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Accident Reporting
What is an Accident?
DEFINITION:
For the purpose of this procedure, an accident is
defined as "any unplanned event that causes, or
has the potential to cause, an injury or illness
and/or damage to person, buildings, or the
natural environment." Incidents range from
serious incidents and emergencies to near-miss
incidents where there is no actual injury or
damage.
Auto
General Liability
Property Loss
Workers’ Compensation
Types of Accidents
Auto Accidents
Auto Accident
Bodily injury or property
damage caused by a land motor
vehicle designed and registered
for use on public roads.
General Liability
Any injuries or damages to
persons or property that are
directly or indirectly attributable
to the design, formulation,
manufacture, distribution, use,
operation, maintenance or repair
of an entity; or the failure to warn
of any such conditions
General Liability Accident
Property Loss or Damage
Fire – Fraternity House,
Mechanical Room
Fire – Selecman Hall,
Kitchen
Flood – Residence Hall
Property Damage
Property damage means
physical injury to or destruction
of tangible property including
loss of use if the loss or use
results from the physical injury
or destruction of the property.
Workers’ Compensation
Any injury or contracted disease
arising out of and in the course
and scope of employment.
It’s time to play
Question:
Which of the following
incident types results in
the largest number of
PROPERTY LOSS claims?
 Trash Can Fires
 Car Fires
 Unattended cooking
 Popcorn in microwave
 Arson 4%
30%
23%
13%
8%
* These are based on estimated statistics
All accidents that arise out of, or in the
course of any University sponsored
activity must be reported. The
immediate supervisor is responsible for
ensuring the correct procedures are
followed. Incidents that occur on the way
to or from work, during lunch or
recreational breaks, or on University field
activities must also be reported.
Accident Reporting
Stay calm.
Bodily Injury? – Secure medical attention for the injured
party(ies). Call campus police (on campus) or local police, as
necessary.
Employees should report all accidents involving bodily injury
immediately to supervisor, campus police (on campus incident),
OR local police, AND to RMEH&S within 24 hours.
As applies, obtain police officers name, police report number.
Auto accident? Exchange driver’s licenses, vehicle data &
insurance information.
Obtain the name(s) and contact information of any witnesses
present at the scene.
 Assist police and RMEH&S with Accident Investigation.
Complete Accident Report Form and forward to RMEH&S.
Reporting Procedures
Accident
Report
Form
Accident
Report
Form
AUTO ACCIDENT REPORT
Driver's Name: ________________________________________________ DOB: _________
Last Name, First Name MI M/D/Y
SSN: _ _ _ - _ _ - _ _ _ _ Driver's License No. _______________ State: __________
Your Department: _______________________________ Address: _____________________
Telephone Number, where you may be reached: Office ___________ Home : _______________
Rental Vehicle: __ Yes __ No If, yes, Rental Company/Agency: _______________________
Vehicle Identification Number: ____________________________ Lic Plate Number: ________
Year: ___________________ Make: _________________________ Model: ______________
Description of Injuries, if any: ___________________________________________________
Damages to Your Vehicle: _______________________________________________________
Were Police/DPS Notified ___ Yes ___ No Were Pictures Taken: ___ Yes ___ No
If yes, Officer's Name: ___________________________ Report or File Number: __________________
Date of Accident: _________________ LOCATION OF ACCIDENT: ____________________
______________________________________________________________
OTHER PERSON(S) INVOLVED
Name: ________________________________________________ DOB: ______________
Address: _______________________________ Driver's License Number: ________________
How may we contact you: Work: __________ Home ___________ Other: _____________
VEHICLE INVOLVED
Vehicle Identification Number: ____________________________ Lic Plate Number: ________
Year: ___________________ Make: _________________________ Model: ______________
Insurance Carrier: _______________________________ Policy Number: ________________
Description of Injuries, if any: ___________________________________________________
Damages to Your Vehicle: _______________________________________________________
____________________________________________________________________________
NARRATIVE REPORT/SUMMARY OF ACCIDENT:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
If you have any questions, please contact Linda Oliver at (214) 768-2807, Risk Management Office Box 750231, Dallas TX 75275-0231
Auto
Accident
Report
Form
Accident Reporting-Student
• In the event of an injury occurring to a student who
is employed on a casual basis, it must be established
whether the person was performing an activity as a
student (i.e. in pursuit of study) or as an employee
(i.e. on a paid basis) at the time.
• If a student was in fact an employee at the time of
the incident, a Work Comp First Report of Injury
must be completed and forwarded to RMEH&S.
(Police reports should also be forwarded to
RMEH&S).
• If a student was involved as a student and incurred
an injury or illness the accident should be reported
on the general Accident/Incident Report Form.
•Never argue with a third party who is involved
in, or witness to, an accident.
•Never admit liability, or say that SMU will pay
for any damages…rather, show compassion
without an admission of responsibility. You
may also tell them an investigation will be
performed by the Police and/or Risk
Management, and responsibility assigned.
What Not to Do –
* Prevents early medical intervention
* Results in higher total claim costs
* Has a much greater probability of
being denied coverage
Late Reporting of Claims:
$$ WC Claims not reported within the business day
following an injury will COST YOUR DEPARTMENT
$1,000 of the claim cost $$
It’s time to play
Question:
What is the most common
type of OCCUPATIONAL
ACCIDENT that occurs on
campus?
 Caught On/In/Between
 Struck Against
 Overexertion
 Struck By
 Slip/Trip - Fall 26%
23%
22%
13%
8%
Accident Investigation
The purpose of accident investigations is
to find the underlying causes of an
injury, illness, or “near miss” and to take
corrective actions. Employees should
understand that accident investigations are
not intended to assign blame.
 Conduct the investigation immediately after the
accident.
 In separate interviews, ask the primary person
involved (i.e. employee, student, visitor) in the
accident, and any witnesses, to tell you in their
own words exactly what happened.
 Repeat the primary person and witnesses’
descriptions of the event to allow them to make
corrections or additions.
 Review the completed form with each person
involved to make certain that the report is
accurate.
Accident Investigation Tips
Accident Investigation -
Risk Management’s Focus
 Understanding accidents - direct and
indirect causes
 Establishing a framework
 Getting to the root cause
 Preparing and delivering findings
 In collaboration with appropriate
departments, initiating corrective
actions to prevent recurrence if threats
to health & safety are identified.
Accident Reporting –
Workshop
The campus garbage truck is out on campus performing routine pickups..
There are three employees assigned to the vehicle; a driver and two
attendants.
It’s been threatening to rain all morning. There have already been a few
sprinkles and the skies are dark. All of a sudden the dam breaks loose…it
starts raining hard. The two attendants on the back run and get in the cab.
They have only one pick up left and they are at the location. They decide
between them that they will back up to the spot and “real quick” dash out of
the cab and put the garbage in the bin. This location usually doesn’t have
much garbage anyway. They are backing up, with very little visibility,
when a student on a skateboard comes around the wall to their side and is hit
by the rear of the truck. The occupants in the cab are unaware of the student
until they feel the bump of the vehicle driving over something. It is the
student’s skateboard and legs. They get out to see what they hit and
discover the injured person.
Accident Scenario #1
What should happen from here?
What sort of claim is this? Auto or General Liability?
Sharon King has been employed at the University for two
months. She is very energetic and dedicated to her job.
Today, she has worked continuously on several projects that
her supervisor has requested by 2:00. After she has
completed this tedious task, she breaks for lunch. Realizing
that it’s 4:00 she decides to eat popcorn as a snack since she
has to meet her husband at Houston’s Restaurant for dinner.
She places the popcorn into the microwave, unknowingly sets
the timer at 20 minutes instead of the 2 minutes required. She
walks down the hall to rest room and pauses for a
conversation with one of her co-workers. When she returns
she finds the popcorn is burning and has ignited cabinets in
the kitchen.
What should she do?
How could she have avoided this fire?
Accident Scenario #2
Accident Scenario #3
On Tuesday morning SMU employee Peruna reported to work to start his day.
Peruna has worked as a carpenter on campus for 31 years. (Peruna always wears
his safety glasses and follows safety procedures) On Tuesday Morning about 9:30
am Peruna mentioned to his supervisor Car Rag Phelps (better known as CRP) that
his left eye was sore. He said some wood dust may have gotten in it while cutting
boards to build the stables for the SMU polo horses. CRP told him to go check it
out in the mirror. While Peruna was looking in the mirror he could see a small
amount of wood shavings in his eye. Peruna went to the eye wash station and
rinsed out his eye. After about 15 minutes he reported back to CRP and finished the
days work. The supervisor filed a quick accident report and did not give the
situation much more thought.
Later that night Peruna woke up about 2:00am and went to look in the mirror. He
had trouble opening his left eye and when he did get it open it was completely red
and looked infected. His wife, Wilma Caustic (WC) immediately took him to the
emergency room. While at the hospital the doctors used a special dye and found a
large amount of wood shavings that needed to be removed. After the doctors
removed the shavings WC took Peruna home but he did have to wear a patch over
his left eye for a week while it healed.
What should happen from here?
What do you think is the root cause of this incident?
QUESTIONS?
Thanks for Coming!

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Accident Reporting.ppt

  • 2. What is an Accident? DEFINITION: For the purpose of this procedure, an accident is defined as "any unplanned event that causes, or has the potential to cause, an injury or illness and/or damage to person, buildings, or the natural environment." Incidents range from serious incidents and emergencies to near-miss incidents where there is no actual injury or damage.
  • 3. Auto General Liability Property Loss Workers’ Compensation Types of Accidents
  • 5. Auto Accident Bodily injury or property damage caused by a land motor vehicle designed and registered for use on public roads.
  • 7. Any injuries or damages to persons or property that are directly or indirectly attributable to the design, formulation, manufacture, distribution, use, operation, maintenance or repair of an entity; or the failure to warn of any such conditions General Liability Accident
  • 8. Property Loss or Damage Fire – Fraternity House, Mechanical Room Fire – Selecman Hall, Kitchen Flood – Residence Hall
  • 9. Property Damage Property damage means physical injury to or destruction of tangible property including loss of use if the loss or use results from the physical injury or destruction of the property.
  • 10. Workers’ Compensation Any injury or contracted disease arising out of and in the course and scope of employment.
  • 12. Question: Which of the following incident types results in the largest number of PROPERTY LOSS claims?
  • 13.  Trash Can Fires  Car Fires  Unattended cooking  Popcorn in microwave  Arson 4% 30% 23% 13% 8% * These are based on estimated statistics
  • 14. All accidents that arise out of, or in the course of any University sponsored activity must be reported. The immediate supervisor is responsible for ensuring the correct procedures are followed. Incidents that occur on the way to or from work, during lunch or recreational breaks, or on University field activities must also be reported. Accident Reporting
  • 15.
  • 16.
  • 17. Stay calm. Bodily Injury? – Secure medical attention for the injured party(ies). Call campus police (on campus) or local police, as necessary. Employees should report all accidents involving bodily injury immediately to supervisor, campus police (on campus incident), OR local police, AND to RMEH&S within 24 hours. As applies, obtain police officers name, police report number. Auto accident? Exchange driver’s licenses, vehicle data & insurance information. Obtain the name(s) and contact information of any witnesses present at the scene.  Assist police and RMEH&S with Accident Investigation. Complete Accident Report Form and forward to RMEH&S. Reporting Procedures
  • 19. AUTO ACCIDENT REPORT Driver's Name: ________________________________________________ DOB: _________ Last Name, First Name MI M/D/Y SSN: _ _ _ - _ _ - _ _ _ _ Driver's License No. _______________ State: __________ Your Department: _______________________________ Address: _____________________ Telephone Number, where you may be reached: Office ___________ Home : _______________ Rental Vehicle: __ Yes __ No If, yes, Rental Company/Agency: _______________________ Vehicle Identification Number: ____________________________ Lic Plate Number: ________ Year: ___________________ Make: _________________________ Model: ______________ Description of Injuries, if any: ___________________________________________________ Damages to Your Vehicle: _______________________________________________________ Were Police/DPS Notified ___ Yes ___ No Were Pictures Taken: ___ Yes ___ No If yes, Officer's Name: ___________________________ Report or File Number: __________________ Date of Accident: _________________ LOCATION OF ACCIDENT: ____________________ ______________________________________________________________ OTHER PERSON(S) INVOLVED Name: ________________________________________________ DOB: ______________ Address: _______________________________ Driver's License Number: ________________ How may we contact you: Work: __________ Home ___________ Other: _____________ VEHICLE INVOLVED Vehicle Identification Number: ____________________________ Lic Plate Number: ________ Year: ___________________ Make: _________________________ Model: ______________ Insurance Carrier: _______________________________ Policy Number: ________________ Description of Injuries, if any: ___________________________________________________ Damages to Your Vehicle: _______________________________________________________ ____________________________________________________________________________ NARRATIVE REPORT/SUMMARY OF ACCIDENT: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ If you have any questions, please contact Linda Oliver at (214) 768-2807, Risk Management Office Box 750231, Dallas TX 75275-0231 Auto Accident Report Form
  • 20. Accident Reporting-Student • In the event of an injury occurring to a student who is employed on a casual basis, it must be established whether the person was performing an activity as a student (i.e. in pursuit of study) or as an employee (i.e. on a paid basis) at the time. • If a student was in fact an employee at the time of the incident, a Work Comp First Report of Injury must be completed and forwarded to RMEH&S. (Police reports should also be forwarded to RMEH&S). • If a student was involved as a student and incurred an injury or illness the accident should be reported on the general Accident/Incident Report Form.
  • 21. •Never argue with a third party who is involved in, or witness to, an accident. •Never admit liability, or say that SMU will pay for any damages…rather, show compassion without an admission of responsibility. You may also tell them an investigation will be performed by the Police and/or Risk Management, and responsibility assigned. What Not to Do –
  • 22. * Prevents early medical intervention * Results in higher total claim costs * Has a much greater probability of being denied coverage Late Reporting of Claims: $$ WC Claims not reported within the business day following an injury will COST YOUR DEPARTMENT $1,000 of the claim cost $$
  • 24. Question: What is the most common type of OCCUPATIONAL ACCIDENT that occurs on campus?
  • 25.  Caught On/In/Between  Struck Against  Overexertion  Struck By  Slip/Trip - Fall 26% 23% 22% 13% 8%
  • 26. Accident Investigation The purpose of accident investigations is to find the underlying causes of an injury, illness, or “near miss” and to take corrective actions. Employees should understand that accident investigations are not intended to assign blame.
  • 27.  Conduct the investigation immediately after the accident.  In separate interviews, ask the primary person involved (i.e. employee, student, visitor) in the accident, and any witnesses, to tell you in their own words exactly what happened.  Repeat the primary person and witnesses’ descriptions of the event to allow them to make corrections or additions.  Review the completed form with each person involved to make certain that the report is accurate. Accident Investigation Tips
  • 28. Accident Investigation - Risk Management’s Focus  Understanding accidents - direct and indirect causes  Establishing a framework  Getting to the root cause  Preparing and delivering findings  In collaboration with appropriate departments, initiating corrective actions to prevent recurrence if threats to health & safety are identified.
  • 30. The campus garbage truck is out on campus performing routine pickups.. There are three employees assigned to the vehicle; a driver and two attendants. It’s been threatening to rain all morning. There have already been a few sprinkles and the skies are dark. All of a sudden the dam breaks loose…it starts raining hard. The two attendants on the back run and get in the cab. They have only one pick up left and they are at the location. They decide between them that they will back up to the spot and “real quick” dash out of the cab and put the garbage in the bin. This location usually doesn’t have much garbage anyway. They are backing up, with very little visibility, when a student on a skateboard comes around the wall to their side and is hit by the rear of the truck. The occupants in the cab are unaware of the student until they feel the bump of the vehicle driving over something. It is the student’s skateboard and legs. They get out to see what they hit and discover the injured person. Accident Scenario #1 What should happen from here? What sort of claim is this? Auto or General Liability?
  • 31. Sharon King has been employed at the University for two months. She is very energetic and dedicated to her job. Today, she has worked continuously on several projects that her supervisor has requested by 2:00. After she has completed this tedious task, she breaks for lunch. Realizing that it’s 4:00 she decides to eat popcorn as a snack since she has to meet her husband at Houston’s Restaurant for dinner. She places the popcorn into the microwave, unknowingly sets the timer at 20 minutes instead of the 2 minutes required. She walks down the hall to rest room and pauses for a conversation with one of her co-workers. When she returns she finds the popcorn is burning and has ignited cabinets in the kitchen. What should she do? How could she have avoided this fire? Accident Scenario #2
  • 32. Accident Scenario #3 On Tuesday morning SMU employee Peruna reported to work to start his day. Peruna has worked as a carpenter on campus for 31 years. (Peruna always wears his safety glasses and follows safety procedures) On Tuesday Morning about 9:30 am Peruna mentioned to his supervisor Car Rag Phelps (better known as CRP) that his left eye was sore. He said some wood dust may have gotten in it while cutting boards to build the stables for the SMU polo horses. CRP told him to go check it out in the mirror. While Peruna was looking in the mirror he could see a small amount of wood shavings in his eye. Peruna went to the eye wash station and rinsed out his eye. After about 15 minutes he reported back to CRP and finished the days work. The supervisor filed a quick accident report and did not give the situation much more thought. Later that night Peruna woke up about 2:00am and went to look in the mirror. He had trouble opening his left eye and when he did get it open it was completely red and looked infected. His wife, Wilma Caustic (WC) immediately took him to the emergency room. While at the hospital the doctors used a special dye and found a large amount of wood shavings that needed to be removed. After the doctors removed the shavings WC took Peruna home but he did have to wear a patch over his left eye for a week while it healed. What should happen from here? What do you think is the root cause of this incident?