** On September 1, 2021 MSYSA switched to a new insurance provider. Any injury claims for injuries received up to August 31, 2021 should be submitted to K&K Insurance (link below). Injury claims for injuries received from September 1, 2021 should be submitted to A-G Administrators, LLC (link below) **
Insurance Claim Checklist
- Claimant must be registered at time the injury took place
- Claimant's injury must have taken place on an insured field location
- Report of the injury must be received by the State Office either by phone or email within 7 days
- Claim form, verified by a witness, must be submitted and received by MSYSA State Office for verification no later than 30 days from date of injury
- $500 deductible applies for all eligible claim
- Include a copy of Permission to Travel approval (if injury took place outside Michigan)
All injuries from MSYSA or US Youth Soccer activities must be reported, in writing, to both the member organization and MSYSA via phone or e-mail within 7 days. All claims are required to first be made through member's primary insurance carrier prior to being submitted to MSYSA. The Michigan State Youth Soccer Association excess accident medical insurance policy is secondary insurance. Failure to follow the rules of your primary healthcare coverage will result in a benefit reduction of eligible expenses to 50% of the amount otherwise paid. Any claims not submitted to MSYSA within 30 days will be denied.
For insurance claims, contact Julie Pearson
Field Insurance / Certificate of Insurance (COIs)
To request for an insurance certificate click here (Login Required)
For more information, see the FAQs
Indoor protection, as a result of indoor participation, is now provided if:
- An MSYSA affiliated league (where players are already registered to teams), in writing to MSYSA, sanctions or endorses indoor team participation
- An MSYSA affiliated league hosts or coordinates indoor training, games, practices, scrimmages, etc.
- MSYSA affiliated leagues must request insurance certificates online from MSYSA in advance of player and/or team indoor participation
- Coaches, Assistant Coaches, Team Managers and other Team Officials must be registered with MSYSA and must be MSYSA Risk Management Certified.
- MSYSA will only provide secondary medical and general liability protection (indoor) for those currently registered with MSYSA.
Insurance Forms & Resources
A-G Administrators Claim for Injuries (for all injury claims from September 1, 2021)
K&K Insurance Claim for Injuries (for all injury claims up to August 31, 2021)