Accident Insurance Form

Accident Insurance Coverage By Chance Insurance Company.

 

Alberta Soccer covers its Members with Commercial General Liability, Sport Accident and Excess Travel (out-of-country is now a mandatory purchase) Insurance protection.

The Alberta Soccer insurance policies apply specifically to registered players, coaches, referees, Alberta Soccer directors and staff, volunteers listed in member’s records, and parent volunteers while supervising registered players at sanctioned games, practices, or events.

Both indoor and outdoor seasons are covered. Please note, district and community directors are not covered.

Please note that all policy information is provided by ASA Please note that all policy information is provided by ASA on a summary basis to give information on what coverages may be available under the Sports Accident and Travel Accident Policies. 

 

Making a Claim, For incidents within Canada use:

 

  1. Submit Completed Form/s within 30 days of the incident to start a claim to ensure you have coverage.
  2. For questions about your claim please contact Alberta soccer association: 780-378-8101 - www.albertasoccer.com
  3. Claims must be completed in FULL or they will not be submitted to the insurance comapny. 
  4. Important: Submit completed forms directly to EDSA. Plesae note that claims are to be signed off by EDSA Laurie Hartley - Edmonton and District Soccer Association (EDSA) - 780-944-4087 - lhartley@edsa.org. Claims not signed off by EDSA and submitted directly to the claims department will not be accepted.
  5. All insurance claims MUST come through Hala Chadi at Alberta Soccer association before going to the insurance company. 
  6. Hala Chadi - 780-378-8101 - Email: hchadi@albertasoccer.com - 

 

Please Click on the Link Below to start your claim.

Click on this link for > Medical Claim Form

 

EDSA Contact;

  • Mike Thome - Executive Director Edmonton and District Soccer Association - (780) 413-0140 (phone) - mthome@edsa.org
  • Laurie Hartley - Edmonton and District Soccer Association (EDSA) - 780-944-4087 - lhartley@edsa.org

ASA Contact;

  1. Lisa Grant - Executive Director for Alberta Soccer - C: +1 (587) 336-8584 - e:  lgrant@albertasoccer.com 
  2. Hala Chadi - Program and Financial Coordinator -  P: +1 (780) 378-8101 - e:  hchadi@albertasoccer.com
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