As concussion cover narrows, athletes face a growing insurance gap
A policy change that reshapes player protection
A recent decision by a major insurer has made it harder for elite Australian rules footballers to access brain injury cover through a common insurance pathway. In March, Zurich Australia announced it would apply concussion and head trauma exclusions to professional players who held total and permanent disablement (TPD) insurance through the AFL Players Association superannuation fund, which is administered by a trustee.
The practical consequence is significant: under the affected arrangement, no TPD benefit will be payable for football-related brain injury, including concussion and chronic traumatic encephalopathy (CTE). From May 1, unless an AFL or AFLW player has their own private TPD insurance, they will need to look to the league and its players association for support.
While the change is specific to a particular group and a particular type of cover, it has prompted a wider debate about who ultimately carries the long-term costs of head trauma in sport, and how insurance markets respond when uncertainty and claims experience collide.
Why an insurer might step back from concussion risk
Zurich has said it is the only insurer offering this type of coverage to AFL and AFLW players, pointing to a reduced appetite among insurers and underwriters to cover these injuries. That statement is important because it frames the decision not as an isolated policy tweak, but as part of a broader market trend: fewer insurers want exposure to long-term head injury risk in high-contact sport.
Media reports have suggested the insurer was concerned by a higher-than-expected volume of claims paid since it began offering coverage in 2020, including several seven-figure payouts to athletes. Another reason cited is the high level of uncertainty associated with brain injuries and a desire to limit liability for high-contact sports.
From an insurance perspective, concussion and related conditions present a mix of challenges that can be difficult to reconcile within traditional product design:
Uncertainty around long-term outcomes: brain injuries can have varied trajectories, and the relationship between exposure, symptoms and later impairment can be complex.
Potential for high-cost claims: where benefits are substantial, even a small number of claims can materially affect the sustainability of a portfolio.
Legal and liability risk: litigation related to concussion and head trauma is rising and is widely viewed by insurers as an accelerating legal risk.
In that context, insurers have responded by withdrawing or excluding head injury cover from their TPD insurance. The shift has been described as treating concussion risk as “uninsurable” rather than “governable” through prevention, monitoring and shared responsibility.
What replaces TPD cover when it disappears?
For players affected by the exclusion, the immediate question is what support remains if a football-related brain injury results in long-term impairment. The AFL, via its players association, offers a “severe injury benefit” that provides financial support of up to $600,000 to eligible AFL and AFLW players who suffer cognitive impairment caused by their playing career, including impacts of traumatic brain injuries.
However, that capped payment is not comparable to the financial security previously offered by the insurer’s TPD arrangement. There are also concerns about the discretionary nature of private schemes and whether funding levels are sufficient to cover the number and size of claims that could arise over time.
In other words, privately funded arrangements can function as a stopgap, but they may not replicate the certainty and scale that some players expected from default disability insurance embedded in superannuation.
A contrast with other football codes
The issue is not uniform across all sports. Unlike AFL and AFLW players, NRL players do not appear to have access to a single default insurance arrangement of the same kind. Instead, the league and its players association have two funds: a “past player medical support fund” and a “player hardship fund”. Publicly available information about the nature and scope of these funds is limited.
This contrast matters because it highlights how uneven the safety net can be between codes, even when the underlying concern—repeated head trauma—has become a shared challenge across contact sports.
Why workers compensation is not the backstop many assume
For most Australian workers, the default safety net for workplace injury is a state-based workers compensation scheme, such as WorkCover. These are no-fault systems that typically pay medical costs and replace part of a worker’s income when they are injured because of their job.
Most professional athletes, however, are excluded. This exclusion was a focus of a 2023 Senate inquiry into concussions and repeated head trauma in contact sports. The gap is crucial: when workers compensation does not apply, the burden shifts to other mechanisms—private insurance, sport-funded benefits, public health systems, and in some cases the courts.
That mix can leave athletes navigating overlapping systems with different thresholds, different levels of certainty, and different time horizons for support.
How other countries organise responsibility for head injury risk
Approaches to the long-term impacts of head injuries in sport vary widely. A useful comparison can be found across three major rugby nations in the southern hemisphere: Australia, New Zealand and South Africa.
Australia: basic cover, capped benefits, and rising legal pressure
In Australia, registered rugby players at all levels are covered by a national risk management and insurance program. But the injury cover is basic and capped, and it does not cover long-term head injury risk.
As a result, the future costs of concussion tend to fall across a mix of private insurance, public health systems and, increasingly for professional players, the courts. With litigation related to concussion and head trauma rising, insurers view the legal environment as a growing risk factor. That, in turn, can feed into decisions to exclude or limit cover.
New Zealand: a universal no-fault model tied to prevention
New Zealand takes a fundamentally different approach through its no-fault Accident Compensation Corporation. Under this model, head injuries are treated as a publicly pooled social risk, with automatic and universal coverage.
The compensation corporation also works alongside sport through SportSmart, a national injury prevention program developed by academics, clinicians and sporting organisations. In this system, litigation is largely replaced with guaranteed medical care, rehabilitation and income support, and prevention becomes a direct tool for protecting the sustainability of the insurance pool.
South Africa: a partnership approach with structured safety protocols
South Africa sits somewhere between the Australian and New Zealand models. While it does not rely on a public insurer, it operates in partnership with a private insurer and incorporates BokSmart, a national safety program that mandates education, enforces evidence-based laws and applies strict return-to-play protocols across all levels.
Litigation is possible in South Africa but remains uncommon, suggesting a different balance between compensation, prevention and legal accountability.
Decentralised governance and the challenge of consistency
Rather than adopting a national initiative like SportSmart or BokSmart, Australia’s concussion governance is largely decentralised. Individual sporting codes are responsible for concussion protocols within their own competitions and development pathways.
This decentralisation does not automatically mean poor practice, but it can make it harder to achieve consistent standards, shared data and coordinated prevention efforts across sports and levels of participation. It also complicates the insurance picture: when risk management is fragmented, insurers may have less confidence that exposure is being systematically reduced.
What this could mean for community and junior sport
The insurer’s decision applies to a specific TPD cover arrangement for elite AFL and AFLW players. But the broader concern is whether decisions to reduce or exclude sport-related concussion cover could lead other insurers to review their own policies, including insurance arrangements connected to community or junior sport.
That possibility matters because concussion and head injuries often first occur in youth participation, and early mismanagement can increase the risk of long-term health consequences. If insurance becomes harder to obtain or more restricted at grassroots levels, the consequences could extend beyond elite sport into local clubs and schools.
Industry warnings have underscored the stakes. In its submission to the 2023 Senate inquiry, the Insurance Council of Australia cautioned that “no insurance means no sport”. The phrase captures a practical reality: many competitions, venues and governing bodies rely on insurance to operate, and gaps in cover can threaten participation and viability even if the sport itself remains popular.
Where solutions may be found: shared data and shared responsibility
Although the absence of TPD cover does not directly threaten the existence of professional competitions, the decision does increase pressure to find alternative ways to protect athletes. One proposed direction is stronger partnerships between sporting organisations, insurers and governments to improve how head injury risk is understood and managed.
A central element of that approach is better information. By pooling more injury surveillance data, stakeholders could develop a clearer picture of long-term exposure and emerging trends. That, in turn, would support better decisions about prevention, policy design and risk management.
Importantly, this approach is likely to be most effective if it extends beyond the professional tier. Community and junior sport are where many players first encounter concussion risk, and where consistent protocols and education can influence outcomes over a lifetime of participation.
A turning point for how sport, insurance and health intersect
The exclusion of concussion and head trauma from a prominent TPD pathway for elite footballers illustrates a broader tension: contact sports generate social and economic value, but they also carry risks that can be difficult to price and difficult to absorb when long-term outcomes are uncertain.
In the short term, leagues and player associations may fill some of the gap with private benefits and hardship-style supports. Over the longer term, the debate is likely to focus on whether Australia continues with a fragmented mix of private insurance, capped schemes and litigation, or whether more coordinated prevention and compensation structures can reduce uncertainty and keep cover viable.
For athletes, the central issue is straightforward: when an insurer walks away from concussion risk, the costs do not disappear. They are simply redistributed—among players, sporting organisations, public systems and, increasingly, legal processes. The policy question is how to distribute that burden in a way that is sustainable, transparent and fair.