Context: National Collegiate Athletic Association (NCAA) institutions are required to certify insurance coverage of medical expenses that result from athletically related injuries sustained while partaking in an NCAA event. This means that the student-athlete must be covered either by their parent’s/guardian’s insurance, their own personal insurance coverage, and/or the institution’s insurance program. Institutions assign this role to a variety of employees, including head athletic trainers (ATs), assistant ATs, athletic administrators, business managers, secretaries, or other institution employees. In 1994 Street, Yates, Lavery, and Lavery observed that the head AT was responsible for administering medical insurance/claims payment at 51% of the institutions studied. The tasks necessary to pay athletic medical claims require a lot of paperwork and can be very time consuming. Additionally, insurance rules and regulations are complicated. Anecdotally, ATs do not always feel well suited to perform these tasks. Objective: Investigate the ways that athletic associations/departments coordinate athletic medical claims and how often an AT is assigned to be the administrator who oversees policies and procedures related to athletic medical claims. Design: Cross sectional. Setting: Participants completed a web-based questionnaire. Patients or Other Participants: Responses from 184 (38%) ATs employed in collegiate settings (Division I 26.1%; Division II 28.8%, Division III 45.1%) were analyzed. Intervention: None. Main Outcome Measures: Demographics. Results: The mean number of full-time ATs on staff was 3.8 (n=97). The head AT was primarily responsible for the payment of athletic medical claims at 48.4% (n=89) of institutions and the assistant AT was responsible at 13.6% (n=25) of institutions. A non-AT was responsible at 38% (n=70). The mean hours spent on this task by head ATs (n=86) was 6.17 hours per week and the mean hours spent by assistant ATs (n=22) was 10.32 hours per week. Most respondents (62.0%, n=103) reported no formal training in athletic medical insurance claims payments whereas 20.5% (n=34) reported the individual responsible had had formal, with 17.5% (n=29) stating they were not sure what training the individual had received. When asked where they felt it was most appropriate to learn these concepts, respondents reported: within an accredited AT program curriculum (36% n=56), on the job training (34% n=52), or CEU event (30% n=46). Conclusions: It is clear that ATs at NCAA institutions are responsible for the administration of athletic medical claims. ATs are spending a large amount of time each week on medical claims, although most have no formal training. An AT may not be the most ideal individual to handle these medical claims; but if an AT is going to continue to be responsible for this task, AT programs should increase the emphasis of this content within the curriculum and CEU opportunities should be made available to ensure athletic medical claims are handled effectively.

Thesis Completion




Thesis Chair/Advisor

Schellhase, Kristen C.


Bachelor of Science (B.S.)


College of Health and Public Affairs


Health Professions

Degree Program

Athletic Training


Orlando (Main) Campus



Access Status

Open Access

Release Date

May 2016