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Risk Management

INSURANCE COVERAGES

For help with filing an insurance claim, obtaining a certificate of insurance or if you have a question concerning any risk management issue, please contact your affiliate's Associate Risk Manager.   

Standard insurance claims are filed directly with K & K (800) 237-2917, prompt 2. The coverage is for excess medical and you have one year to file your claim.     

To obtain a certificate of insurance for ice usage please complete the attached form and submit it with a copy of your ice rental contract(s) to your Associate Risk Manager for initial review and approval. These requests may take up to 30 days to process depending on the number of requests that are being submitted from all over the country.     

All serious injuries should be reported immediately to Skip Williams, Southeastern District Risk Manager.

Skip Williams

Southeastern District Risk Manager
(865) 335-8740
fxn2plyhky@aol.com
    
 

   

CLAIM FORMS

Please contact your local association registrar to receive a claim form.

Insurance Claims

To file an insurance claim: 

  1. Obtain a USA Hockey Case Report/Accident Medial Insurance Claim Form from your local association registrar.  
  2. Do NOT take the Case Report/Insurance Claim Form to your medical provider for completion: YOU MUST FILL IT OUT.  
  3. You and your Coach/Program Administrator MUST SIGN the form.  
  4. You must include a copy of your online registration confirmation page, IMR (Individual Membership Registration) form, or USA Hockey Roster to process your claim.USA Hockey Insurance is an excess policy and may carry a DEDUCTIBLE.  
  5. Mail your completed form and proof of current USA Hockey membership to:  

USA Hockey
c/o K&K Insurance Group - Claims Dept.
1712 Magnavox Way
P.O. Box 2338
Fort Wayne, IN  46801-2338  

For more information, please contact your Risk Manager. 

Tips for Filing an Claim

If you are a registered USA Hockey member and you are injured while participating in a USA Hockey sanctioned activity, follow these procedures:

  • Step 1: At the hospital or doctor’s office, always provide them with your individual, employer health plan, union plan, etc., information as your primary plan.
     
    • The USAH plan requires that treatment following an injury must occur within 30 days from the injury date.
       
  • Step 2: The Next Business Day: Call your local program Registrar to request a claim form, or if you do not know who to call locally, please call USA Hockey at 800 566 3288, x123. If you have no other insurance, then your USAH plan will be the primary plan with a $3,500 deductible.
     
    • DO NOT DELAY getting a claim form or submitting to K&K Insurance. The policy has a timely filing provision and you do not want to jeopardize your claim by not filing within the required time. Upon receipt of your claim, we send an acknowledgement letter and highlights of the coverage/limitations of the plan. By filing your claim after your injury, you are made aware of this information early. DO NOT WAIT UNTIL YOUR PRIMARY INSURANCE HAS COMPLETELY FINISHED YOUR CLAIM BEFORE SENDING IN YOUR USAH CLAIM FORM.
       
    • Make sure your claim form has been signed in the appropriate  places by the appropriate designated persons.
       
    • Make sure your claim form is submitted along with documentation of your USAH membership.
       
    • ONLY CLAIMS ARISING FROM A USAH SANCTIONED ACTIVITY WILL BE HONORED.
       
  • Step 3: Upon receipt of your acknowledgment letter from K & K you should provide the hospital or doctor’s office with your USA Hockey plan information as your secondary plan.
     
    • By giving all of the medical providers both your primary and secondary information, they will automatically send us the proper itemized medical bill and your primary insurance Explanation of Benefits (EOB), thereby, removing this responsibility from you of collecting the proper information to send with your USAH claim. By following this instruction, your K & K claim administrator will be able to contact the medical providers to request information without being told they cannot release anything to us because we are not on file with them.
       
    • Whether provided by the medical provider or directly from you, medical bills must be in an itemized format with dates of service, diagnosis codes, and procedure codes.
       
    • If submitting as a secondary claim, each itemized bill must be accompanied by your primary insurance Explanation of Benefits (EOB), whether this is provided by the medical provider or by yourself.
       
    • If you have paid any of your medical expenses, please indicate that clearly on the medical bills so that payment will be sent to you.

IF YOU HAVE QUESTIONS ABOUT YOUR CLAIM AFTER IT HAS BEEN FILED: Call K&K Insurance at 800/237-2917, Option 1.

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