As a benefit to our players, US Adult Soccer provides secondary accident insurance coverage. This benefit furnishes coverage for participants without access to a health insurance plan and for medical cost not covered by a player’s own health insurance. Coverage is subject to the terms, conditions, and exclusions of the policy.
We are thrilled to announce that we have implemented a new online insurance claim form process to enhance your experience and simplify the claims submission process.
If you are looking to file a claim you have come to the right place.
If you encounter any issues or have questions about the new process, please don't hesitate to contact [ your insurance verification officer ]
Casey Frankewicz or Vivian Parisotto
email: viviv26@aol.com ].
Participants who are injured while participating in a US Adult Soccer (USASA) sanctioned game or practice.
You must complete the online Participant Claim Form available on the USASA website.
Yes, there is a $400 deductible.
You may. HOWEVER, if you have other health insurance, you MUST file a claim under that insurance. This policy is a secondary accident policy designed to supplement your medical insurance or assist if you have no other health insurance.
If you do not have any other health insurance, this insurance will pay allowable charges up to the policy limits, and after a $400 deductible is paid.
You must be treated within 90 days of your injury. The benefit period begins on the date of your injury and continues for 52 weeks.
Check your spam/junk folders for emails confirming your claim was submitted and verified. You will receive emails from the following email addresses: cdxnotify@agadministrators.com and affinity@agadm.com. Please set your spam filters to allow these email addresses.
The acknowledgement email you receive will have information about who to contact and how.
It is being worked on; as soon as it is available, it will be updated.
The form will still be submitted for verification and can be approved but confirmation of the submission and verification will go to the email address that was submitted. If you haven't received a confirmation of submitting the form within one week, you may contact the state association or member organization with which you are affiliated and let them know of the possible error. The email can then be corrected.
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