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Insurance

 

Insurance Forms & Information

Member Clubs are covered by insurance policies as part of their member benefits.  Clubs receive secondary medical coverage for players and coaches as well as  liability coverage for property owners; Directors and Officers Insurance for not for profit club boards and liability insurance for the coaches.  More information on the insurance coverage can be found below.

YOUTH SOCCER INSURANCE FORMS


To learn more about the youth soccer general liability benefits and accident medical expense benefits & accidental death and dismemberment benefits, please click on the links below:

2018-19 Indiana Soccer Insurance Summary, (Updated 9/2018)
2018-19 Indiana Soccer Youth or Youth Coach Medical Claim Form, (PDF) - Updated 9/2018
Insurance Claim Instructions

Mailing Address

Please mail a completed claim form to:
Indiana Soccer Association
19000 Grand Park Blvd, Suite J

Westfield, IN 46074

ADULT SOCCER INSURANCE FORMS

 

To learn more about adult soccer insurance forms including medical coverages, liability insurance summary, directors & officers liability, directors & officers insurance forms, optical coverages, adult medical claim form, please click on the links below:

USASA Medical Coverages
USASA 17-18 Liability Insurance Summary
USASA Directors and Officers Liability
2017-18 D&O Insurance forms, (must be completed each year by each league)
USASA  Optional Coverages
Indiana Soccer ADULT Medical CLaim Form, (PDF), (updated 10/3/2018)

Mailing Address

Please mail a completed claim form to:
Indiana Soccer Association
19000 Grand Park Blvd, Suite J

Westfield, IN 46074

Release of Liability form for all USASA participants, (Updated 10/3/2018)
Must be completed before play or added to the organization's online registration form  and signed digitally

En Espanol

INSTRUCCIONES PARA PRESENTACIÓN DE RECLAMACIONES DE PÓLIZAS DE ACCIDENTE DE USASA
USASA Cobertura Medica 
USASA Cobertura  de Responsabilidad 

 

YOUTH & ADULT FUTSAL INSURANCE FORMS

 

Indiana Futsal Medical Claim Form, (pdf - updated 9/2018) 

Insurance Claim Instructions
Please mail completed claim form to: 

Indiana Soccer
19000 Grand Park Blvd   Suite J 
Westfield IN 46074

 

OPTIONAL INSURANCE FORMS


We would all like to think that employees / volunteers would conduct their organization’s activities with honesty and integrity. Unfortunately, this is not always the case. According to a U.S. Department of Commerce study, one-third of all employees / volunteers admitted stealing from their employers in the previous year. 

Travel Assistance Flyer 

 

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