Insuring Alex Rodriguez: Yankees and Fraud

As an insurance adjuster, Alex Rodriguez's injury story and the subsequent insurance policy that may pay out this year is exceptionally interesting.  The New York Yankees purchased a policy that would protect them in a situation exactly like they are facing this season, but the second Rodriguez was once again linked to PEDs the story changed.  That insurance policy, the one that was designed to protect the Yankees, immediately became the focus of a possible out.  A loophole.  But for that loophole to be exercised, the Yankees would have to prove that Rodriguez's career is over.

When Yankees' GM Brian Cashman announced during the Winter Meetings that Alex Rodriguez would undergo hip surgery, he never indicated the star's career would be over.*  In fact, the timeline for his recovery was still unknown at the time.  Eventually, Rodriguez's recovery time was set at six months.  He would be back sometime after the All-Star Game.  Unfortunately, Rodriguez's pre-hab (designed to help prepare the body for surgery) took longer than expected.  Shortly after Rodriguez's surgery, word came out that the slugger could miss the entire 2013 season.  Then the PED scandal broke.

*To his credit, Cashman has also expressed happiness that Rodriguez himself does not feel his career is over.

After previously telling reporters, fans, and the Yankees organization repeatedly that he has not taken any performance-enhancing drugs since 2003, Rodriguez was linked to a PED distribution clinic in Miami.  Rodriguez was among numerous players linked to the clinic.  If true (and at this point it seems pretty clear), Rodriguez may never have stopped taking drugs.  This is another shot to the reputation the Yankees try so hard to uphold.

$114 million keeps New York from taking any action against Rodriguez.  He can't be suspended because there is not enough proof.  He has the Player's Association on his side.  He can't be traded because no team wants to take on his remaining contract - the $114 million mentioned previously.  And he can't be cut because his contract is 100% guaranteed.  So they may turn to their insurance policy.

Back in 2009, Peter Keating wrote an article for ESPN outlining the business of insuring professional athletes.  It's a common practice among teams and players.  Teams want to insure their investment.  Players want to insure their future.  The Yankees took out a policy to protect themselves in the event that Alex Rodriguez was injured and could not perform for an extended period of time.  The exact language of the policy is not public, but essentially the club gets paid like a person would get paid for temporary partial disability.

Yet, if the Yankees were to try to get the entire $114 million covered by the insurance company and part ways with Rodriguez, they would have to proved that A-Rod is suffering from a permanent partial disability.  A permanent partial disability is one that will not allow Rodriguez to perform the duties of his job any longer.  It is not a total disability, so he will be able to live his life normally, but he won't be able to continue playing baseball.  The problem with making this claim is the fact that Rodriguez has re-affirmed his dedication to playing again as soon as possible.

No one within the Yankees' organization has publicly stated the team would pursue a permanent partial disability claim for Rodriguez.  It's all but certain the team will be paid out by the insurance company for the time Rodriguez misses this season, though.  Sources within the organization were the one who started the firestorm of discussion surrounding the Yankees' and their hopes of parting ways with the veteran slugger.  These anonymous sources lit the fuse on the bombshell possibility that Rodriguez's career may be over.  Or that the Yankees would at least try to make that case.

That could be insurance fraud.  Of course, the Yankees would have to find doctors willing to call Rodriguez's injury career-ending, and they would have to provide medical paperwork and supports that show A-Rod is disabled to the extent that he cannot play the game at even a diminished capacity.  But considering what we know some doctors will do (the PED distribution clinic in Miami was run by doctors), is it such a stretch to believe the Yankees could find a doctor willing to present documents showing a permanent partial disability?

Insurance fraud is something of an accepted practice in American.  Not because people are criminals, but because most feel insurance companies take their money and do not give them anything in return.  So little things, things that would otherwise be frowned upon, suddenly become acceptable in society.  A lie to your health insurance company to get a procedure covered.  A misrepresentation on your auto insurance policy to get lower rates.  It happens.  And it could happen in the world of big money insurance contracts for pro athletes.

But let's be clear.  The Yankees have never come out and publicly stated they would present a claim of permanent partial disability.  This came along with the reports of A-Rod involvement in the PED scandal.  The people in the organization who were quoted may have little to no knowledge for the front office's plans.  No, it was not the Yankees that have suggested a claim against the insurance company could be the loophole the team needs.  It has been sports media.  Knowing that Rodriguez's career is probably not over, the suggestion that the Yankees paint that picture has come from writers around the country.

But if A-Rod is not dealing with a career-threatening injury, even the claim that he is in an attempt to get an insurance payment is fraud.  Remember that.

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