain service **It is the job of the athletic trainer to know what medical facilities and procedures an athletes ins covers.**

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Knowledge know benefits associated with different insurance companies and types Documentation clearly document date of injury, assessment, initial tx rendered, and plan Communication athlete & parents (if applicable) need to be informed of their financial responsibility that might be incurred as a result of the injury
COCs Insurance Form

Referral responsibility of ATC to refer athlete to primary ins approved provider Timely claim filing accurately fill out ins claim form and submit with appropriate itemized bills.
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