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Insurance

Questions And Answers

What to do when a Player has an insurance claim

 PRESENTED BY: FLORIDA YOUTH SOCCER ASSOCIATION
                  and M.E. Wilson Co., Inc., PO Box 373, Tampa, FL 33601
                  (813) 229-8021
                  FAX: (813) 229-2795

Excess Accident coverage is automatically provided to registered members of the Florida Youth Soccer Association as part of the registration fee.  The Accident policy provides coverage for registered players during sanctioned events, including regularly scheduled practices and games.  This insurance is payable in excess of any other valid and collectible Health Plan or insurance in force at the time of the accident causing injury. In other words, this coverage is excess above the player’s own family health insurance.

 
Policy Limits
Accident Medical/Dental Maximum
$50,000
Accidental Death & Dismemberment
$10,000
 
Deductible per claim
 
$2,000
Physical Therapy/Chiropractic benefit
$2,000/$50 maximum limit per visit
Co-Insurance
80/20
Benefit Period
104 weeks from date of injury

The deductible will apply to each covered accident. To be eligible for coverage, medical and/or dental expenses must be incurred within the Benefit Period.

Complete the Youth Soccer Accident Proof of Loss (claim form), .  The form must be signed by the Coach, the Agent of Record from your club, and parent or legal guardian.  More information about FYSA insurance can be found here at the Bollinger website.
 
The fully completed, signed claim form must be returned for processing to:

M. E. Wilson Company, Inc.
P O Box 373
Tampa, FL 33601
 
Be sure to include any itemized doctor bills as well as all Explanation of Benefits that you receive from your primary insurance carrier.
 
What keeps the Insurance Company from paying your claim?
 
·       Incomplete or unsigned claim forms
·       "Balance forward statements" from the Healthcare providers rather than Itemized   Billings.
·       Failure to provide your insurance company’s explanation of benefits.
 
If you have any questions about reported claims or completing the claim form, feel free to call the FYSA Claims Department at M. E. Wilson Company, Inc. 
 
1-888-229-8021

Underwriting Carrier: Markel Insurance Company


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