Sample Accident Investigation Report Form

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Have you ever had an accident at work and then failed to report it? Most people take some kind of short cut to avoid trouble, but did you actually take the time to fill out a proper Accident Investigation Report Form? If not you are probably one of the many people who have been injured or killed as a result of another employee’s negligence. Every year thousands of people are seriously injured or killed in workplace accidents that should have been reported. But too often victims go into their employers medical files, never to be told about the accident and the resulting injuries.

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One of the first things you need to do when you believe you have been injured or killed in an accident on the job is to write a personal injury report, or accident investigation. You are entitled to this, as long as you are filing in accordance with your state’s Workers’ Compensation Act. A well written report can make a huge difference in pursuing a claim against your employer and/or bringing the negligent party to court. It can also lead to a favorable settlement, if the insurance company is willing to negotiate. However, it is important to remember that the accident report serves only one purpose. It must be filled out and submitted within a certain period of time.

It is not necessary to include everything you know about the accident. In fact, including too much information or trivial details can actually have a detrimental effect on your case. The more you can describe, the more time it will take for your report to be processed and turn out to be a valid claim. So here are some sample contents to include in your accident investigation report:

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* Names and contacts – This is the most important part of your report. Write down names and contacts of all those who witnessed the accident and was injured. This makes it easier to determine who is liable for the accident and who needs to be held responsible. Your accident investigation report is not a fair trial if you do not name everyone who could have been involved.

* All physical and chemical substances – These are the substances found inside the vehicle when it was struck or damaged. Include the brand, model, color and estimated values of each of these substances. Also indicate the approximate amount of damage to the vehicle caused by the accident.

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* Photos and videos – If there were any camera or video cameras at the scene of the accident, take photos of them. Make sure they show the position of where the accident occurred, including any nearby vehicles or structures. Use the zoom feature on your camera to get closeups of people and objects in the foreground. Record the date, time and address of all those who may be involved in the accident. The details should always be as precise as possible.

* Names and contacts – Add the names of all witnesses and anyone who saw the accident. Include their contact numbers and addresses so that they can be contacted if necessary. These reports will also include the registration number of the other vehicle as well as that of the police officer who arrived at the scene after the crash. It is best that you include all the data that the police officer needs to process your report accurately and quickly.

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Once you have finished preparing your report, make sure it is well organized and easy to read. Proofread your report several times, including correcting spelling and grammar errors. You may also want to make a supplemental list of bullet points to make things easier for the investigating officer. Once you are done with the formalities, print out your accident investigation report form and gather any evidence that might be helpful. Keep all the information in a safe place and keep it easily accessible until you need it.

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