WHAT YOU NEED TO KNOW

All players are covered by the Participant Accident Insurance (PAI) selected by your state association or league.

As soon as the player completes the player registration process in which they must sign the waiver, their coverage’s begin.

If a player gets injured during a sanctioned USASA function and then fills out the current USASA Adult Injury Claim Form.

WHAT YOU NEED TO KNOW

DO NOT DELAY SUBMITTING THIS CLAIM FORM.

This form must be received by USASA, with or without attachments, within 90 days from the date of the accident, or benefits may be denied due to untimely filing.

Medical bills are not needed in order to submit this form, just an incident report from the referee.

The form must be sent to the league verification officer, who will review the form for completeness and then signs and dates the form.

DO NOT SEND FORMS DIRECT TO THE USASA NATIONAL OFFICE OR TO TSSA REGIONAL OFFICE.

Fill out the form then send it to the KMSL league verification officer (currently the KMSL President or Field Officer) at knoxsoccer@hotmail.com.

The completed and signed form is then forwarded on to the TSSA office, who verifies completeness, logs the claim in and forwards it on to USASA.

Finally, USASA processes the form and forwards it on for insurance processing.