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The MDCVSA currently provides limited Player Participant Accident (secondary coverage) to leagues that purchase it. Participant Accident Insurance can cover certain medical expenses (within limits) for injuries sustained during sanctioned amateur soccer activities. Participant Accident Insurance is secondary coverage to a member's primary insurance. If no primary insurance exists, then this becomes their primary insurance coverage.

Summary of Benefits

Claim Form

**IMPORTANT**

The Insurance carrier asks that the claim be filed as soon as possible from the date of the incident, (ideally within 30 days) but no later than 60 days after the accident occurred. The claim form will need to be submitted to your League FIRST, for a signature - cslsoccer@outlook.com. DO NOT send claim forms directly to MDCVSA until this signature is taken care of. ORIGINALS are not mandatory, so claim forms can be sent via regular mail or scanned and emailed. The league will then send to the State Administrator, Mary Beth Falk, at:

mdcvsa.info@gmail.com

or
DCVSA, c/o MaryBeth Falk, 1357 Carolyn Drive, Virginia Beach, Va 23451

**Please follow the directions on the claim form carefully, in order for it to be processed correctly**

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