Website Manager

West Milford Soccer Club

MEDICAL CLAIM/RELEASE FORM

Filing a Medical Claim under NJYSA


  • If a player from  WMSC is injured during a league sponsored event and it becomes necessary to file a claim, then the parent or guardian needs to follow the directions to the web site below.
  • DO NOT WAIT TO FILE THE CLAIM
  • READ ALL OF THE INFORMATION ON THE WEB SITE TO SEE IF YOU ARE ENTITLED TO COVERAGE
  • DO NOT ALLOW THE PLAYER TO CONTINUE TO PRACTICE OR PLAY IN GAMES UNTIL THEY RECEIVE MEDICAL CLEARANCE
  • THIS IS SECONDARY INSURANCE
  • KEEP THE COACHES INFORMED OF THE PROCESS
  • REMEMBER TO DOCUMENT EVERYTHING IN THE PROCESS

 
To gain access to the information PROCEED AS FOLLOWS:

    1. GO TO http://njyouthsoccer.com/
    2. Select Administrative Information
    3. Go down to Insurance and select the Medical tab
    4. Follow all instructions from there.


Copies of all claims must be submitted to the West Milford Soccer Club President as soon as the claim is made.

Filing a Claim Under West Milford Soccer Club

  • If a player from WMSC is injured during a club approved/sanctioned event and it becomes necessary to file a claim, then the parent or guardian (or adult player) needs to  complete the K&K Insurance claims form and submit to the WMSC President to be forwarded to "K&K Insurance " once approved:

 

  • DO NOT WAIT TO FILE THE CLAIM
  • THE INJURED PLAYER SHALL NOT BE ALLOWED TO CONTINUE TO PRATICE OR PLAY IN GAMES UNTIL THEY RECEIVE MEDICAL CLEARANCE TO DO SO AND IS PROVIDED TO LSC
  • THIS IS SECONDARY INSURANCE
  • KEEP THE COACHES INFORMED OF THE PROCESS
  • REMEMBER TO DOCUMENT EVERYTHING IN THE PROCESS
  • YOU MUST PROVIDE A COPY OF THE CLAIMS FORM TO THE WMSC PRESIDENT FOR AUTHORIZATION PRIOR TO THE CLAIM BEING FORWARDED TO "K&K INSURANCE"
  • PLEASE CONTACT THE WMSC PRESIDENT WITH ANY QUESTIONS REGARDING SUBMISSION OF CLAIMS

Contact

West Milford Soccer Club

P.O. Box 854 
West Milford, New Jersey 07480

Email: [email protected]

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