Skip links
Carrier Appointments
Employees
Ordering Portal
MI Fintech EFT Enroll
Alliance Beverage Distributing

Field Accident / Property Damage Report

POST-ACCIDENT CHECK-LIST

All items are required.
As you complete a section, return to this page and check off the item

PREVENT ADDITIONAL INJURY.
               ➢ Move vehicle out of harm’s way.
               ➢ Place appropriate warning signals and/or flares.
               ➢ Keep a close eye on approaching traffic.
ASSIST THE INJURED.
               ➢ Check for injuries
               ➢ Call 911 if anyone has been injured.
CALL THE POLICE
               ➢ Remain at the scene until the police arrive.
               ➢ Answer all police questions honestly.
EXCHANGE INFORMATION
               ➢ Complete the Accident Exchange Information Sheet for every person at accident scene.
               ➢ Keep your conversation with the other drivers and passengers to a minimum.
               ➢Do not apologize or admit guilt.
               ➢ Do not give statements to adjuster’s at the accident scene.
               ➢ Do not sign any document unless instructed to do so by the police or your own safety department.
GATHER INFORMATION.
               ➢ Complete both sides of the Field Accident/Property Damage Report.
               ➢ Write down all of the details about the accident, including the location, the circumstances and weather conditions.
               ➢Describe the damage to each vehicle involved.
               ➢ If a camera is available, take photographs of the scene and all damaged vehicles. (Do not photograph injured parties)
6) NOTIFY SUPERVISOR

Report details

All sections must be completed.
Is this report for
Date / Time of Accident:
Cross street, nearest business, buildings, etc.
Exact Location
DL # and issuing state if not MI
Drag & Drop Files, Choose Files to Upload, or Capture With Your Camera You can upload up to 10 files.
Pictures of vehicles, documents, surroundings.
DO NOT TAKE PICTURES OF PEOPLE.
Were police called?
Where there injuries?
Were there witnesses?

Driver Statement

Explain briefly what happened (direction of travel, what you saw first, what you did, what was hit):
Clear Signature
Instructions:
• Draw vehicle positions
• Indicate direction of travel
• Mark point of impact
• Add any relevant notes
QUICK POST-ACCIDENT CHECKLIST