NFL told insurer to deny claims for retired players' medical care, lawsuit claims

Arthur Weinstein

NFL told insurer to deny claims for retired players' medical care, lawsuit claims image

An Illinois medical clinic alleges in a lawsuit that the NFL told its insurance carrier to deny medical claims filed by former players, according to a report by Law360.com.

The suit, filed in March, moved Thursday to U.S. District Court in Illinois. According to Law360, Advanced Physicians S.C. alleges that the NFL has for several years been instructing insurer Cigna to deny claims submitted by the clinic.

The suit says Advanced has treated more than 200 former NFL players since 2007, but beginning in mid-2015 Cigna began subjecting all claims to an audit process. Cigna administers the NFL Player Insurance Plan. As outlined in the collective bargaining agreement, the plan provides benefits to vested veterans and their families for up to five years after their retirement.

According to the suit, the NFL did not want the clinic to provide tests to players to diagnose disabilities that would make them eligible for benefits under the $1 billion concussion settlement finalized with thousands of retired players in late 2016.

"Because the NFL doesn't want to pay its former players disability payments under the disability plan … it decided to retaliate against Advanced for providing diagnostic services to former players," the clinic claims in the suit.

“The NFL does not want independent medical providers like Advanced to treat players and provide independent and honest medical opinions about a player’s brain health. The NFL made the decision to try and economically harm Advanced so that Advanced would no longer treat former NFL players and their dependents.”

The suit claims the lack of payments has caused financial hardships for Advanced in terms of lost business from former players, as well as increased operating costs and financing issues.

According to Law360, the NFL requested the move from state to federal court because it says the clinic's claims are preempted by the Employee Retirement Income Security Act and the Labor Management Relations Act.

Arthur Weinstein