USA Hockey Insurance Claims
USA Hockey provides insurance coverage for its officiating members. This coverage
is secondary to your primary insurance and includes
excess medical, accidental death or dismemberment, liability and catastrophic coverage.
Officials should have received a complete summary of the coverage in their exam packet.
You can also obtain additional insurance information on the
USA Hockey Insurance and Risk Management web page.
Although we would hope no one would have to use our
insurance program this season, we do realize that accidents do happen
and we want to make sure you are being provided the best service and
care possible. For this reason, we would ask that you follow the
procedure outlined below when you receive an injury during a sanctioned
USA Hockey event.
Note: You must complete these first two steps before any injury
claim can be processed.
- File with your primary insurance provider.
- Contact your District Referee-in-Chief as soon as possible after being
treated. Be sure to obtain his mailing address. This will allow your
District Referee-in-Chief to start some preparations in making sure your
claim is processed in a timely manner.
- On the back of your Referee Card, at the bottom, is a line titled “TO
FILE AN ACCIDENT CLAIM” with a telephone number. Call that number to
speak with a representative of K & K Insurance. Ask the rep to e-mail
you a Claim Form. Additional information can be found on the
USA Hockey Insurance
and Risk management web page.
- On the claim form, the first box gathers standard basic information.
For Program Name, type “USA Hockey Officiating Program”,
All of the other questions should be self explanatory.
Don't forget the info needed on page three.
For INJURED select “Referee”,
For “Confirmation Number”, type in your
“Official's #” found on the face of your
In the “Team Name” field, type “n/a”.
At the bottom of page 2, in the “REFEREE INJURIES” block,
it asks for “USA Hockey District:”, type in
All of this information can be typed in from your “Adobe Acrobat
Reader”. When you have everything completed, be sure to sign the
form at the bottom of page 3, then save the file. You have two
options on how you can sign this:
1) Use a Digital Signature (your computer may or may not have this
capability), then e-mail the form to
2) Print it out, then sign it, then mail it to the Referee-In-Chief
for his signature.
More information on the Claims Reporting procedure can be found on the
USA Hockey website.
If anyone advises you that someone other than a registered member of USA Hockey, has an actual or potential
claim arising out of an incident or an injury, or arising out of a possible dispute between USA Hockey
members, you should notify your District Risk Manager and District Referee-in-Chief promptly. The District
Risk Manager will notify the appropriate member(s) of USA Hockey's national office staff, and will conduct
any necessary preliminary investigation.
If any member of USA Hockey, its Districts, Affiliates, leagues, teams, or any of its local associations are
served with any lawsuit, civil summons, or other legal papers, they must immediately notify the District
Risk Manager and District Referee-in-Chief. Failure to notify USA Hockey immediately may jeopardize the
applicable legal times for a response, and could be grounds for the insurance company to deny coverage for
the legal action involved.
You must be a completely registered USA Hockey official to qualify for the USA Hockey insurance benefits.