As the whistles blew on the first premiership games of the season last Saturday, many of the world's great footballers headed for the treatment room to nurse the knocks and injuries they picked up in the 90 minutes of fast-paced and bruising action on the pitch.

Ahead lies a season of more than 50 top-flight games that will test the body's endurance and fitness to its limits. While the chances of serious injury are high, the superstars of the game are likely to be underinsured.

Football is following a pattern set in the US by baseball, basketball and American football. As transfer fees explode, players become uninsurable. And with Real Madrid paying Juventus £45m for Zinedine Zidane over the summer, footballers have reached that level. Top players can still get accident and health cover, but not as much as they want.

“The world class players have reached the top of the barometer,” says SLE Worldwide underwriter Richard Hicks.

“There have been players I could have taken on the books at a very high price, but not sufficient for me to take the risk. Some continental players in the UK are having to pay five times as much as last year.”

But footballers are still a long way down the table of uninsurable risks. At the top is golfer Tiger Woods, who is widely expected to become the world's first billionaire sportsman. But while other sportsmen can insure against injury and loss of earnings, Woods's income is so large that no insurer could single-handedly take the risk.

Reaching the bracket
One of the reasons for footballers to join this bracket are the sky-high transfer fees. Changes in the market are another factor. In January 2000, when some big reinsurers, including UNUM and Cigna Re, pulled out of accident and health, the remaining ones pushed their rates up, partly as a consequence of extraordinary workers' compensation claims in the US. As a result, capacity shrunk throughout the whole accident and health market. Lloyd's managing agent Duncanson Holt closed.

Now primary underwriters have to take a higher percentage of the risk on their own books. One underwriter says 95% of the risk would have been reinsured in the past, but now only about 85% would be. But this leaves specialist sport insurers with more leeway to pick and choose risks at the price they want.

“$40m (£27.6m) is the cut-off point, which would leave many of the top footballers off the scale, considering earnings from sponsorship and endorsements,” one market analyst says.

Figures are kept under close wraps, although rates are thought to have hardened by more than 30% across the board in the past two years. But despite the price hike, the market remains notoriously treacherous.

“The problem with sports is that it is very risky – it only takes one bad tackle, as the old saying goes,” says Matthew Todd of broker firm Europa.

As a consequence, top players see their insurance premiums rise far higher proportionally than those in the lower divisions. The same risk applies to any player given their age, position and injury history.

The more expensive the risk, the bigger the chance the underwriter takes of incurring a loss on the books. If you have a hundred players on your books and the one superstar among them suffers an injury that ends his career, the insurers makes a hefty loss. Zidane costs more than the whole squad of the UK premiership side Ipswich, but the risk of injury is roughly the same for all players.

Policies are bespoke and vary as much in content as they do from player to player. An increasing number of European players are taking out disability insurance and there are rumours that some soccer agents who failed to secure cover have been sued by players who subsequently had accidents.

This raises the issue of clubs falling into the same trap in the future. With many floated on the stock market, directors have a duty under corporate governance to shareholders to protect their assets. American baseball clubs have already come under the kosh trying to insure some of their top players.

Contract disputes are part and parcel of professional football and insurance is no exception. Italian striker Pierluigi Casiraghi demanded his club, Chelsea, continue paying him for the remaining two years of his contract, despite his broken leg.

Chelsea, meanwhile, had already accepted an insurance payout for more than £4m on the injured striker because it thought he would never play again. In the end, he retired.

Lloyd's sporting history
Lloyd's has a history of being burnt in the professional sports insurance market, most famously when it entered American baseball in the 1980s just before a strike. But the changing economic backdrop has left the ball at its feet and the market is making the goals.

As one broker puts it: “I expect insurance contracts will become as intricate and tight as football contracts soon.”