Get the free usa hockey claim form - dyhockey

3. YOU and your COACH/PROGRAM ADMINISTRATOR MUST SIGN this form. 4. We MUST have a copy of your USA Hockey Individual membership card IMR form or USA Hockey roster to process your claim. 5. USA Hockey Insurance is an excess policy and may carry a DEDUCTIBLE. 6. Keep a copy for your files. WARNING Any person who knowingly and with intent to injure defraud or deceive any insurer makes any claim for the proceeds of an insurance policy containing any false incomplete or misleading information is...

How to fill out usa hockey claim form

How to fill out usa hockey claim form:

1. Obtain the usa hockey claim form from the official website or your local hockey association.
2. Fill in your personal information such as your name, address, phone number, and email address in the designated fields.
3. Provide your usa hockey membership number and the date of the incident or injury for which you are filing the claim.
4. Describe the incident or injury in detail, including the location, date, and time it occurred. Be as specific as possible and include any supporting documents or evidence.
5. If applicable, provide the names and contact information of any witnesses to the incident.
6. Attach any relevant medical records, bills, or receipts related to the injury for proper documentation.
7. Sign and date the usa hockey claim form to verify the accuracy of the information provided.
8. Submit the completed usa hockey claim form to the appropriate authority or insurance provider as instructed.

Who needs usa hockey claim form:

1. Players, coaches, or officials who have experienced an injury or incident while participating in any usa hockey-sanctioned event or activity.
2. Individuals who require medical treatment, reimbursement, or insurance coverage for the incurred expenses due to the incident.
3. Any party seeking legal or insurance action in relation to the injury or incident that occurred during a usa hockey-sanctioned event or activity.

People Also Ask about

When should an official stop play for an injured player?

When should the play be stopped? Play should always be stopped the instant any of the On-Ice Officials believes the injury to be serious or when the injured player 's team gains possession of the puck in a non-scoring position. Rule Reference 206(a).

What does hockey insurance cover?

Provided the local association follows the team and member registration procedures of USA Hockey and plays in “sanctioned events,” we provide members with $2,000,000 general liability coverage against claims for bodily injury, property damage and personal (libel, slander, defamation) injury.

What are injury potential penalties in USA Hockey?

Injury Potential Penalties include Boarding, Body Checking (Body Contact Classifications), Butt-Ending , Charging, Checking from Behind, Cross-Checking , Elbowing, Head-Butting , Head Contact , High Sticking, Holding the Facemask, Kicking, Kneeing, Roughing, Slashing and Spearing .

How long does it take for compensation to be paid?

After accepting an offer of settlement for a personal injury claim you will usually receive your compensation money within 14-28 days from the date of settlement. However this timeframe is only a general guide, as how long it takes to receive your compensation can vary based on the below factors.

How do I file an injury claim with USA Hockey?

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.

What is the rule for intent to injure in hockey?

Rule 602 | Attempt to Injure or Recklessly Endanger An Opponent. (a) A match penalty shall be assessed to any player or team official who recklessly endangers or attempts to injure any opposing player or team official .

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What is usa hockey claim form?

The USA Hockey claim form is a document used to report injuries or incidents that occur during sanctioned hockey activities, allowing for potential insurance claims.

Who is required to file usa hockey claim form?

Players, coaches, referees, or team officials who have experienced an injury or incident during a USA Hockey sanctioned event are required to file the claim form.

How to fill out usa hockey claim form?

To fill out the USA Hockey claim form, provide detailed information about the incident, including the nature of the injury, date, location, and individuals involved. Ensure all required sections are completed before submitting.

What is the purpose of usa hockey claim form?

The purpose of the USA Hockey claim form is to facilitate the reporting of injuries or incidents, allowing individuals to seek insurance benefits and ensuring proper documentation for safety and review.

What information must be reported on usa hockey claim form?

Information that must be reported includes personal details of the claimant, the specifics of the injury or incident, date and location of the incident, and any witnesses present during the event.