Insurance Claims – TORSO Soccer

If you are a registered member of TORSO Soccer League and were injured during league play, you can file an insurance claim through our league supplemental accident insurance policy provider, USASA /AG, within one year from the date of the injury.

What’s Covered?

This benefit furnishes coverage for participants without access to a health insurance plan and for medical cost not covered by a player’s own health insurance. For detailed benefit information, please click below:

Because insurance can be confusing, below are Frequently Asked Questions (FAQs) related to USASA insurance coverage.

How To File A Claim

Click the button below to go to the online form to file your claim.

You must complete all sections of the online form to submit your claim. Once submitted, your claim will be sent automatically to the verification officer based on your answer in the Association section.

The next step will be for the TSSAS State Administrator to approve it. After the claim is approved, you will receive an email from our insurance carrier (A-G) with your claim number.

You will also receive a hard copy in the mail about 1-2 weeks after the claim number is issued. Further instructions for submitting medical bills will be included in the acknowledgment letter from AG.

You will need to have the following information ready to complete the claim:

Reporter information:

Select the title for the person reporting the injury – most likely, it will be the injured person.

Then, fill in the reporter’s name, phone number, and email address.

Injured Person:

Complete name
Gender
Date of Birth
Email Address
Phone Number
Complete Address

Team:

Team Name – Your TORSO team name
Team State Association – Select “Texas State Soccer Association South” from the drop down menu.
League or Tournament Name – Select “type in manually” and then type “TORSO”.

Primary Insurance:

Carrier Name
Policy Holder Name
Policy Number Group Number

Incident Details:

Date of Injury
Location
Event Name
Event Type – match or practice
Playing Surface Type
Weather Conditions

Injury Specifics:

Body Part
Side
Severity – you can enter this based on your pain level at the time of injury. Injury Description – list the type of injury—for example – broken ankle. Incident Description – describe how the injury occurred. You can add attachments if you would like. Examples would include referee reports.

Please make sure your contact information is correct when filing your claim. You will receive a couple of emails and an acknowledgment letter by mail with further instructions after your claim is approved. The email addresses you will receive communication from are cdxnotify@agadministrators.com and affinity@agadm.com. Check your spam/junk files before contacting your member association.