In the event an incident occurs that results in damage or loss or which is likely to result in damage or loss to property, or which results in injury to third parties (visitors, guests, or in some cases students) a risk management incident report must be completed and filed to record the incident. In some cases an insurance claim will be opened and the appropriate claim investigation measures will be initiated.
“The following summary gives some examples of the types of incidents resulting in injury, damage, or loss that will require a risk management incident report form to be filed. Call MSU Safety and Risk Management if you need any assistance. Please use the following link to complete a risk management report of incident.”
REPORT OF INCIDENT FORM (PDF)
Please fill out the form as much as you can. After signing, you may fax the form to (406) 994-7040, scan and email the form to firstname.lastname@example.org , or mail the form to:
Safety & Risk Management
1160 Research Drive
Bozeman MT 59718
Property Damage Incidents:
Damage or Loss to Property Owned, leased or rented by MSU: This includes damage or loss to MSU property resulting from, but not necessarily limited to, damage caused as a result of wind, hail, rain, ice, snow, freezing, explosion, contamination, mechanical breakdown, fire, theft and vandalism.
Property can include, but not necessarily be limited to: structures, equipment, furniture, inventory, cash, securities, livestock and/or research animals.
Liability Loss Incidents:
Damage or Loss to Property Not Owned by MSU which is in MSU’s Care, Custody and Control: This includes property owned by others for which it is alleged or likely to be alleged the loss or damage occurred as a result of MSU’s negligence. This can include property not owned, leased, rented to or loaned to MSU, but property of others over which MSU exercises some control regarding where it is used, stored or maintained.
Damage or Loss to Property Not Owned by MSU which is NOT in MSU’s Care, Custody and Control: this includes property of any kind owned by others for which it is alleged or likely to be alleged that loss or damage occurred as a result of MSU’s negligence. This can include vehicles in parking lots or third party owned property in dormitories and University owned apartments.
Injuries to MSU Visitors, Guests and/or the Public: This includes incidents that result in injury to visitors, guests, or the general public that occur on MSU property or for which it is likely to be alleged the injuries were due to MSU’s negligence.
Injuries to MSU students: This does NOT include injuries or illnesses arising from intercollegiate, intramural, recreational, academic, student club/organization or research activities. Student injuries that require a risk management incident report be filed include incidents that result in injury to students for which it is likely to be alleged the injuries were due to MSU’s negligence.
Motor Vehicle Incidents:
Any incident or accident involving an MSU owned, leased, or loaned vehicle that results in damage to either the MSU vehicle, damage to vehicles owned by third parties, or injury to any individual require that a risk management Incident Report be filed.
REPORT OF INCIDENT FORM (PDF)
Injuries to MSU Employees:
In the event that any of the above incidents result in injury or illness to an MSU employee a “First Report of Injury and Occupational Disease” worker’s compensation report must also be completed and filed. Please consult the SRM Worker’s Compensation Program:
Third Party Claims
Directions for “public reporting a loss” are found at this link http://rmtd.mt.gov/claims/publicreportclaims.mcpx