Investigation and incident response guidelines
Despite your best efforts to prevent slips, trips, and falls at your business there may come a time when an accident does occur. How should you respond? A good initial investigation of the incident will go a long way to helping claims adjusters, if a formal claim is filed, conclude the case favorably. Your investigation may lead adjusters to conclude that a quick settlement is justified or that defense is warranted.
If a slip or fall occurs, obtain appropriate medical attention for the victims, and then promptly investigate the incident. The investigation should be conducted when victims and witnesses are readily available, and the facts are fresh in their minds. Investigators should stick to fact collection and never indicate when or how your business may respond to the incident.
If fraud is suspected, the investigator should generally “red flag” the report when submitting it, but not put the suspicion in writing. These claims need to be handled aggressively yet discretely. You can create your own Incident Investigation form but it should contain the following at a minimum:
- Be written
- Record the place of occurrence, date, and time
- Record the name and contact information for all victims and witnesses
- Record victim and witness statements. Investigators should keep victims and witnesses apart and interview them separately to assure accurate recollection of the facts by each person
- Indicate if the victim was carrying anything
- Record the type of footwear worn by the victim
- Describe any injuries reported and any medical attention received or denied by victims
- Describe the floor surface (e.g., marble, carpet)
- State the floor finish applied, if known
- Indicate if mats were in use
- Describe lighting and visibility
- Describe the floor conditions as observed by the investigator and any containment or foreign substances
- Include photographs of the scene and surrounding area
Incident investigation forms should be submitted to the handling adjuster / insurance company with the first report of injury or immediately after the claim has been assigned. It is important for the insurance company representative to have the incident investigation form prior to their contacting the injured person to aid in their claim handling.