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Insurance Claims & Information

If you are a member of TORSO Soccer League and you were injured during league play, you can file an insurance claim through the league insurance provider, USASA / K&K.

As of September 1, 2011, USASA has changed insurance providers to K&K Insurance. Please use the following forms when filing a claim.

After you download the USASA Player Insurance Claim Form, be sure to fill out all parts as indicated including Part B. TORSO is the local organization as it asks for in the instructions. The ONLY thing the TSSAS office is responsible for is to verify that the injured player is a registered member of TSSAS/USASA and sign the top of the first page.

When completed, send the forms to Harmony Zajdel, registrar with TSSAS, for verification. Harmony will submit the forms to USASA.

Send forms to:
   Harmony Zajdel
   234 Bright Trail
   San Antonio, Texas 234 Bright Trail
   Phone: 210-326-5942 | Email


Forms

Adobe ReaderGet Adobe Reader®

USASA Player Insurance Claim Form (English) (Requires Adobe Reader®)

USASA Insurance Claim Form Instructions (Requires Adobe Reader®)

K&K Information on Player Insurance (English & Spanish) (Requires Adobe Reader®)

Insurance Provider Contact

If you have questions on filing a claim or need more information, contact the USASA agent - Tom Hayes, Des Champs and Gregory - 800-741-1238