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Administration - Bulletin Details
ISSUE #:      2013-19-A
July 23, 2013
TO: BC Hockey Membership
FROM: Barry Petrachenko
Executive Director

SUBJECT: Participant Injury Reports

As we begin another new season, the following procedures should be noted and reviewed with the appropriate person(s) in your association.
1.   All Claims must be submitted to the BC Hockey office within 90 days of the injury on a Hockey Canada Injury Report Form. If this form is not received, the claim will NOT be processed.
2.   Please noteinvoices and / or receipts can follow the original claim later – payment on the claim may be affected if the claim is received after the above mentioned 90-day period. Receipts/Invoices can be submitted up to 52 weeks after the date of the injury.
3.   Coverage is not in effect for services or treatments that are insured services (BC Medical Services Plan, Extended Benefits, Dental Plans, etc.).
4.   Hockey Canada is a secondary insurer.  As such, if a member has Extended Benefits or other insurance, request for payment must be filed with the Extended Benefits or other insurance prior to any reimbursement being made from Hockey Canada. However, the injury claim form must still be submitted to the BC Hockey office within 90 days of the injury. Any coverage statements from the member’s Extended Benefits or other insurance should be forwarded to the BC Hockey office along with the invoices and / or receipts.
5.   If the family does not have Extended Benefits or other insurance coverage and the member is a resident of Canada with provincial coverage, then coverage is in place for services such as ambulance transportation, prescriptions, crutches, collars, and physiotherapy treatments after the provincial medical have paid their maximum. Out of country players must purchase a separate primary insurance coverage plan in order for the Hockey Canada Insurance Program to be in effect.
6.   As with other insurance carriers, the Hockey Canada Insurance Programs has coverage limits. For further information regarding coverage limits, please refer to the Safety Requires Teamwork booklet.
7.   Regardless of the seriousness of injury, an Injury Report Form must be submitted. This applies to all situations, including those where no corresponding monetary claim will be submitted.
8.   Please note that the form can also be downloaded from the forms page of the BC Hockey website,
9.   Please keep copies of all documentation you forward to BC Hockey.
10. Forms MUST be completed in full with the following information.
  • Name and address including postal code and telephone number
  • Date of birth
  • Date of injury
  • Type of injury and nature of condition
  • Whether the injury took place at a Hockey Canada sanctioned activity
  • Name of Association and team
  • Description of accident
  • Signature of team official
  • Signature of parent / guardian (if under 18 years of age), signature of member (if over 18)
  • Insurance information
Incomplete forms will NOT be processed. They will be sent back for additional information only if documentation is received seeking payment.
11. Please attach additional physician’s and / or dentist’s statement and / or letter to the form if more space is required or more details of the injury need to be provided. 
12. All invoices and / or receipts attached or following the original claim must be itemized, so please check invoices and receipts carefully before sending them to the BC Hockey office. Please also make sure the injured individual’s name is on all correspondence.
If you have any questions or require assistance completing this form, please contact the BC Hockey office.

BC Hockey is a non-profit organization and member of Hockey Canada, providing stewardship of amateur hockey at all levels in British Columbia and Yukon.

Approximately 150 minor hockey associations, 55,000 players, 4,500 referees, 20,000 official volunteers and countless others make our great game possible here in Pacific Canada.



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