To File a Claim: Parents have up to 15 months from the date of the injury to submit claim form. For claims to be eligible for coverage, you must seek medical attention within 90 days of injury.
1. Parents need to complete a claim form from the Insurance link below
2. After you complete the form, please email it to Laura Sturdivant, Executive Director at Executivedirector@dysa.org
3. DYSA will validate the claim and forward to K & K Insurance/Specialty Benefits. K & K Insurance will send you a coverage letter and your claim number. Advise your Doctors/Hospital so they can file claims directly to your primary insurance first, and K & K Insurance/Speciality Benefits second.
4. Itemized bills are required: You or your providers must submit itemized bills with your primary insurance explanation of benefits (if applicable); balance due or notices do not provide the information needed to process your claim. Payments will be made to you if itemized bills indicate that they have been paid. Otherwise, payments will be made directly to the doctor, hospital or other service provider.
5. Parents will hear directly from the insurance company and not DYSA if there are any questions or problems with your claim
Insurance Certificates and Additionally Insured
Beginning with the 2008-2009 season the following procedure will be put into effect for obtaining insurance certificates:
Delaware Youth Soccer Association will issue an insurance certificate for each member club in September of the seasonal year.
Delaware Youth Soccer Association will issue an insurance certificate to Independent teams upon successful completion of the registration process
Lost or additional certificates may be obtained from Delaware Youth Soccer Association for a fee of $25.00 per certificate
If a club would like to obtain additional certificates (field use, gym use, etc.) please have the club president send request to the Executivve Director at, Executivedirector@dysa.org
. Please send,
- Name of the Facility to be insured
- Address of the Facility to be insured
- Mail a check for $25.00 to DYSA, 222 Benjamin Blvd., Bear, DE 19701 (per certificate). Payment must be received prior to issuing certificate.
Please allow 2-5 business days to process. Requests will not be taken from individual teams.