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Injuries and Insurance Claims

Last updated 20 Apr 2011

HWSA, through its affiliation with the U.S. Adult Soccer Association, maintains limited insurance coverage against soccer-related injuries for all players who are registered with the league. This insurance is intended to be supplemental to primary health insurance as the limits of the coverage are quite low. Coverage is not guaranteed and claims must be submitted within 90 days of injury date.

In the unfortunate event of an injury at an HWSA game, the team representative or injured player should follow the following procedures:

  1. 1. Make sure the referee notes the injury on the game report form at the field.
  2. Contact the league Vice President to obtain an insurance claim form information as soon as possible.
  3. The injured player should:
    • complete the form (both parts A and B),
    • obtain the signature of either the coach, manager or referee present at the time of the accident/injury (the signature is to appear on Part B, line 7 of the claim form),
    • sign and date the form,
    • attach any available bills,
    • submit via regular mail to the State Administrator at the address printed on the front of the claim form. The State Administrator will mail the claim to AIG.

      • Incomplete forms will invalidate the claim and will be returned to the sender.

  4. Upon receipt of each claim form, the State Administrator will verify the player's registration. The State Administrator will then mail the original form with any available bills to the insurance company.
  5. From this point on, the State Association's involvement in the process will end. The injured player will deal directly with the insurance company. The insurance company's claim examiner, upon determination of a viable claim, will notify the injured player where to send all applicable bills and to whom all player and physician inquiries are to be directed. The number to call with any questions and to follow up is 1-678-240-1983 or 1-866-642-5246. The contact person is Angelica Cruz-Forero.

Our USASA insurance representative is Tom Hayes and he can be reached at 1-800-741-1238. If you questions about what the insurance covers or how to submit the claim, please contact Tom.

Please contact HWSA Vice President with any questions.