If an incident occurs which you feel could lead to being a defendant in a lawsuit or legal action, you need to take time immediately after the event to write down the details of the incident. Because some incidents for which the insured could be held accountable may not take the form of a lawsuit or legal action for several months, the insured can protect themselves by writing down the important facts of the incident on this form immediately after they occur.
Choose from below to fill out the form online:
Liability Incident Report
| » | Include a clear identification of all injured persons and others involved including name, age, sex, address, phone number, social security number or drivers license number (if available); identification & description of property damaged; specific location of the accident (including as much detail as possible such as reference to fixed, identifiable objects showing distance and direction from such objects and movement of persons, vehicles or objects during the event). |
| » | Time and date of event; general activity of the injured person(s); name and address of any witnesses; general conditions at the time of the event including surface conditions, lighting, noise, weather conditions, possible distractions and all other details obtainable. |
| » | Full identification of any vehicle or machinery involved, including make, model, serial or identification (ID) number. A brief description of injuries and copies of any medical reports as well as any police, fire or accident reports available. |
