Medical Insurance Requests

Medical Insurance Request

All players are covered for a specific membership year as soon as they complete the player registration.

When a player is injured, that needs to be reported to the league and to the MSA. The information required is the date and time of the injury, the teams involved in the game and name and contact information (name, email and mailing address) of the injured player.

The league will verify player membership & validity of injury by verifying game sheets, referee reports, practice times and will inform the MSA of the findings.

The MSA will send the injured player a Special Risk Accident Claim Form which must be filled out and returned to the league mailing address:

MN Soccer Association
2751 Hennepin Ave, Suite #28
Minneapolis, MN  55408

Once the state verification officer (currently the President of the MSA) has both the claim form and the verfication information from the league, he or she will sign the fully completed & verified claim form and send it to the insurance company for processing.  Once that has happened, the insurance company deals directly with the injured party.

The specific detail of the insurance policy can be found on the USASA web site ( under the Insurance tab. Note that all Minnesota leagues have currently chosen not to pay the extra cost associated with the higher limit policies, so the association carries the basic 5000 limit policy.

All fields are required to successfully submit the request.

League Name
Date & Time of Injury
Teams Involved when the Injury Occured
Telephone Number
Email Address