Insurance & Process (revised 3/15/24)
Starting 2024, all claims will be submitted online. You can use your computer, tablet, or mobile device.
Click here to submit a claim.
Take this information to Dr. with you:
- QBE Insurance Corporation – Policy UBH000002-935
WHAT ABOUT THE INSURANCE?
LIABILITY INSURANCE
Updated 3/15/24
Note: We have a new insurance carrier. There are some changes from our usual process. The information is below. There is a change and a form is now needed for Dr./ER visit. Players will still need to contact the SISL Board to get their paperwork or ER claim #.
Some may wonder why we have insurance at all. Mainly we protect the facilities we use with liability insurance. Most cities, parks departments, school districts or other locations that allow athletic play require some sort of liability insurance coverage for the participants that use the facilities. The United State Adult Soccer Association (USASA) furnishes that insurance at a reduced rate to member leagues and their teams. The teams that play in the Southern Idaho Soccer League (SISL) are affiliated with USASA through the Idaho State Soccer Association (ISSA).
So when you play you now know that there is $5 million dollars worth of liability insurance in place to help protect the facility you are using, to help protect the league and to help protect you the player.
Coverage Definition: Commercial General Liability – Provides coverage for legal liability imposed by law up to the policy limits. The liability must stem from bodily injury to members of the public or damage to their property, caused by the occurrence. The company will defend you, even if the allegations of the suit are groundless, false, or fraudulent. Suits brought by athletic participants are also covered but player claims are excluded.
MEDICAL / PARTICIPANT ACCIDENT INSURANCE
So why do we have Participant Accident Insurance (PAI)? The reason we have a form of Accidental Medical insurance is because our liability insurance carrier requires that we have some other coverage to help lower the liability; which in turn reduces the liability insurance rate. This requirement also helps those participants that do not have insurance by providing some minimal coverage and it becomes a secondary insurance for those that do have insurance.
The Accidental Medical insurance coverage is very inexpensive and you get what you pay for as with anything else. This is a token bare bones schedule benefit plan which means, that it pays certain predetermined amounts for certain identified procedures or expenses attributed to the claimed injury. So don’t expect to get all your medical bills paid in full by this insurance coverage. We actually see quite a few claims filed annually which means our players are indeed using this benefit.
Coverage Benefits: Benefit period is 52 weeks. Eligibility includes all registered participants. Maximum medical benefit pre claim is $25,000.00 and there is a $400.00 deductible per claim. You must file a claim within 90 days of the accident or incident by submitting a completed claim form to the state verification officer. A pre-existing condition must be treatment free for six months before it is considered a “new” injury. Any chronic, pre-existing condition for which treatment has been recommended or received six months prior to the effective date of enrollments is covered to a maximum of $1,000.00.
QUESTIONS AND ANSWERS ABOUT
THE ACCIDENT INSURANCE
AND THE CLAIM FILING PROCESS
1. If I get injured playing soccer how do I file a claim?
To file a claim you need a claim form filled out completely and sent in to the ISSA post office box indicated on the form so they can verify that you are a registered player in an affiliated league in the state. You must use an original USASA claim form. To get a claim form, contact the SISL President.
2. Should I use ISSA as my insurance company for the medical providers I see such as the Doctor of hospital?
No! ISSA is not the insurance company and to have your bills sent directly to that post office box could hold up payment of you bills. With the claim form send one bill and ISSA will forward it to the administrator of the insurance for United States Adult Soccer Association.
3. How soon after I send in the form and a bill should I expect to be contacted?
The Claim will be processed within 2 weeks of receipt if you have followed the process and the claim form is complete and there is a bill to go with it so they can open a working claim. ISSA usually sends claim forms and bills forward on the same day mail is picked up at the post office.
4. Who should I deal with about my claim?
If you have sent in the completed USASA claim form along with a bill to the ISSA post office box so they can verify that you are a registered player from that point forward you will deal directly with the claims administrator. You will receive correspondence from them instructing you where to send the remaining bills and an explanation of your benefits as well as names and numbers of people you can contact if you have questions or concerns about your claim and a claim number you can use as a reference when contacting them.
5. Is the soccer insurance secondary insurance?
Yes. So when you go to the hospital or doctor you should give your own insurance as the primary insurance and the soccer insurance as secondary insurance. If you do not have any other type of insurance then the soccer insurance does become your primary insurance.
6. Should I contact the insurance company right when I get injured?
No. There is no need to contact the insurance company until you establish a working claim. To establish a working claim you need to fill out an official claim form and send it along with one bill to ISSA so they can verify that you are a registered player. ISSA then forwards the information on to claims administrator who then start a working claim. Part of that process includes contacting you with claim information, a benefit summary and a contact person and address so you can send further bills directly to the USASA claims administrator.
7. Do I need to contact ISSA about my claim?
No. ISSA is not the insurance company and does not get information about your individual claim. It is best to contact the claims administrator after you have a working claim established for all your claim questions.
8. Is there a time limit to file a claim?
Yes. You have 90 days from the date of the accident to file a claim.
9. Where can I find a claim form?
If for some reason you can not obtain a claim form you can request one from ISSA. Just send a self addressed stamped envelope to:
ISSA
P. O. Box 190069
Boise, ID 83709