Malpractice Insurance in Combat Sports Medicine
SUMMARY, TIPS, AND RECOMMENDATIONS
Malpractice coverage for ringside events is variable from state to state, and even within the state itself. It also changes from time to time, so it is important to know your status, what is and what is not covered, what are the policy limits, whether there is a deductible, and more. Because of the drastic variability, there is no central resource to help physicians obtain coverage or check their statuses.
It is critical to know your policy to avoid practicing without coverage. Although lawsuits are relatively rare in ringside medicine, the time to look into your coverage is not after being served notice.
COMMON COVERAGE MODELS
1. Indemnified by your state physician.
Some state commissions view physicians who work sanctioned events as “state employees” and as such, their activities are covered. This is a relatively good method of coverage, but be sure to talk to your commission to find if they have an official policy, or if there have been any prior issues and how they were covered. For example, if there has been a lawsuit which included a malpractice allegation against the physician, did they cover legal expenses, payouts, etc. Is it a blanket policy, or will they decide after the fact if the physician part of the suit is covered. If not, it is highly recommended to have a supplemental policy.
- Does it cover separate procedures?
Some states will not indemnify procedures such as suturing or joint reduction. The concept is that your primary duty is to decide whether an athlete is fit to compete, and to determine what they will need before being allowed to compete again. Actual treatment is considered outside the “standard scope.”
- For the most part, this is only for state sanctioned events.
For example, if the event is on tribal land or sanctioned by a non-state agency, malpractice will likely not be covered by the state, even though the event is occurring in a state that usually provides coverage.
2. Covered by your current policy.
If you are a solo practitioner or part of a private group, you may have a policy that includes, or can include outside activities. This is especially true with sports medicine where event coverage is part of the expected scope of practice. (Football, hockey, soccer, etc). Ringside activities are often included. Sometimes at no extra charge, sometimes with an addition. Be sure to look at your policy and have your carrier specify in writing that combat sport activities are included.
3. Separate policy specifically for Combat Sports.
This is the most expensive, but most secure type of policy. Like everything else, policies vary by state, and are typically state specific. Policies quoted by members of the ARP have ranged from $2500 to $7500.
4. Covered by the sanctioning body.
For example, USA boxing covers malpractice for its events. This obviously only applies to events they are sanctioning.
5. Covered by the promoter.
Most promoters carry liability insurance. Some can add physician malpractice to their existing policy. Again, make sure it is in writing and find out exactly what is covered.
OTHER CONSIDERATIONS
If you are insured by your hospital or a staffing agency, outside activities are typically excluded.
Multiple states?
Be sure your policy travels with you, or you are covered in some other way. Practicing in multiple states may require more than one strategy to maintain coverage.
Professional vs. amateur?
Some policies have caveats excluding professional events. The rationale is that is a very different level of liability between say a local high school football game and the NFL, or, in this case, an amateur boxing show and a world title fight.
Follow-up care?
If you see an athlete in follow up, which plan covers the liability?
Procedures?
Most policies do not specify which procedures. Simply break it down by “Minor” vs “Major.” If the policy covers minor procedure, lacerations and joint reductions should be covered. If it does not mention procedures, be sure to clarify if you intend to perform any.
Tail coverage?
Tail coverage means they continue to cover for adverse events that are filed after the policy has expired. For example, you cover a bout in December. The policy expires in January. An athlete files suit 6 months later. If your policy includes a tail, the answer is yes. If not, a tail would need to be purchased, even though the physician was covered at the time of the incident. Tail coverage is typically more expensive than the annual premium.
“Claims made” means no tail included. You need to purchase the tail after the policy lapses. Typical cost is between 100% and 175% of the annual premium. For example, you have a policy from 2020-2025. At the end of 2025, you stop working bouts or no longer need the coverage because you transitioned to a different policy. If a suit gets filed in 2026 for an event in 2024, and you purchased a tail, you are covered. If you did not purchase the tail, you are not covered, even though the event happened while you were covered.
“Occurrence” means tail included. In the above scenario, no additional payment is needed. You would be covered.
SUMMARY
Talk to your insurer and find out what is covered. Be sure to get everything in writing. It is highly advisable NOT to practice outside the scope of your policy. Amend the policy to fit the reality of what you do.
This article was provided for general informational purposes only, and should not be construed as legal advice, nor should it be considered all encompassing. Each person’s situation is unique so legal advice should be sought for their specific situation.