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Player Injuries

                              What to do if a player is injured in AYSO Region 97

1) Determine if the injury is serious and needs further medical attention
a) If the injury is not serious, provide rest, a bandage, etc…
b) If the injury is serious, call the parent and comfort the player until they arrive

2) If the injury is serious, complete an “Incident Report Form” available here: https://www.aysovolunteers.org/incident-report-form/

3) Return the completed Incident Report Form within 2 days of the injury to the AYSO Region 97 Safety Director Bruce Skibby at [email protected] and cc the Regional Commissioner at [email protected] so the form can be signed and sent to the AYSO National Office for processing.

4) Provide Bruce Skibby the email address for the injured child’s parents so he can send them the supplemental insurance form should they need to file a claim. This covers the player for any expense not covered by their primary insurance policy up to $50,000.

5) If the player needs medical attention, the player must submit a “Participation Release Form” before they can return to the field. That form is available at Participation release form or from me.


If you have any questions or are unsure of what needs to be done, please don’t hesitate to contact us for further assistance.

Helpful link: Regional Safety

Soccer Accident Insurance (SAI)

What is Soccer Accident Insurance (SAI)

Soccer Accident Insurance (SAI) – serves as a secondary/excess medical and/or dental insurance should an accidental injury occur during specified AYSO activities and events.

Who is covered:

All AYSO members currently registered* (players, coaches, referees and other volunteers) are “Covered Persons” for accidental bodily injury while participating in the following covered activities:

-Team practice sessions, scheduled matches, tournaments, or other sponsored activities (meetings, banquets, fundraisers) provided they are under the direct supervision of an AYSO registered volunteer.

-Group travel, defined as (5) five or more people in one vehicle, directly to and from an AYSO sanctioned event such as practice sessions, matches, tournaments, or sponsored activities, provided that players are traveling as a team and a licensed adult driver operates the vehicle. Group travel which is interrupted for more than two hours, is excluded. (Please see Automotive Liability Chapter for further details)

What is covered?

-Medical/surgical treatment by a doctor or dentist.

-Services of a licensed or graduate nurse.

-Stays in a hospital.

-AYSO Nationally Sanctioned Events

Policy Limits

Soccer Accident Insurance (SAI) pays excess medical costs up to $50,000 maximum per accident to an insured person for accidental bodily injuries incurred as a direct result of participation in a covered activity subject to the policy terms, conditions and exclusions. Eligible expenses incurred within 1 year of the date of a covered accident (one within 1 year of the policy effective date) are eligible for benefits under this policy. Accident Medical and Dental Expense Benefits are only payable for:

-Usual and customary charges incurred after the deductible has been met;

-Those medically necessary covered expenses that the covered person receives;

-Claims when the first medical/dental expense is incurred within 90 days of the covered accident;

All claims must be filed within 90 days of the covered accident and each claim is subject to a $1000 Deductible.

Filing an SAI Claim

The Regional Safety Director is responsible for ensuring that any injured participant, or their parent/guardian, receives the SAI information and claim form from the AYSO website.

To file a claim, the claimant must:

  1. Obtain an AYSO Soccer Accident Insurance (SAI) form, here.
  2. The injured person (or their parent/guardian) must complete, sign and date Part A of the claim form and return the form to the Safety Director for signatures.
  3. The Regional Safety Director and Regional Commissioner must complete, sign and date Part B of the claim form. This section also requires proof of eligibility in the form of the claimant’s AYSO identification number on the printed player registration or volunteer application forms or ID cards.

It is the responsibility of the claimant to collect the fully completed form from the Regional Safety Director, make a copy for his/her own records and should submit the claim form to the address provided on the form within 90 days of the date of injury.

Claimant should consider sending the form Certified/Return Receipt through the US Postal Service.

If the player or player’s parents are covered by any other health care plan, bills must be submitted to the other plan first. After the primary plan has paid its share of the claim, any remaining balances will be eligible for consideration under the AYSO SAI Plan.

SAI claims may be submitted before receipt of the Explanation of Benefits (EOB) Form in order to comply with the 90 day filing period, but copies of the EOB and all itemized bills should be submitted as soon as the claimant receives them.

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Newport AYSO Region 97

PO Box 1848 
Newport Beach, California 92659

Email Us: [email protected]
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