Sports team insurance

marcarm · 12 February 2018 at 7:24PM

Hi,

Back in October I broke my leg playing for my Sunday League football team. I eventually got the insurance forms completed from the doctor and sent them off.

I got a settlement figure today and have 2 questions:

1) They pay a MAX of £375 for a broken leg, but have been offered £250. I have asked why my break (which was very bad, I broke my tib/fib in 4 separate places and dislocated my ankle) is only worth 2/3 of the max but no reply as yet.

2) In my haste I emailed back and accepted the offer, before realising that they were short. Can I retract my acceptance or is that it now? I have emailed them separately and asked for a breakdown.

At the end of the day the difference is £125 but it's better in my pocket than it is theirs.

I cannot find the policy booklet online that quotes figures, I am going by info I was sent when I was in hospital, there is other info online but nothing that relates to how they work out whether you get the max or not.

I have had 3 months of hell with it, I had compartment syndrome in the hospital which lead to a fasciotomy, and a skin graft which will now be permanently disfigured. My leg is also held together with metal and 12 pins and of course it means I can no longer play football ever again.

Thank you

paddyandstumpy · 12 February 2018 at 8:23PM

Maybe the £125 is your excess?

marcarm · 12 February 2018 at 8:33PM

paddyandstumpy wrote: »

Maybe the £125 is your excess?

Possibly, I didn't think of that. Not too familiar with insurance really so wasn't sure if there would be an excess or not.

marcarm · 12 February 2018 at 9:35PM

Turns out my club gave me the wrong figures, it is to a max of £250 so they are paying the maximum.

But, they also pay for scarring but there was nowhere on the original claim form to add that I have been left scarred and with no feeling.

I have a 5 inch by 3 inch oval scar where I had the fasciotomy/skin graft, which will always be numb as there are no nerve endings there, and also a 3 inch scar among other smaller ones on the other side of my leg.

All that just from falling awkwardly!!

BooJewels · 13 February 2018 at 12:03AM

I'm sorry to hear of your injuries, it sounds like you've had a rough time of it. My personal expertise with insurance is limited to being a customer, but my husband is a sports coach (not professionally, in an evening and weekends) and has to have liability cover for his students and these numbers just didn't sound right to me, so I asked him.

He seemed to think that a serious injury would pay out in the tens of thousands, if not more, not a couple of hundred quid. He has something like £5 million of liability cover. Is that maybe if the fault lies elsewhere rather than 'falling awkwardly'?

I may be getting the wrong end of the stick and missing something (as no one else seems as surprised as I feel), but I would suggest that you take professional advice on this at least. Do you have legal cover on your home contents insurance as this might be the sort of scenario that they'd cover? [ETA: I just checked mine and personal injury legal cover is included]

marcarm · 13 February 2018 at 5:44AM

BooJewels wrote: »

I'm sorry to hear of your injuries, it sounds like you've had a rough time of it. My personal expertise with insurance is limited to being a customer, but my husband is a sports coach (not professionally, in an evening and weekends) and has to have liability cover for his students and these numbers just didn't sound right to me, so I asked him.

He seemed to think that a serious injury would pay out in the tens of thousands, if not more, not a couple of hundred quid. He has something like £5 million of liability cover. Is that maybe if the fault lies elsewhere rather than 'falling awkwardly'?

I may be getting the wrong end of the stick and missing something (as no one else seems as surprised as I feel), but I would suggest that you take professional advice on this at least. Do you have legal cover on your home contents insurance as this might be the sort of scenario that they'd cover? [ETA: I just checked mine and personal injury legal cover is included]

Thanks.

I did email and withdrew my acceptance in light of new info ie bodily scarring etc.

The insurance company have a chart if figures they pay out for, currently I am line for 250 broken bone, they don't pay for a dislocated ankle. Also 50 medical expenses and 25 hospitalization benefit, of which I was in hospital for 14 days making a total of 650.

I then found that my club has the "superior" level of cover which includes a "broken bone top up" of 125 which the ins company have neglected to include, as well as up to 600 for scarring, but no info on how this is worked out so potentially another 725 that I am due which as a single father is quite a considerable amount of money

Unfortunately it was due to falling awkwardly, twisted my leg as I went up to catch the ball and my tib/fib broke in 4 places, no one was near me at the time, and if truth be told it was in the warm up! Still managed to catch the ball though!

rs65 · 13 February 2018 at 9:33AM

BooJewels wrote: »

I'm sorry to hear of your injuries, it sounds like you've had a rough time of it. My personal expertise with insurance is limited to being a customer, but my husband is a sports coach (not professionally, in an evening and weekends) and has to have liability cover for his students and these numbers just didn't sound right to me, so I asked him.

He seemed to think that a serious injury would pay out in the tens of thousands, if not more, not a couple of hundred quid. He has something like £5 million of liability cover. Is that maybe if the fault lies elsewhere rather than 'falling awkwardly'?

I may be getting the wrong end of the stick and missing something (as no one else seems as surprised as I feel), but I would suggest that you take professional advice on this at least. Do you have legal cover on your home contents insurance as this might be the sort of scenario that they'd cover? [ETA: I just checked mine and personal injury legal cover is included]

Sounds like you are talking about liability cover. The OP seems to have personal accident cover.

marcarm · 13 February 2018 at 9:49AM

Thanks, I did find the guide online eventually

https://bluefin-live-assets.s3.amazonaws.com/media/filer_public/1c/b6/1cb6be15-1d9d-487c-b09e-1d0dcaf7f677/1777-0317_summary_of_cover_-_2017_ngis_finalv2.pdf

So paying #15, #22 @ 14 days and £50 medical expenses, but as my club has the Superior cover, they should be paying the broken bone top up, and also #26.

I also have a 5" X 3" scar in the shape of an oval where I had a fasciotomy, and a 3" scar on the other side of my leg where they operated. My lower leg is swollen twice the size of the normal one and will never go back to normal.

rs65 · 13 February 2018 at 10:31AM

The top-up is Superior Extra.

Where is the £50 Medical Expenses? Have you paid expenses?

You need to see the full policy as scarring is 'up to'.

marcarm · 13 February 2018 at 11:09AM

rs65 wrote: »

The top-up is Superior Extra.

Where is the £50 Medical Expenses? Have you paid expenses?

You need to see the full policy as scarring is 'up to'.

I have the documents sent to me from my Club Chairman, we have the Superior 120 cover, and it does state that we have upgraded to the extra broken bone cover, so not sure why they are not paying out the £375 for that.

I have found this online about the scarring from the same company

Length of
scarring
Benefit amounts
for scarring of face
Benefit amounts for
scarring of the body
0cm – 2.4cms Nil Nil
2.5cms – 4.9cms £200 £100
5.0cms – 10cms £400 £200
10cms or over £600 £300

So according to that I should get £300 for the big one and £200 for the smaller one, the others are not big enough to qualify.

This is the email I got from them yesterday:

Thank you for supplying the completed claims form in connection to the fractured fibula and tibia.

I can confirm the benefit for your injury will be £250 and the policy also extend to cover your medical expenses up to £50 and hospitalisation of up to £25 per day bringing a total claim settlement at £650.

We will await acceptance of our offer before requesting the above payment in settlement of the claim.

rs65 · 13 February 2018 at 11:48AM

marcarm wrote: »

I have the documents sent to me from my Club Chairman, we have the Superior 120 cover, and it does state that we have upgraded to the extra broken bone cover, so not sure why they are not paying out the £375 for that.

The document you linked to doesn't mention Superior 120 - only Superior and Superior Extra.

The document from your Club Chairman will be the relevant one.

Sports team insurance

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