Soccer Accident Insurance (SAI)
AYSO purchases Soccer Accident Insurance ("SAI"), which pays excess medical costs up to $50,000 maximum per accident to an insured person for accidental bodily injuries incurred as a direct result of participation in a covered activity subject to the policy terms, conditions and exclusions. Eligibility for benefits is 52 weeks from the policy effective date or the date of a covered accident. Download the SAI Brochure for more detailed explanation of the plan.
Accident Medical Expense Benefits are only payable:
- for usual and customary charges incurred after the deductible has been met;
- for those medically necessary covered expenses that the covered person receives;
- first medical expense must be incurred within 90 days of covered accident;
- all claims must be filed within 90 days;
- each claim is subject to a $200 Deductible; and
- social security numbers, visa or green card are REQUIRED on SAI claim.
- Claims will require:
- Copies of primary Explanation of Benefits (EOB)
- Copies of itemized insurance billing forms – UB04 or CMS1500
- No Primary Insurance: If there is no other insurance available to the registered member, the medical benefit will be processed on a primary basis subject to Usual and Customary rates, and the policy terms, conditions and exclusions.
- MAXIMUM BENEFITS PAYABLE: (subject to policy terms, conditions & limits)
- $50,000 maximum excess medical costs
- $15,000 for Accidental Death & Dismemberment
- $10,000 for Dental Benefit
- $10,000 for Orthopedic Benefit
- $1,000 Physical Therapy
All AYSO currently registered* members (players, coaches, referees and other volunteers) are "Covered Persons" for accidental bodily injury while participating in the following covered activities:
- Team practice sessions, scheduled games, tournaments, or other sponsored activities (meetings, banquets, fundraisers) provided they are under the direct supervision of an AYSO registered volunteer.
- Group travel of five or more participants directly, without interruption to or from such practice sessions, games, tournaments, or sponsored activities, provided that players are traveling as a team and a licensed adult driver operates the vehicle.
*Registration requirements will be verified before any benefits are paid.
SAI Claim Forms & Brochures
Incident Report Form
The AYSO Incident Report Form is used whenever there is a personal injury, damaged property, or threats of or actual physical violence surrounding an AYSO game, practice, event or property. The form should be prepared by the Coach, AYSO Official, or other AYSO Volunteer. The form may also be prepared by a member of the regional staff such as the regional safety director, or by tournament or event staff members.
Incident Report Form with Instructions
Participation Release Form
Whenever a player or youth volunteer has suffered a concussion or an injury or illness that required the care of a physician or a visit to an emergency care facility, the AYSO Participation Release Form must be given to the parents or guardians. The participation release form must be completed in full and signed by the child’s parents or guardians before the player or youth volunteer will be allowed to participate further in the program.
This form protects not only AYSO, but more importantly, the participants. Too often participants are out playing again before they are physically ready. Players should not participate until they are ready to play again. This form should also be used in cases of major illness.
Directions for use:
- The Regional Safety Director should enter the mailing information located in the lower portion of the form on a master copy of the form each year, and prepare copies for distribution or make the form downloadable from the Region's web site
- One or several blank forms should be given to all team coaches as part of the materials provided them at the beginning of any season.
- Tournament directors would be advised to have a supply on hand as well.
- The form should be sent to the Regional Safety Director for filing, but could be retained by the coach for a week or so in the event anyone might question the participation of the player subsequent to an illness or injury. (At the Region's option a two part NCR version of the form could be produced so that the coach retains a copy and sends the original to the Regional Safety Director.)
- The form is required whenever a player is removed from participation for concussion symptoms or it is known that the player has had to seek emergency room treatment or a physician office visit to treat an injury or illness affecting the player's readiness to participate.
- Participation Release Forms for a Concussion and any accompanying Medical Release required by State law, must be forwarded to the National Office at email@example.com.
Participation Release Form
AYSO General Release Form
Once the team coach has assumed charge of the children on his/her team, the coach remains responsible until a duly designated adult has taken charge of each child after a practice or game. No child shall be left unsupervised after a game or practice
General Release Form
AYSO does not encourage children to walk or ride a bicycle home or to a friend or relative’s house. However, we recognize that it may be necessary in some cases. When it is, coaches should secure a general release form from the parents/guardians to ensure their approval.
AYSO carries a General Liability policy and the policy period is July 1 through June 30 of the next year.
Who is covered: The Organization, its Directors, Officers, field owners, employees and volunteers for injuries or damages the Organization becomes legally obligated to pay, including applicable legal costs for defense.
Coverage is provided for:
- Participant injury
- Spectator injury
- Property damage liability
- Volunteer injury
- Activities necessary and incidental to the conduct of games or practices
- AYSO sanctioned functions, including meetings, banquets and fundraisers
- Adults participating in
- Soccer scrimmages or games with the players
- Soccer games with other adults (other than the Adult League)
- Fireworks (sale or detonation)
- Amusement Devices (specifically excludes bounce houses, climbing walls, tractor pulls but also excludes carnival-type rides in general) Call the National Office for a full list.
Certificate of Insurance
AYSO Regional Equipment Insurance Program
This coverage is for loss or damage to regional equipment due to fire, vandalism or other specified causes (subject to actual policy terms and conditions.) Note: this is a completely voluntary program for any region who wishes to participate and pay for this coverage directly from regional funds. Download the application for more information.
Regional Equipment Insurance Program
About Willis North America - AYSO's Insurance Broker
Willis is the insurance broker of record for the American Youth Soccer Organization and is the nation's third largest insurance broker. Willis is recognized as a leading global insurance broker, handling risk management and reinsurance across a wide range of service areas and industries. With nearly 20,000 Associates positioned in 400 offices across 100 countries, Willis offers something unique: a truly worldwide network, combined with outstanding local service and expertise.
If for any reason you have a problem or concern about your insurance program, please do not hesitate to contact the National Office at 800-872-2976 or via email here.