ACCIDENT CLAIMS PROCESS

In the event of an actual injury, or an incident involving a possible injury during a USPHL Sanctioned event the following procedures should be used to report these injuries properly.

If you are a registered USPHL member and you are injured while participating in a USPHL Sanctioned event please follow the instructions below:

• At the hospital or doctor’s office, always provide them with your individual, employer health plan, union plan, etc., information as your primary plan.

• INTERNATIONAL PLAYERS – Provide your US Travel  Insurance information to the doctor or hospital.

The Next Business Day

• Download the Claim Form on this page. Complete this form and PROVIDE THE COMPLETED FORM TO YOUR COACH OR TEAM ADMISTRATOR TO OBTAIN LEAGUE SIGNATURE BEFORE SUBMITTING TO MUTUAL OF OMAHA. CLAIMS FILED WITH OUT THIS SIGNATURE WILL BE RETURNED TO YOU AND WILL NOT BE PROCESSED

• Please note that claims not filed within a timely manner will also be returned.

• Make sure your claim form has been signed in the appropriate places by the appropriate designated persons including the USPHL League office.

• ONLY CLAIMS ARISING FROM A USPHL SANCTIONED ACTIVITY WILL BE HONORED.

• Explanation of Benefits from your primary insurance must be included with the claim form.

• IF YOU HAVE QUESTIONS ABOUT YOUR CLAIM AFTER IT HAS BEEN FILED: Call Mutual of Omaha 800-524-2324

ACCIDENT & MEDICAL LINKS

INSURANCE SUMMARY

CLAIM FORM