MI Stars Injury Report
Report must be made to club within 72 hours of Injury.

All injuries from MSYSA or US Youth Soccer activities must be reported, in writing, to both the member organization and MSYSA via e-mail within 7 days. All claims are required to first be made through member's primary insurance carrier prior to being submitted to MSYSA. The Michigan State Youth Soccer Association excess accident medical insurance policy is secondary insurance. Failure to follow the rules of your primary healthcare coverage will result in a benefit reduction of eligible expenses to 50% of the amount otherwise paid. Any claims not submitted to MSYSA within 30 days will be denied. Once a claim has been approved by MSYSA, the insurance provider A-G will review the claim within 24-48 hours.
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Players First Name *
Players Last Name *
Players Birthdate *
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