Bringing the Risk of Sports Concussions into Focus

New research studies are shedding more light on the scope and complexity of the issue of concussion liability.

If you ask someone to list the school sports with the highest risk for concussions and brain injuries, the hard-hitting tackles of football and the high-speed collisions of ice hockey and lacrosse probably come to mind first.

Certainly, NFL, college and high school football have been garnering the majority of the headlines and attention in terms of concussions and traumatic brain injuries.  Over half of a $1 billion settlement plan for the NFL with former players who have filed lawsuits that claim they were diagnosed with brain injuries linked to repetitive concussions has already been paid out.

However, a number of new studies have shown that the risks and long-term effects of repetitive brain trauma spans a much wider age range for both boys—and increasingly girls—who participate in a range of “collision” sports.

What we’re learning is that concussion and brain trauma is a broader and more complex issue than previously understood.  Younger players are more at risk for concussions than coaches and parents have thought, and studies are indicating that girls are even more susceptible to concussions than boys.

Research conducted by Seattle Children’s Research Institute and UW Medicine’s Sports Health & Safety Institute has indicated that the occurrence rate of concussion among football players ages 5 to 14 is much greater than previously reported.  The study found that 1 out of every 20 youth players in this age group has experienced a football-related concussion in each season.  Experts believe that the reason for this higher-than-expected rate may be due to incomplete reporting, compounded by a lack of sports trainers at the grade-school and middle-school level, who would be able to diagnose a concussion on the sideline.

Additionally, there is increasing concern over the heightened risk of concussion for girl athletes.  A new study published in the November 2019 issue of Pediatrics, a peer-reviewed medical journal, presents startling evidence that, at least statistically, girls soccer can be nearly as dangerous as boys football when it comes to concussion risk and head injury—with higher concussion rates than boys hockey or lacrosse.

According to the study, girls soccer was the second highest sport in terms of concussion risk as measured by reported occurrences.  UNC researchers discovered that boys football had the highest concussion rate (10.4 concussions per 10,000 athletic exposures), followed by girls soccer (8.19).  By comparison, boys soccer players had a significantly lower concussion rate (3.57).  Overall, in comparable sports, girls had a 1.5 times greater concussion risk than boys.  Experts are unsure of the difference; speculation varies from anatomical differences (neck musculature) to likelihood of reporting (statistically, boys hide significant head trauma and its effects more often than girls).

As it relates to the insurance industry and those who provide coverage to sports teams and leagues involved in contact sports, the emergence of the concussion issue has had a broad and varied impact.  Greater understanding of the risks and ramifications of concussions—not to mention repeated sub-concussive impacts—with regard to CTE (chronic traumatic encephalopathy) and other degenerative brain disorders is expanding liability for sports organizations, who have in turn sought to focus on enacting safety and preventative measures.  While tackle football has long been in the spotlight, other contact leagues (e.g., soccer) are realizing that they are also at risk.

Brain trauma is an emerging latent exposure, meaning the total effects of the risk in terms or cognitive or neurological issues may not be revealed for years (similar to asbestos or chemical exposure).  There has been a solid connection to degenerative brain diseases such as CTE, ALS (Lou Gehrig’s disease) and Alzheimer’s to multiple head trauma; however, creating a direct causal link to a specific event or incident remains elusive.

Recent industry trends in the marketplace:

  • Overall, liability premiums have increased significantly and coverage availability is shrinking, with some carriers having less appetite or no longer offering GL coverage for tackle football.  According to Brenda Campbell, Alive Risk’s Director of Sports & Leisure, “Overall, we’re seeing the market getting harder.  More companies are pulling out of writing excess coverage.”  She adds, “We’re also seeing some carriers pull out of writing coverage for certain sports.”
  • The introduction of liability coverage exclusions or sub-limits for concussion injuries, a reflection of the heightened concern over participation in tackle football and other collision sports.  Other options include a special aggregate that caps the award on sports concussion or brain trauma lawsuits, on a per-program or per-organization basis.
  • Adoption and improvement of risk management strategies will be increasingly essential for teams and organizations.  These range from preventative (e.g., rule changes, more advanced safety equipment and gear technologies, no-impact training and drills, player education) to post-event recognition and treatment (e.g., independent medical professionals on the sidelines to administer monitoring, screening, baseline testing, and strict adherence to protocols).

Just as youth sports organizations and legislators have taken major positive action to ensure greater player safety (all 50 states now have a “Return to Play” law), the insurance industry can take a proactive role in understanding the evolving medical science behind the prevention, diagnosis and treatment of concussions and brain trauma, and then work in collaboration with sports organizations at all levels to ensure appropriate risk management strategies are in place.

Interested in learning more? The Centers for Disease Control and Prevention (CDC) is offering a free HEADS UP online concussion training course to help coaches and parents improve the culture of concussion and create a safe environment for young athletes to play and stay healthy. Click to visit the site.


Alive Risk works with retail insurance agents nationwide to make available Sports & Leisure Insurance across a broad range of exposures.  In sports, injuries are part of the game.  Torn muscles, broken bones, sprains and concussions plague participants and sponsors.  Alive Risk, a division of All Risks, Ltd., offers Sports Insurance to Camps, Clinics, Teams, Leagues, Tournaments, Associations and more.  Our team of expert underwriters design coverage to keep you in the game.  Contact our Sports Insurance Program specialists today to learn more about our coverage options!

Legal Disclaimer: Views expressed here do not constitute legal advice. The information contained herein is for general guidance of matter only and not for the purpose of providing legal advice. Discussion of insurance policy language is descriptive only. Every policy has different policy language. Coverage afforded under any insurance policy issued is subject to individual policy terms and conditions. Please refer to your policy for the actual language.