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Texas accident medical insurance 2026

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The document provides detailed instructions for STX Youth Soccer members on how to file a medical injury claim. It outlines the necessary steps, required signatures, and documentation needed to submit a claim within 90 days of an injury. The packet emphasizes the importance of completing all forms accurately and submitting them to the appropriate parties, including K&K Insurance. It also clarifies the insurance coverage provided by STX Youth Soccer for registered players and officials during sanctioned events.

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Click ‘Get Form’ to open the Texas Accident Medical Insurance form in the editor.
Begin by completing Section I, which requires the claimant's name, date of birth, and home address. Ensure all fields are filled accurately.
In Section II, provide statistical information about the accident, including the type of claimant and a description of the injury. Be specific about how the injury occurred.
Section III must be signed by a coach or local official who witnessed the accident. This verification is crucial for processing your claim.
Complete Section IV with signatures from both the Local Member Association Insurance Commissioner and an authorized state official to validate your claim.
Finally, review all sections for completeness and accuracy before submitting your packet via email or mail as instructed.

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