Wise Words Tell Truths (at least on insurance applications)

Suddenly you are lying by the side of the road, dazed, dusty, and injured. You know that you are not dead, but you also know that things are not good: the car is a twisted mess and your head hurts like hell. What is your first thought when you "come to"? No problem, I will turn it over to my insurance carrier. What is your second thought? Gosh, maybe I should have told them about my prior DUI when I filled out the insurance papers.  

You do not want this to be you  - whether in dealing with auto insurance or with athletes' insurance. All policies that I have seen have an application to fill out. The application asks you for prior lawsuits or criminal history and prior matters that could give rise to a claim. At the end of the policy application, there is always a note that the application becomes part of the insurance policy and that failure to level with the insurer will void coverage. So, what does this mean? Treat it like a meeting with your doctor - tell them everything. Better to get it out in the open, then to worry about coverage being negative when you need it most.  

Yes, juries may not be crazy about insurance companies, but judges generally do not have that attitude and if they do, they bury it. However, judges routinely throw out cases where the policy application is false; in many states that falsehood does not even have to be material to get rid of coverage. As my 5th grade teacher used to say, "A word to the wise should be sufficient."   

Exceptional Insurance: Safeguarding the Superstar

By Jeffrey S. Kravitz, Esquire & Sekou Campbell, Esquire

Sam Kahn, Jr. of ESPN Radio recently reported that Johnny Manziel is exploring the option of "Exceptional Student-Athlete Disability Insurance," provided by the NCAA. The insurance coverage is reported to be routinely sought by players in Manziel's position. Insurance, a frequent theme on this blog, poses interesting questions for college athletics generally, and for the "exceptional athlete" in particular.

 
Most critically, perhaps, insurance may be a way to reconcile the NCAA's tension between amateurism and big-money media contracts. Generally, insurance is a type of compensation. Employees frequently receive health insurance, life insurance, retirement insurance and other forms of financial protection as part of their compensation. However, the actual payout is generally deferred until a "triggering event."
 
The Exceptional Student-Athlete Disability Insurance Program, however, limits who can pull the "trigger" and makes the "trigger" itself tiny compared to the potential losses all student athletes face. The policy provides coverage for a limited number of athletes (top round draft picks in baseball, basketball, football, and men's hockey), charges a premium (though there is a mechanism for impecunious players to acquire the necessary coverage), and pays out in a limited number of circumstances ("permanent total disability," requiring what amounts to a career-ending injury).
 
However, the NCAA's insurance policy is, at worst, a tepid acknowledgment that at least some of its athletes bear a burden by playing NCAA sports. Advocates for compensating athletes may be able to convince the NCAA that the success of its nearly 25-year old insurance program may be due for some broadening for two reasons.
 
First, this policy does not cover the "late bloomer" exceptional athlete. For instance, the current insurance policy would have likely excluded the likes of Scottie Pippen, Tom Brady, or Randy Johnson. Second, athletes who decide to "go pro in something other than sports," also bear a risk from injury. For instance, a student-athlete may suffer a hand injury foreclosing her from a career as a surgeon. There are obvious costs to expanding exceptional athlete insurance, but those can be captured in premiums, deductibles and other terms, as with any insurance package.

Fiduciary Obligations; Do Sports Teams Owe Vendors Anything?

By Jeffrey S. Kravitz

As featured in the Toronto Globe and Mail a Canadian company that sells 95% hockey chatchkes is suffering mightily by virtue of the hockey lockout. Does the NHL owe that person anything...no, because it is a commercial relationship and not a fiduciary one. What is a fiduciary? It is a person or institution that owes another the highest duty of good faith. Think a trustee or dare I say it, a lawyer. The law imposes superior obligations on such folks by virtue of the trust imposed in them. The NHL....likely nada. How could the vendor have protected himself?  He could have tried to put a clause in his license contract with the NHL that required them to pay him in the event of a strike or lockout (good luck). Perhaps he could have obtained business insurance that did the same thing. Or he could have diversified as stated in the article to Major League Baseball or the NBA. The lesson? As presidential advisor Bernard Baruch once remarked, "if you are going to put all of your eggs in one basket, watch the hell out of the basket."

 

Now the Fun Begins: Insurance and the NYC Marathon

By Jeffrey S. Kravitz, Esq.

I am not going to debate the bona fides of the decision to cancel the NYC Marathon. Beyond my pay grade. But ultimately this comes down to insurance. 

 

 

A lot of people are going to suffer a lot of hurt. Start with the event itself.....what happens to the contracts to televise the event.

 

Is the event cancelled by an act of God, in which case there is a bad case to be had against the organizers of the event. Whose decision was it? Government's or the event's? (Could they really put on the event without government help?) Does the event have a case against the City for want of fulfilling its contractual obligations?

 

I was a partner at a firm that did a lot of insurance work. Clients and lawyers (who wanted to hire me as a consultant) would call and ask if they had insurance for a given problem. My first question always was....have you read the policy? In most cases they had not obtained the policy. Many entities have business interruption insurance, but until they read and interpret the terms, "no one knows nothin' about nothin'.'" (Samuel Goldwyn)  

 

As We Enter the New Year

As featured in BusinessWeek.com on December 30, 2010, the question looming over the NFL playoffs is the possibility of a strike next season. The players' union has estimated the cost of such a strike at $160 million and has written the nation's governors and mayors regarding this potential loss.

What goes unstated is whether either side has strike insurance to "share the wealth" with carriers, foreign or domestic. This writer worked on the baseball strike of '88, which was insured in part. The insurers in turned reinsured the risk through other carriers. Reinsurance is basically a side bet by the insurer with another company so that the entire risk does not fall on one carrier or underwriting group. Insurance law and reinsurance law is basically the law of contracts with a heavy dose of public policy thrown in.

 

So when the figure of $160 million is used, the question becomes, who will bear the ultimate risk?