Fishing is the most dangerous sport in the UK. The number of deaths from drowning among fishermen is far higher than the mortality figure for hazardous physical contact sports.
But for the purpose of selling private medical and personal accident insurance, the sports with the best prospects are those with the highest risk of injury and disablement. Over 20 million sporting injuries happen every year. They occur most frequently in football, rugby, hockey and cricket.
Not only are injuries more common, they now tend to be more serious. One reason is that technical developments, like artificial pitches and parabolic skis, enable faster speeds. Another is worsening behaviour on the pitch.
Young players want to emulate their television heroes. They imagine they can tackle in the same way and survive unhurt. Thuggish conduct by professionals is also initiated by amateurs, from school age upwards.
Personal accident is still a valid form of protection against sporting injury and disablement. However, general insurers no longer regard personal accident as part of their core business. They have largely given up selling individual personal accident through the broker channel, and concentrate on direct mail shots instead.
Fortunately, activity on the group side continues to be healthy. Wholesale broker Crispin Speers is prominent in arranging schemes for major sporting bodies. Director David Stirling says: “Any club, league or association can design its own product and we’ll provide it. Clubs are happy for insurers not to pay for the first two visits to the physiotherapist, or the first two weeks of treatment. We prefer local brokers to introduce and service business, as we’re not geared to handle business direct.”
Personal accident is normally just on element in a package deal for clubs”
Marshall Wooldridge of Yeadon near Leeds, has a typical scheme with the English Hockey Association, under which £25,000 or £50,000 of personal accident benefit can be chosen. Basic cover is for total disablement but there are a number of optional additions such as total temporary disablement. The premium depends on the number of extensions taken. The physiotherapy cover provides up to £500 for each incident. Claims can be made for any number of incidents, providing they are not related. The cover, which is with Cornhill, also includes dental treatment up to the £300 NHS limit. Marshall Wooldridge operates a similar and somewhat larger scheme for 4,000 cricket clubs.
Unfortunately, because personal accident has become the poor relation, insurers’ offerings are looking rather tired. The public has more appetite for cash plans, such as the physiotherapy plan from friendly society, Forester Health. However, it is only available through company schemes.
Spokeswoman Lorraine Dunmock says: “If we advertised it to the general public we’d soon go under, because we provide cover for pre-existing conditions, even chronic ones.” The policy cannot be taken out by student groups or sports groups. Members of firms’ sports clubs therefore have to get their cover alongside other company employees. Otherwise the scheme would invite too much selection. Members are entitled to up to 32 physiotherapy sessions a year, at a cost of £20 a time. A standard course provides eight treatments for one condition, and cover applies not just to sporting mishaps, but to conditions arising form repetitive strain accidents in the home, or any other cause. Costs depend on occupation, starting from £79.56 a year for the most common class of subscription. Forester has done business through brokers for two years and pays up to 20% commission, though the standard rate is 15%.
Numerous other cash plans are suitable for sporting types. WPA has four levels of cover under it Health and Sickness plan, the highest of which provides £200 for physiotherapy, osteopathy, chiropody and specialist consultations, As cover does not relate to private treatment, there is no exclusion for professional sport.
Personal Accident cover is fine as far as it goes. But professional football and rugby clubs need something more in way of healthcare for sport injuries. Those wanting private medical insurance have a limited choice, as few providers want the business. Norwich Union Healthcare offers only its Express Care contract, with a compulsory excess of £250 a person a year. Each member of the group is underwritten, with premiums working out double what an individual would pay.
Larger groups of about 50 are experience rated. Conditions like a previous and recurring knee injury are excluded. Clinicare’s customers are restricted to Club cover, which excludes MRI and CT scans, physiotherapy, and out-patient consultations unlinked to in-patient stays. There is no excess for rugby. Pre-existing conditions can be either excluded or underwritten.
BUPA has over 3,000 registrations from professional sports clubs or bodies. Having been caught out by failing to exclude professional injuries from some of its contracts, since last October BUPA has shut the door on scans and out-patient physiotherapy. Excesses range from £100-£500, depending on what scheme is chosen.
The market rate for a squad of 40 professionals ranges anywhere form £20,000 to £50,000. Yet not everyone thinks this is the right solution. Intermediary First Health has devised a different method for the premier league. Claims managers are Johnson Fry, whose broker support manager, Ian Laws, says: “We don’t believe full private medical insurance is a realistic way of dealing with professional sports. Premiums never keep pace with claims. The only way to do it is on a self-funded basis with the claim fund written under trust, and no IPT being payable.” He adds: “We get enquiries from amateur clubs which we deal with on a case by case basis. The first question we ask is why they want the cover.”
The First Health scheme has been in existence for 18 months. Marketing director Keith Phillips admits, “We’ve kept quiet about it while we were proving that what works on paper works in practice.” The benefit schedule was designed by clinicians. It excludes irrelevant benefits such as hospital cash.
Core benefits of the scheme are in-patient and out-patient costs, including high-tech diagnostics such as MRI and CT scans and ultrasound. There are no excesses, and no exclusions for pre-existing conditions.
Phillips says: “What some insurers are offering is not suited to football clubs. Medical history should be disregarded. It’s no use having exclusions because every time a player sees the physio it could be regarded as a condition. Managed care is the key, but not on American lines. The best processes should be made available to the sport, and there should be complete clinical freedom.”
First Health uses BUPA and BMI hospitals, and a network of scan providers on a discounted basis. Its scheme has been taken up by a minority of premiership clubs and is available to the rest of the football league. The scheme could also serve as a model for other sporting bodies, and Phillips hints that further schemes are currently in the pipeline.
While First Health has monopoly status with the premiership, it faces competition form Leeds-based intermediary, Corporate Healthcare Protection, for other league clubs, not mention rugby and other professional sports. Under its ProSport plan, Corporate Healthcare Protection uses BUPA’s in-patient policy, together with a scan card which can be used at 160 MRI centres, out of the 250 around the country.
Director Alan Walton says: “Most clubs use diagnostics for second opinion purposes. If the player took a knock and the physio’s not happy by Monday, he’ll want a scan in case it’s more that just a bruised heel. Getting an opinion form Alliance Medical costs £400-£500 with the radiologist’s report. If a club intends signing a new player, they will want a pre-signing scan in the closed season.”
Walton forecasts that a number of clubs will be re-thinking their private medical insurance this year, because of rising costs. And professionalism on both sides will be crucial in the future.