COVERED ACTIVITIES and PARTICIPANTS
Activities that are covered include those sanctioned by VYSA. This includes travel and recreational programs registered with VYSA, tournaments sanctioned by VYSA, tournaments sanctioned by another direct member of US Soccer. Secondary medical coverage is extended to all players registered with VYSA for a defined sanctioned activity. This is accidental injury coverage only and does not cover sudden illness or emergency medical transport coverage or coverage outside the sanctioned event.
FUTSAL ACTIVITIES
VYSA sanctions Futsal events separately through Virginia Futsal and US Futsal. Registered Futsal players and coaches are covered at all Virginia Futsal sanctioned events, leagues and tournaments.
ACCIDENT INSURANCE CLAIMS
Insurance Accident Claims Form
Questions and Insurance Claims forms should be submitted to Kristen at [email protected] 540-693-1430 x213.
DO NOT mail claim forms to the address listed on form. It will not be processed. Email to [email protected] for submission.
If you have Primary Insurance, you will submit a claim to your insurance first.
Injury insurance from VYSA is to be used as secondary, UNLESS you do not have primary. Then this can be used as primary.
To fill out the Accident Claim Form please refer to the steps below.
Page 2 - Part I
- Fill out box B and C
-LEAVE BOX D BLANK
Page 3 - Part II
-Fill out Box A
-Fill out box B1 and B3
-Fill out Box C
Page 4 - Signature at bottom required
CERTIFICATE of INSURANCE