Pullen Insurance Services

Contact us online

Youth Soccer Accident Medical Claims Process Overview

The accident medical policy provided by your state soccer association is an excess / secondary policy. If you have other valid and collectable primary insurance, all charges must first be submitted to your primary insurance carrier.

The online claims submission program is for accident dates on or after September 1, 2014.

Online Claims Submission Process


Complete the IYSA League Verification Form and mail to IYSA at the address on the form. IYSA will not approve your online accident medical claim submission until the properly completed and signed verification form is received by their office. The IYSA League Verification Form is found here.


The claimant (injured person) or parent / legal guardian (if claimant is under the age of 18) should complete the online claim form on this website. A confirmation email will be sent to you upon completion.


The claims information will be sent to your state soccer association for approval or denial. Once approved, you will receive an email with the claim form as a PDF attachment. You will need to send the claim form to the claims payor/insurer with the itemized medical provider bills and explanation of benefits (EOB) from your primary carrier (if applicable). If your claim was denied by the state soccer association, you will receive an email indicating the reason for the denial.


Additional bills and EOBs can be submitted at a later date (after the initial submission of your claim) to the claims payor/insurer. Your claim form will have their contact information on it.