Chapter 3 : Legal Concerns and Insurance Issues

What are the ways in which Athletic Trainers avoid litigation?

1. Establishgood relationships with athletes, parents, patients, clients, etc. 2. Establish policies and procedures 3. EAP 4. Be familiar with the health status and medical history of athletes 5. Keep accurate and timely documents 6. Safe rehab or training environments 7. Detailed job description in writing 8. Minors = obtain consent 9. Confidentiality of medical records 10. Use extreme caution of OTC medication 11. Use of therapeutic methods that they are qualified to use and that the law states should be used 12. Do not use of permit injured players to participate unless cleared by the team physicians 13. Do not use hazardous equipment 14. Work cooperative with coach and physician 15. Develop understanding with coaches 16. Follow orders of the physician at all times 17. Purchase professional liability insurance 18. Know limitations as well as state regulations 19. Use common sense in making decisions about a patients health and safety

What are two types of torts?

1. Nonfeasance 2. Malfeasance / Misfeasance

Point of service plan

A combination of HMO and PPO

Tort

A legal wrong

What is premium?

A periodic payment made to an insurance company by an individual policy holder

Copayment

A specific amount paid by the policy holder

Statue of limitations

A specific length of time in which an individual may sue

Assumption of risk

Acknowledgment of hazards in sports

List the health care systems designed to contain cost

Indemnity plans, HMO, PPO, EPO, PHO, POS, TPA, workers compensation, capitation, medicaid, medicare

Capitation

Members make a monthly payment

Fee-for-service

Most traditional form of billing for health care

What is negligence and list the four things that must be proved in order to claim negligence

Negligence - the failure to use ordinary or reasonable care 1. A duty of care existed between the person injured and the person responsible for the injury 2. Conduct of the defendant fell short of the standard of care 3. The defendant caused the injury to occur 4. Personal, property, or punitive damages resulted

Deductible

Owed by the insured annually before the insurance company will pay

Negligence

Result in unreasonable risk of harm to others

Describe the standard of reasonable care

The standard of reasonable care is when an individual is assumed to be neither exceptionally skillful nor extraordinarily cautions, but the individual is a person of reasonable and ordinary prudence.

Define liability

The state of being legally responsible for the harm one causes another person

Exclusions

Treatment not covered by insurance policies

Product liability

Written guarantee athletic equipment is safe