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Youth Insurance Carrier
Pullen Insurance Services
6300 Ridglea Place, Suite 614
Fort Worth, Texas 76116
(817) 738-6100 |
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Adult Insurance Carrier
AIG Domestic Claims
Attn: USASA Claims Unit
A&H Claim Department
PO Box 25987
Shawnee Misson, Ks 66225
Contact NHSA State Office for AIG Claim form: nhadmin@soccernh.org |
NHSA Insurance COI (Certificate of Insurnace) for use of field spaceIn order to receive a COI for your club or team you need to contact the NHSA State Office by e-mail
listing the name, address, town or city, that you need it for.
nhadmin@soccernh.org NHSA Insurance Forms, Outlines, and Reports
Injury Claims ProcedureThe correct procedure for processing an injury claim is as follows:
- Fill out Injury Report form and mail to the NHSA State Office with in one week after the injury occurs
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Please make sure the Coach has signed the Injury Report Form before mailing it into the state office
- Contact the NHSA State Office and confirm that the injury report form has been received
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Keep accurate records for all bills pertaining to this injury
- Contact the State Office and get the Insurance Claim form (see link above)
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This must be filled out and mailed into the state office with copies of all the bills from your primary insurance carrier
- Contact State Office to confirm that your claim has been sent to the Insurance carrier