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Professional Opinion

Colleges must work to mitigate concussion risk now and in the future

Football isn’t the only sport that can lead to traumatic brain injury
University Business, September 2018
John McLaughlin is the managing director for Higher Education Practice at Gallagher Insurance. Elizabeth Carmichael is president of Carmichael Associates, which specializes in compliance and risk management.
John McLaughlin is the managing director for Higher Education Practice at Gallagher Insurance. Elizabeth Carmichael is president of Carmichael Associates, which specializes in compliance and risk management.

Insurance carriers working in the higher education space are taking a keen interest in understanding and evaluating how colleges and universities manage brain injury risk in collegiate sports.

Almost all markets now require more detailed underwriting information about the risk of traumatic brain injury and verification that insureds are following NCAA guidelines.

Additionally, insurance carriers are modifying their policy form to specifically define and restrict how their policy responds to this risk.

At the extreme, in some cases, underwriters are excluding coverage for the risk of TBI. Because almost every college and university is dependent on insurance to underwrite their risks, following the changing nature of the insurance market relative to coverage for TBI is critical.

Not just football

Creating a comprehensive concussion management plan (CCMP) is straightforward, but not always easy for institutions, given their organizational structure and uneven resource distribution.

In addition to athletics, a CCMP will cover multiple divisions and departments, including health services, disability services, academic deans, residence life, student activities and, sometimes, legal and internal audit.

While football receives the most media coverage when it comes to brain injuries, NCAA research shows that college athletes participating in men’s wrestling as well as in men’s and women’s ice hockey run a greater risk of suffering a concussion than football players.

Women athletes are not immune. Concussion risk in women’s soccer, basketball and lacrosse are not far behind football. Universities and colleges can also be at risk from their students sustaining head injuries while participating in club and intramural sports.

The plan

Key elements of a CCMP include taking steps to reduce concussion frequency and having a consistent, documented process for recognizing head injuries and managing post-concussion treatment, with the goal that the student-athlete successfully returns to the field and classroom.

Training for student-athletes, athletic trainers and coaches should also be documented.

Managing on-field concussions is aided by assessment tools that are continually improving and evolving.

Academic and residential life deans, disability services and faculty members must work together to help the injured student return to class and to the team.

A comprehensive plan includes an audit structure so that the administrators can monitor its implementation.

Going further

Some collegiate conferences are going beyond what the NCAA has set forth as appropriate concussion protocols.

In NCAA Division I, for example, the Pac-12 conference announced an initiative for all members to access specialized technology to begin developing and tracking consistent brain trauma and concussion data across the conference. The challenge is to ensure that consistent standards are applied to all levels of each sport across the institution.

An emerging concern in concussion management is post-college health issues that manifest after graduation. A considerable amount of time may elapse between a concussion and the appearance of some symptoms.

This is particularly the case with those that suffer from chronic traumatic encephalopathy (CTE). Some athletes can go 15 to 40 years without showing signs of injury. Medical science has just begun to link CTE to concussion risks.

New resources for concussion management should help colleges and universities work together to find ways to mitigate head-injury risk among student-athletes now and in the future.


John McLaughlin is the managing director for Higher Education Practice at Gallagher Insurance. Elizabeth Carmichael is president of Carmichael Associates, which specializes in compliance and risk management.