Standardized Operator Accident Report Background Information

Getting background information onto standardized accidents reports helps both the operator and the reviewer in analyzing the causes of claims. Standardization keeps the operator on track in reporting all the relevant data and having a standardized form helps the reviewer in analysis and record keeping.

Background Information:

Personal Background Information: Provide the following for each person in the company vehicle:

a. Name:

b. Qualified to drive the vehicle or operate the equipment? __ Yes/No

c. Equipment problems experienced:

d. Experience in vehicle or on equipment: __ Years, etc.

e. Training you received:

f. Date of last training:


This format should be adapted to fit reporting for any mishap. It should be able to cover workman’s compensation claims, shop accidents, etc.

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