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Accident investigation form

Reporting all work-related incidents, whether injury, illness or even a “near miss” can help you identify and reduce workplace risks. This form can be used to document and investigate each incident.

CSM Report of Injury


This article is provided solely as a reference tool to be used for information purposes only. The information in this article shall not be construed or interpreted as providing legal or any other advice. The information material does not amend the provisions of any insurance policy issued by CompSource Mutual. It is not a representation that coverage does or does not exist for any particular claim or loss under any such policy. Coverage depends on the facts and circumstances involved in the claim or loss, all applicable policy provisions, and any applicable law.

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