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Metropolitan DC-Virginia Soccer Association Soccer: Fun, Fitness, and Friends -- for Life

How to file an Insurance Claim

2016-17 Medical Insurance Coverage

 The MDCVSA currently provides Player Participant Accident (secondary coverage) to leagues that purchase it. Participant Accident Insurance generally covers medical expenses (within limits) for injuries sustained during sanctioned amateur soccer activities. Participant Accident Insurance is secondary coverage to a member's primary insurance. If no primary insurance exists, then this becomes their primary insurance coverage.
The Insurance carrier asks that the claim be filed within 30 days, from the date of the incident. The claim form will need to be submitted to your League FIRST, for a signature.  DO NOT send claim forms directly to MDCVSA until this signature is take care of. ORIGINALS are not mandatory, so claim forms can be sent via regular mail or scanned and emailed. Please send to the State Administrator, Mary Beth Falk, at:
MDCVSA P.O. Box 673, Locust Grove, Va 22508
**Please follow the directions on the claim form carefully, in order for it to be processed correctly**
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