Bodily activity has been one of the relevant phenomena of human society that significantly affects personal well-being and nurturing desirable social values. However, practicing a professional or amateur sport, inevitably leads to the injuries whose treatment requires certain costs that can be covered through insurance. The authors investigate the legal position of athletes in the Republic of Serbia in relation to insurance, classification of sports for the purpose of insuring athletes against the consequences of accidents, the place of accident insurance in the insurance system and the meaning of sports, sports injuries and insured mishaps in sports. The topic was explored with insight in the domestic and foreign literature in this field. Particular attention was given to the relevant pieces of regulations, general conditions for accident insurance and rules for insurance of athletes of domestic and foreign insurers.

SOMMARIO:

1. Introduction - 2. Legal position of athletes in the republic of Serbia in relation to insurance - 3. Classification of sports for the athletes’ accident insurance - 4. Place of accident insurance in the insurance system - 5. The concept of sports injury - 6. Insured accident in sport - 7. Conclusion - 8. References - NOTE

1. Introduction

Sport has always been a part of the social life of human communities and through the process of its commercialization, today there is a division into professional, amateur and recreational sports. Sport strongly contributes to the establishment and nurturing physical and intellectual well-being, health, self-confidence and self-esteem and social values like tolerance, equality, integration and cohesion (Mićović, 2020; Zakon o sportu, 2016, art. 3(1)(1)&(3) and art. 4(1)&(2); Gilchrist, Wheaton, 2011; Department for Culture, Media and Sport, 2008). Some authors especially point out that playing sports leads to a reduction in the rate of crime, higher employment and a positive attitude towards education (Gilchrist and Wheaton, 2011). According to the European Sports Charter, “sport means all forms of physical activity which, through casual or organised participation, aim at expressing or improving physical fitness and mental well-being, forming social relationships or obtaining results in competition at all levels” (Recommendation No. R / 92 / 13 REV, Art. 2(1)(a)). Engaging in sports is sometimes the cause of injuries, which is why they are termed sport injuries. In a broader sense, sport physical traumas relate to those occurring when playing sports or exercising, and in a narrower sense, a sport injury is a characteristic injury of a sport by the mechanism of its occurrence and frequency (Banović, 2006, 11). They occur both in the field of professional sports trainings and competitions, and during informal exercise or practice of a sport (recreation). A sports injury means violating the bodily integrity of an athlete through the physical damage he has suffered. According to the Pension and Disability Insurance Act, bodily injury exists when the insured suffers loss, significant damage or disability of certain organs or parts of the body. Furthermore, it should hinder normal body activity and require greater efforts to satisfy life needs, regardless of whether it causes disability (Zakon o penzijskom i invalidskom osiguranju, 2003, art. 37(1)). The authors investigate the legal position of athletes in the Republic of Serbia in relation to insurance, classification of sports for the purpose of insuring athletes against the consequences of accidents, the place of accident insurance in the insurance system and the meaning of sports, sports injuries and insured mishaps in sports.

2. Legal position of athletes in the republic of Serbia in relation to insurance

According to the Sports Act 2016, the insurance of notable athletes and sports experts against the consequences of an accident during sports activities and professional work in sports is carried out by a sports organization based on their personal ranking. [1] Athlete insurance is carried out as a compulsory type of accident insurance, for which the said Act prescribes minimum insured amounts. In addition, the Act provides for the mandatory insurance cover for death, permanent loss of general working ability or ability to engage in sports activities and for temporary incapacity to engage in sports activities (Zakon o sportu, 2016, art. 21(1)&(2). [2] The Act also stipulates that compensation for loss of income is an additional type of coverage, but in insurance practice it is implemented through a special contracting. In this sense, the conditions of insurance of domestic insurers are clear: other contracted cases are regulated by additional conditions (DDOR Novi Sad, 2019, art. 2(2)(5); Generali Osiguranje Srbija, 2013, art. 2(2)(5); Wiener Städtische osiguranje, 2020, art. (3)). In addition to the basic accident insurance, we emphasize the cover can be extended to the reimbursement of medical expenses, loss of earnings [3] and the costs of temporary incapacity for work (daily allowance). In all aforementioned cases, cover is extended only by a special agreement and at an additional premium (Jovanović, 2016, 231; Šulejić, 2005, 495). Furthermore, if the athlete or sports expert is uncovered by the said insurance, the competent national branch sports federation is required to insure them against an accident during the performance for the national sports team. In accordance with the practice of domestic and international insurance, it should be noted the accident insurance of athletes covers only the accident during the stay of athletes on the field, arenas, etc. This means athletes are uninsured against injuries that would occur in all other cases (e.g. accidents before and after training and competition). According to the data of the German insurer Allianz Versicherungs AG, athletes should take into account that two-thirds of all accidents occur in the private sphere, at home and in the garden, or while playing sports or hobbies. [4]

3. Classification of sports for the athletes’ accident insurance

In Serbian legal system, the ranking of sports is not regulated by the hazard intensity, but to how important they are in the Republic of Serbia. Insurers classify sports according to the hazard intensity by treating the accident insurance of athletes as an activity outside the regular occupation. For the purpose of accident insurance, insurers divide sports into the hazard classes to which the appropriate, actuarially determined premium rate applies to the agreed sum insured. For example, Tariff Group 1 – Insurance of persons against the consequences of an accident while performing and outside the regular occupation, insurance of sports risks is classified into the following three hazard classes: 1st – gymnastics, athletics, badminton, golf, bowling, fencing, volleyball, swimming, fishing, sledding, chess, tennis; 2nd – cycling, horseback riding, hunting, skiing, water polo, diving; 3rd – handball, football, rugby, baseball, American football, motorcycling, motoring, hiking, wrestling, judo, divers, mountaineering and amateur athletes (Krstić, 2020). [5] A different premium rate is applied for each hazard class so that the 1st represents the lowest hazard intensity for which the lowest rate applies. From the above classification, it is apparent the tariff does not include many other sports and activities similar to sports (e.g. weightlifting, archery, walking and dancing) as worded by the English insurer General & Medical Finance Ltd. (General & Medical Finance Ltd, n/a, 8-9). Serbian insurers explicitly limit their liability in relation to a certain number of sports that they consider to carry the highest hazard intensity. However, their coverage may be specifically agreed upon if relevant increased insurance premium is paid. These are: football, ice hockey, jiu-jitsu, judo, karate, boxing, skiing, rugby, wrestling, ski jumping, alpinists and spearfishing as well as accidents in the car, motorcycle speed lanes, motocross and training for them (DDOR Novi Sad, 2019, art. 9(1)(2); Generali Osiguranje Srbija, 2013, art. 9(1)(2); Wiener Städtische osiguranje, 2020, art. 10(1)(3)). To that end, the Rulebook on the national categorization of sports 2017 of the Republic of Serbia recognizes the importance for 108 sports, whereas the stated tariff includes only thirty. Of those covered by the tariff, the classification of football into the most risky hazard class is completely in line with the data of [continua ..]

4. Place of accident insurance in the insurance system

Deciding on the place of any type of insurance in the insurance system means determining its characteristics, the area and relationship to other branches. In that sense, accident insurance belongs to the field of non-life insurance of natural persons. In terms of the Insurance Act, accident insurance belongs to group (1), as one of the eighteen types of non-life insurance (Zakon o osiguranju, 2014, art. 9(1)(1)). This is a specific type of insurance in which, depending on the particular coverage, both the rules of life and non-life insurance may be applicable (Jovanović, 2016, 156; Ilkić, 2011, 137; Šulejić, 2005, 496). If the subject of insurance is compensation for treatment costs, daily allowances and lost earnings, this type is about the damage insurance. If the subject of coverage is life and health, i.e. the bodily integrity of the insured, then accident insurance demonstrates the legal nature of the capital insurance. As with some other types, accident insurance can be provided in combination with some basic coverage. Depending on the connection between the risks or interests covered by the insurance, supplementary insurance against the consequences of the accident is known in addition to life insurance (Zakon o osiguranju, 2014, art. 8(1)(4)), as well as accident insurance and voluntary health insurance. However, it should be borne in mind that the Insurance Act provides for all other combinations of life and non-life insurance coverage. Therefore, it is possible to provide accident insurance package, e.g. with credit and guarantee insurance. Although this type of cover can be provided individually, accident insurance of athletes is sold as group insurance. Accident insurance is taken out through a policy with or without a list of the insured athletes. Membership in a sports organization acting as a policyholder enables an athlete to acquire status of the insured (Generali Osiguranje Srbija, 2005, art. 1(2); Wiener Städtische osiguranje, 2005, art. 4). As stated previously, the accident insurance of athletes is mandatory and can be extended to other types of coverage, for which the principle of free contracting will applies. It is up to the sports organization or the athlete, whether to purchase insurance for other costs or risks or to widen the cover territorial and temporal validity to embrace accidents regardless of the place and time of the injury occurrence. With the consent of the insurer, this can be executed by [continua ..]

5. The concept of sports injury

Depending on the manner in which the athlete’s injury occurs, we distinguish between contact and non-contact injuries. In the first case, the injury in team sports is caused by the kinetic action of a part or the entire body of the opponent in an attempt to reach the ball (start of the opponent’s player, [7] jump or collision in a race). Contact of sports opponents repeatedly occurs in some individual sports. These are martial arts in which the goal is to overcome the rival by giving blows, applying certain grips and levers, affecting the opponent’s body balance etc. In the second case, non-contact injuries occur in both team and individual sports (for example, an awkward landing that leads to a sprained ankle or a fall followed by a stretched ligament or fracture). Sports in which an individual is elevated off the ground, such as horseback riding, mountain climbing, and rappelling, account for a high number of head and spinal injuries as well as fractures (Anderson, 2023). Thus, non-contact injuries are those that occur with voluntary or involuntary movement of the athlete’s body (inertia and gravity), without external influence (for example, without the influence of impact, pushing, collision, etc.) According to the etiology of sports, injuries are divided into endogenous (internal – anatomical and physiological changes in tissues due to fatigue and overexertion) and exogenous (external – caused by external influences) (Banović, 2006, 15; Đurđev, n/a). Therefore, whether an injury occurs suddenly while engaging in sports or exercising, injuries are divided into acute and chronic. Acute injuries are those bringing the body into a deteriorating health condition in which it was not previously (for example, sprained joints and fractured bones). They represent the new health condition of the injured athlete, which first manifested itself on or in his body during the insurance period. Unlike acute, chronic injuries are health conditions or persistent diseases producing far-reaching consequences because they existed before the conclusion of the accident insurance contract or develop after long-term playing (for example, “tennis elbow” occurs as a consequence convulsed and clenched fists holding the racket). Chronic sports diseases are caused by repeated stress, which imposes failure of the structural adjustment of the body engaged part (Banović, 2006, 15).

6. Insured accident in sport

The general rule that insurance covers a future event, uncertain and independent of the exclusive will of the contractor equally applies to accident insurance. In addition, there must be an incident causing an external and sudden effect on the bodily integrity of the insured. This event must result in the insured death, complete or partial disability, temporary incapacity for work or impairment of health that requires medical attention, while other consequences may be subject of a special agreement (Jovanović, 2016, 232; Ilkić, 2011, 139; Kalinić, Vojinović, Žarković, 2012, 113; Šulejić, 2005, 497; Vojković, 2019, 349). In that sense, the general conditions of insurance against the consequences of an accident also contain appropriate provisions (DDOR Novi Sad, 2019, art. 2(2); Generali Osiguranje Srbija, 2013, Art. 5(1); Wiener Städtische osiguranje, 2020, art. (3)). Exceptionally, there are differently formulated definitions of an accident which essentially do not convey anything new. However, they are specifying the place and moment when the casualty occurred has to be identified, the accident must have caused bodily harm or death and the incident is not in any causal relationship with the previous health condition of the insured (Vojković, 2019, 349). The treatment of sports injuries is specific, and the recovery must be complete, otherwise there is a danger of re-injury (Djurdjev, n/a). It is then debatable whether the consequences of such injuries are coverable by insurance at all or to what extent. In sports medicine, we broadly distinguish between injuries that occur during any sports activity from the injuries in a narrower sense, those that are typical for a particular sport by the mechanism of occurrence and its frequency (Banović, 2006, 11). In addition to a number of events considered as accidents, in terms of insurance conditions, a typical case of an insurer’s obligation to compensate for a sports injury would be: muscle rupture, sprain, fissure of joint ligaments, fractures of healthy bones due to unexpected body movements or sudden stresses caused by an unforeseen external event (DDOR Novi Sad, 2019, art. 5(3)(7); Generali Osiguranje Srbija, 2013, art. 5(3)(7); Wiener Städtische osiguranje, 2020, art. 6(2)(6)). However, one gets the impression that the definition of an incident (insured) event applicable on the Serbian market excludes accidents that would occur through [continua ..]

7. Conclusion

Sport is a generally beneficial personal and social activity that enables the realization of the mental and physical strength of the individual, and cohesion and inclusion in society. As for the hazard intensity, they depend on the type of sport in question. However, comparative experiences in the world do not match. Because of the injury occurrence specifics and the manner of treatment of athletes, it seems necessary to specialize insurers to insure athletes against the consequences of an accident. Limiting insurance coverage only to training and tournament, while the insured is on the way to a training or competition facility represents an aggravating circumstance for athletes. Those who may want this coverage valid for twenty-four hours, regardless of where they are, have to conclude an extension of an existing or have a separate insurance policy.

8. References

Abdolkarim Alhdad, T.H., Gavrilović, P., Životić, D. (2020). Economic effects of injuries in elite soccer players with regard to ankle injury, Facta Universitatis, Series: Physical Education and Sport, 18(1), 83-92: https://doi.org/10.22190/FUPES190918008A. Allianz Versicherungs AG. (2021a). Versicherungsbedingungen Unfallschutz BASIS, PU---7040Z0 (000), 10/2021, retrieved from: https://www.allianz.de/service/dokumente/#unfallversicherung-erwachsene, 21 October 2021. Allianz Versicherungs AG. (2021b). Versicherungsbedingungen Unfallschutz PLUS, PU---7030Z0 (000), 10/2021, retrieved from: https://www.allianz.de/service/dokumente/#unfallversicherung-erwachsene, 21 October 2021. Anderson, J. (December 4, 2023). Accident. Encyclopedia Britannica, retrieved from: https://www.britannica.com/topic/accident, 11 December 2023. Banović, D. (2006). Povrede u sportu, drugo izdanje [Injuries in sport, 2nd edition]. Beograd: Draslar partner. DDOR Novi Sad. (2019). Opšti uslovi za osiguranje lica od posledica nesrećnog slučaja (nezgode) [General conditions for personal accident insurance], DDOR-RS-OUN-01-0519, 15 May 2019. Department for Culture, Media and Sport. (2008). Playing to win: A New Era for Sport, June 2008. London: Department for Culture, Media and Sport. Đurđev, Z. (n/a). Povrede u sportu [Injuries in sport], retrieved from: http://lekarimedicinesporta.rs/povrede_u_sportu.html, 11 November 2023. General & Medical Finance Ltd. (n/a). Sports Accident Insurance Brochure. Generali Osiguranje Srbija a.d.o. (2013). Opšti uslovi za osiguranje lica od posledica nesrećnog slučaja (nezgode) [General conditions for personal accident insurance], TL-U-01-ON-01-04, 11 March 2013. Generali Osiguranje Srbija a.d.o. (2005). Dopunski uslovi za osiguranje članova sportskih organizacija od posledica nesrećnog slučaja (nezgode) [Additional conditions for accident insurance of members of sports organizations], TL-U-01-DN-06-01, 23 May 2005. Gilchrist, P. & Wheaton, B. (2011). Lifestyle sport, public policy and youth engagement: Examining the emergence of parkour, International Journal of Sport Policy and Politics, 3(1), 109-131, DOI: 10.1080/19406940.2010.547866. Ilkić, Z. (2011). Osiguranje od posledica nesrećnog slučaja – osobenosti i osigurani slučajevi [continua ..]

NOTE