Insurance Policy Coverage
Member Clubs are covered by insurance policies as part of their member benefits
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 club. More information on the insurance coverage can be found below.
Insurance Forms/Filing a Claim – Youth Soccer
Indiana Soccer has recently changed (2021) insurance companies to Players Health and continues to provide our members with the best coverage at the most reasonable rates. To learn more about the youth soccer general liability benefits and accident medical expense benefits & accidental death and dismemberment benefits, please contact the Indiana Soccer office.
The process to file an accident medical claim is now managed through an online portal. Simply click the link below and follow the prompts:
Insurance Coverage, Forms, and Filing a Claim – Adult Soccer
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:
- Release of Liability Agreement (reviewed 9/13/23) Must be completed each season per player, may be located on the registration form.
- Release of Liability Agreement – Spanish (reviewed 9/13/23) Must be completed each season per player, may be located on the registration form.
- USASA Medical Coverage Summary (reviewed 9/13/23)
- USASA Directors and Officers Liability Summary (reviewed 9/13/23)
- D&O List for Insurance Coverage (Updated 9/13/23 – must be completed each year by each league)
- $25K Insurance Coverage Request Form (reviewed 9/13/23)
- Indiana Soccer ADULT Medical Claim Form (reviewed 9/13/23)
- Indiana Soccer ADULT Medical Claim Form-Spanish (reviewed 9/13/23)
- Insurance Claim Instructions (reviewed 9/13/23)
- Insurance Claim Instructions-Spanish (reviewed 9/13/23)
Mailing Address:
Please mail a completed claim form to:
Indiana Soccer Association
19000 Grand Park Blvd, Suite J
Westfield, IN 46074
Certificate of Insurance (COI’s) – Youth and Adult
All member clubs should receive or request a Certificate of Insurance for each facility where you train and/or play games. This COI proves to the property owner that you have liability coverage for incidents that could occur during your use. The COI will list the coverage summary.
- YOUTH Members: You can request additional COI’s using the online request form.
- ADULT Members: Please contact Amber Cremeens via email (amber@soccerindiana.org) and request the COI’s you need.
