The loophole Bupa had to close

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The Independent Online
NOTHING IS more important to the success of top soccer stars - and the fortunes of their clubs - than their legs. And nothing is more vulnerable to injury.

Torn ligaments, broken bones, pulled hamstrings, even bruised muscles can all put paid to goal-scoring success. No wonder, then, that treatment for these injuries, provided by the most expert of doctors and physiotherapists, is essential.

Treatment like that doesn't come cheap. But then, canny health brokers, whose clients include football clubs seeking medical insurance for their players, realised that it could. Bupa, one of the biggest provident health organisations in the country, had devised a general insurance scheme for ordinary members of the public but it failed to exclude professional sportsmen.

The result: thousands of professional footballers, including some of the most famous names in the business, were signed up to Bupa's individual insurance plans. The brokers, who urged club officials to insure some of the country's most valuable legs, knees and ankles under the Bupa deal, even negotiated discounts on normal premiums, which are already very cheap because men in their 20s are usually considered low-risk customers.

The majority were paying premiums of less than pounds 300 a year for each player, yet were benefiting from treatments averaging around pounds 1,000 a year with treatment at some of the country's most prestigious private hospitals, including the Princess Grace in London. Brokers estimated that it cost Bupa pounds 5m a year.

Footballers' injuries can take months, even years, to heal, and can require some of medicine's most advanced techniques. A broken leg in a nasty tackle is only one of the dangers. The strain on the limbs from constant stretching and turning at high speed is immense. The resulting ligament injuries to knees and ankles are often the most damaging - for example the knee injury that Paul Gascoigne famously suffered in the 1991 FA Cup final and which kept him out of the game for more than a year. The groin strain might be an old joke in football circles, but the worst groin injuries are career threatening.

Alan Shearer, the England centre forward, has received tens of thousands of pounds worth of treatment for the many injuries he has suffered over the years.

John Salako, the former England forward, is one of a number of players who have sought medical help from doctors in America. So prized a commodity is the modern top-flight footballer that clubs will go anywhere and try anything to solve a complicated problem.

That was why the clubs could not believe their luck when the brokers found them the perfect golden opportunity. Invoices for pounds 600 for CT scans, ligament repairs costing pounds 3,000 and 20 follow-up physiotherapy sessions worth pounds 1,000 were being picked up by Bupa. All the clubs had to do was keep paying the monthly or annual premiums and they were quids in.

By the time enterprising brokers discovered the loophole in the Bupa contracts, the choice of insurers had narrowed considerably. Other large medical insurers had left the sector by the end of 1996 because they could not make money from it, due to the expense of the treatment.

All the failed old-style schemes insured players on an "experience-based" premium, which means assessing the previous year's claims and setting the next year's price to match.

Earlier this year, Bupa, which had been offering a group insurance deal to football clubs, closed the loophole on its individual policies. Instead, the revised deal now being offered by Bupa involves the very "experience- based premiums" which had failed to make money for other insurers.

The insurer has removed all discounts for existing policies and is asking brokers and clubs to move to new specially designed policies which exclude these services.

According to a Bupa statement, this move is designed to give clubs a better deal: "We found that we could offer a much keener price to sports groups if we excluded some benefits such as MRI/CT scans and out-patient physio from cover, thus allowing clubs to negotiate their own prices with local providers or through their intermediary."

Broker Mike Hastings, who counts half of the Premier League among the 40 football clubs on his books, told this month's Health Insurance magazine that he insures players as individuals and has not transferred any to Bupa's new scheme for professional sports clubs.

However, documents seen by the Independent on Sunday suggest that Bupa may withdraw from the professional sports sector if clubs do not move to its new policies.

If Bupa were to withdraw, some star footballers could find themselves uninsurable. The Football Association is stepping in to end the uncertainty by running its own medical insurance scheme.

The FA Premier League Medical Care scheme will be open to Premiership and Football League clubs, and will offer preventive treatment such as cardiac screening as well as injury treatment.

Clubs will pay premiums into a self-funding trust, so it will be much more expensive than the Bupa individual contracts. However, the scheme will be part-subsidised by grants, including BSkyB payments, made to the Professional Footballers' Association (PFA). The first year's subsidy is pounds 560,000.

Independent consultant Healthfirst, which is running the scheme, said: "This tackles the clinical, administrative and financial problems facing professional football clubs which have caused problems in the past."