Injuries - NJYS Medical Claim Forms

If a player is injured, IT IS THE RESPONSIBILITY OF THE PARENT AND COACH to IMMEDIATELY complete the injury report form and present it to the President of the club for counter-signature BEFORE it is sent to the state. DO NOT SEND TO THE STATE UNTIL YOUR OWN INSURANCE IS APPLIED FIRST.

The insurance that each child gets by registering with HUSA is obtained by the club through NJYSA. THE INSURANCE IS NOT PRIMARY. You must submit all bills/treatment to your own insurance FIRST. Whatever your insurance does not pay should then be sent to the insurance company/agent for the state.

This Link is to the state web site and explains what you need to know about this process and allows you to download the MEDICAL CLAIM FORMS. http://www.njyouthsoccer.com/Content/directors/upimg/dir5106/insurance/claimform2014b.pdf

Injuries - NJYS Medical Claim Forms