Reporting Procedure For Third-Party Incident/Accident
Read These Instructions Before Completing The Forms!

Anytime there is a contact with the public concerning an accident or incident:

1. immediately report the incident to your supervisor;
2. fill out a Standard Liability Incident Report;
3. fill out a Scope of Employment Form;
4. send the original completed forms to the Office of Risk Management, 112 NEL Building.

When you send a Standard Liability Incident Report, regardless of the type of incident, the form must be filled out by the OU employee (not the Claimant), with the following information provided:

Claimant - The person who sustains the injury is the Claimant. You should provide as much information as possible about the person, including their name, address, telephone number and extent of injuries, if any. If a vehicle was involved, please list the year, make, model and describe any damage.

OU Employee - Please provide the requested information on the Standard Liability Incident Report. Additionally, you should complete the Scope of Employment Form. If a state employee is directly involved in an incident or accident, have it signed by the employee's direct supervisor. If not directly involved, please list the name and telephone number of an employee who has knowledge of the incident and may be contacted if questions arise.

Description of Incident - What happened to the Claimant?

Personal Injury - For slips-and-falls, find out how the claimant was dressed. What were they carrying and how much (arms full, couldn't see where stepping, etc.)? Where was the claimant injured (i.e., left leg, right knee, lower back, etc.)?

Vehicle Damage - Describe the area of damage (i.e., left front fender, passenger side tail light, right door, etc.) Describe the condition of the vehicle, noting any possible pre-existing damage. Get pictures if possible.

When : Time, day, and date of incident.

Where : Exact location of the incident. Pictures of the site are very beneficial.

Why : Was there something that caused the incident? If so, what exactly was it? Was something broken? If so, what exactly was it? Something wrong with walks, stairs, roadway, etc.? If so, what and who put it there? Was someone at OU aware of it? Was it something we did, did not do, something we should have done? Were safety procedures being followed? If we were aware of it, what were we doing about it? Did we respond in a timely and reasonable manner? What were the weather conditions, if applicable? Please use the Standard Liability Incident Report. Since it is impossible to design one form that will cover all potential incidents, any additional information can be put on another sheet using the outline above. The Incident Report should be filled out and a statement taken from all employees and witnesses involved immediately when the incident is reported.

Be sure to check the "Claim Form Requested" either yes or no. State Risk Management does not solicit for claims so if neither box is checked, a claim form will not be sent to the Claimant. Do not, under any circumstances, take documents, estimates, etc. from the Claimant! This causes the claimant to believe that they have already filed a claim and only creates confusion for the Claimant.

When an incident is reported to you or your staff, instruct them to give only the address and telephone number of State Risk Management to the Claimant. (State of Oklahoma Risk Management Division, Department of Central Services, P. O. BOX 53364, Oklahoma City, OK 73152; Phone: 405/521-4999).

There should not be any statement made by anyone to the Claimant, or anyone else, as to guilt or negligence on anyone's part. This will keep you out of the middle of any confrontation that might develop. When any state employee is assisting the Claimant during an incident, do not suggest, recommend, or insist that the Claimant go to a doctor, call an ambulance, or suggest that the state will pay for it. If the Claimant asks for an ambulance on their own, or is unconscious or disoriented, then by all means accommodate them.

Most of the time, injuries to a state employee would not constitute a tort claim, but would, most likely, be a worker's compensation claim. Original Incident Reports, Scope of Employment, witness statements, pictures, etc. should be sent to the Department of Risk Management, 112 NEL Building. Please call 325-2981 if you have any questions.

INSURANCE PROGRAMS

Liability to Others

General Liability--Provided under the Governmental Tort Claims Act of 1985, which provides the only procedure by which tort claims may be brought against the state or an employee of the state. This program is administered by the State Risk Management Division (hereinafter referred to as SRMD) of the Office of Central Services of the State of Oklahoma. Statutory limits are $175,000 per person for any loss other than property; $25,000 per person for property damage; and $1,000,000 per occurrence, all claimants and coverages. OU Legal Counsel administers claims.

Auto & Watercraft Liability--Provided under the Governmental Tort Claims Act and administered by SRMD. Statutory limits are the same as those for General Liability. Claims are administered by OU Legal Counsel. Premiums are collected by SRMD for all vehicles owned or leased by state agencies, as reported annually by the OU Motor Pool.

Excess General & Auto Liability--An insurance policy is purchased for the State of Oklahoma and excludes All Accidents/Occurrences within the State of Oklahoma. OU Legal Counsel administers claims.

Personal Auto Liability--Provided under the Governmental Tort Claims Act and administered by SRMD. Statutory limits are the same as above. OU Legal Counsel administers claims.

Aircraft Liability--An insurance policy is purchased for the State of Oklahoma for owned and non-owned aircraft. This policy also insures hull damage for particular aircraft as designated by OU. OU Legal Counsel administers claims.

International General & Auto Liability--An insurance policy to protect against judgments awarded for actions occurring outside the State of Oklahoma. OU Legal Counsel administers claims.

On any given day, OU employees can be found in other states and around the world in the performance of their duties, so it is important to note that this policy does not provide coverage in specified countries. A good rule of thumb to follow for University-sponsored travel programs and foreign operations is the U.S. State Department’s restrictions for travel for U.S. citizens, which may mirror the insurance carrier’s exclusions.

Special Events Liability--
Tort negligence for University-sponsored activities is covered by the Governmental Tort Claims Act. Liability for student-sponsored activities and for the activities of others who use our facilities should be provided by those same parties. Please note that outside parties may purchase these types of insurance policies through local insurance agents in Norman or indemnify OU through a Certificate of Insurance on the owner’s existing General Liability Policy.

Professional Liability
Educators Legal Liability/Directors & Officers/Errors & Omissions--The Governmental Tort Claims Act of 1985 does not cover actions brought pursuant to federal statutes, such as EEOC and discrimination lawsuits. Therefore, an insurance policy covering the directors and officers, and all other state agency employees, is purchased by SRMD. Claims are strictly reported and administered by OU Legal Counsel.

Medical Malpractice--An insurance policy is purchased by OU naming the physicians, because of limitations under the Governmental Tort Claims Act specifically related to physicians. OU Legal Counsel administers these claims.

Property Coverage
State of Oklahoma Property Insurance Program--This mandated program was begun by SRMD in 1990, with the State acting as the insurer. SRMD purchases a reinsurance policy from several insurance carriers, with different tiers of retention levels.

It is important to note that each building carries a maximum amount of insurance for the structure and its contents, per the replacement cost values reported by OU. Premiums are charged by SRMD, and various accounts pay the applicable premiums based upon the facility use of the property (such as E&G, academic, auxiliary, etc.). Losses are adjusted by SRMD as the primary insurer, with the other insurance carriers involved as retention levels are reached. Documentation for reimbursement of losses is extensive.

There is a $750,000 Per Occurrence deductible for the Norman Campus. The policy contains industry standard exclusions and specific stop loss levels for certain coverage’s, such as fine arts.

Commercial Crime Insurance--A policy has been purchased by OU from a local insurance agent for many years to cover theft or robbery of monies and securities.

Fine Arts Insurance--The OU Museum of Art and the Sam Noble Oklahoma Museum of Natural History have purchased fine arts insurance policies to cover specific pieces or collections of fine arts or museum specimens that are located in OU facilities or travel to outside facilities.

Surety Bonds--OU purchases two surety bonds from a local insurance agent, as required by the U.S. Postal Service to operate the post offices in Adams Center and the Oklahoma Memorial Union. Premiums are paid by the departments.

Employee Dishonesty Bond--Administered by State of Oklahoma Risk Management Division under Oklahoma Statute.

Departmental Policies--Because of the limitations of the SRMD Property Insurance Program (particularly the $750,000 deductible on the Norman Campus), many OU departments have purchased commercial property insurance policies through local insurance agencies. The most common type of coverage purchased is electronic equipment coverage, to insure departmental computers and office equipment. Many of these policies have a $1,000 deductible and the premiums are paid by departmental funds.

Accident & Sickness Insurance

Worker’s Compensation Insurance & Excess Coverage--Since 1995, OU has been self-insured for workers’ compensation and the claims program is administered by a third-party administrator.

Employee Benefits--The Office of Human Resources, Benefits Office, is responsible for the purchase of employee benefits policies, including such coverages as health insurance, life insurance, long-term care, and accidental death and dismemberment.

Student Athlete Insurance--An insurance policy is purchased by the OU Athletic Department for student athletes’ and cheerleaders’ catastrophic injuries during participation in Athletic Department sports programs, as mandated by the NCAA and Big 12 Conference. Claims are administered by the Athletic Department, and the premium is paid by Athletic.

Camps & Clinics Insurance--Camps and clinics which are operated by outside parties in OU facilities are required to provide proof of liability insurance and to name OU as an additional insured under their policies. Camps and clinics, which are operated by OU, purchase a basic accident/illness insurance policy from various vendors, and OU camp/clinic participants are required to sign a waiver before participating in activities.

Student Health Insurance on the Norman Campus--The UOSA purchases a health insurance policy through an open bid process, and premiums are paid by the enrolled students. There is mandatory enrollment for international students, unless they can provide proof of coverage through their home countries. This program is administered by the Office of Human Resources, Benefits Office, and claims are coordinated through Macori, Inc.

Child Care Centers--An accident and illness insurance policy is purchased by the Institute of Child Development of the College of Education for the participants in their children’s program. The premium is paid for by the College. All other childcare centers in OU facilities are operated by outside parties and OU is named as an additional insured under their liability insurance policies.

PROPERTY INSURANCE

A critical component of a Risk Management Program is property insurance. In order to assure adequate coverage on the University’s property it is imperative that current accurate property and inventory records are maintained. At a minimum at least once a year updated property values for all University buildings/structures must be reported to the State of Oklahoma Department of Central Services Risk Management Division. For all University-owned structures a completed Summary Sheet For Insured Structures/Buildings form must be submitted to the Department of Risk Management. The Summary Sheet for Insured Structures/Buildings may also be used during the year to report changes or additions. This form is available through the Department of Risk Management at 325-2981. New buildings and structures including those that have been significantly renovated will be reported through Architectural & Engineering Services to Risk Management.

For all University leased buildings/location that contain property owned by the University, a completed Summary Sheet For Leased Or Occupied Buildings/Office Space/Warehouses form must be submitted to the Department of Risk Management. The "Summary Sheet for Leased or Occupied Buildings/ Office Space/Warehouses" may also be used during the year to report changes or additions.

Building Replacement Value

1. Only buildings and/or structures owned by the University should have a replacement value.
2. The amount shown should be the total replacement cost to rebuild "as was" should a loss occur.
3. Replacement cost should include the following:
A. Costs to bring the building up to code (BOCA, ADA, etc.) should a loss occur.
B. Interior heating, air, plumbing, electrical wiring, fireplaces, permanent shelving, floor coverings, and anything permanently attached to the structure.
4. Replacement costs should not include architectural fees to rebuild. Architectural fees are above and beyond the replacement value to rebuild "as was". Architectural fees will be prorated for improvements or betterments and may be prorated if there is a change of location.
5. Building replacement values will be established and provided by Architectural and Engineering Services to Risk Management.

Contents Replacement Value

1. The total replacement value of the contents owned by the University at each location shall be reported. The replacement value should be the price you pay to purchase a new "like" item should a loss occur. Replacement cost is not acquisition costs unless you could buy the object today for the same price you paid originally.
2. If you are unsure of the current replacement cost of an item you may be able to reference some prices listed on current "State Wide Contracts" or through Purchasing.
3. In the event of a loss you will be required to provide State Risk Management with a current inventory, which includes all items over $100.00 each. Since the University’s current reporting requirements for inventory require only items over $5,000.00, you should have an alternative reporting method for insurance for items between $100.00 and $4,999.99. Some acceptable alternatives may include the following:
A. Copies of purchase orders
B. A department inventory that shows all non-expendable items over $100.00
C. A video of the premises showing the insured items (Be sure the date the video was filmed is stated on the video.)
D. Pictures of the insured items (Include the date within each picture.)
4. Contents are considered non-expendable (non-consumable) items. Contents are usually inventoried by the University. Some examples of items that you would consider as contents are: desks, chairs, file cabinets, modular furniture, typewriters, shelving, mail room equipment, etc. Contents usually have a value over $100.00. Contents are items that can be moved from one location to another. They are not permanently attached to the building or structure or they are not included with the original construction of the structure.
5. Department account/organization/project sponsors are responsible for determining whether equipment should be capitalized, and for initiating the inventory tagging process. Department account/organization/project sponsors should contact the Equipment Inventory Department on the Norman Campus. The Equipment Inventory Department on the Norman Campus will input associated information into the University’s inventory program and will ensure that the pieces of equipment are properly tagged.

Computer Replacement Value

1. The total replacement cost of University-owned computers and computer-related accessories at each location should be listed.
2. Examples of items are: PCs, mainframes, monitors, computer cables, printers, software, computer/software instruction manuals, etc.

Other Replacement Value

This is for non-inventoried, expendable (consumable) items, or items that do not fit any other category.

1. Non-Inventoried Items below $100.00
A. This may include the replacement of such items as: cooking utensils, flatware, dishes, small tools, lamps, staplers, hole punches, sheets, towels, tablecloths, etc.
B. Personal items of employees are not covered and should not be included.
2. Expendable (Consumable) Items
A. Items that are expendable (consumable) should be included here. These items may be the following:
1. Office Supplies – paper, pencils, envelopes, pens, paper clips, staples, whiteout, ink, toners, etc.
2. Construction Supplies – lumber, paint, nails, screws, glue, etc.
3. Household Supplies – food, soap, detergent, toilet tissue, etc.
4. The replacement cost should reflect an estimate of items on hand on any given day if a loss should occur.
3. Non-Category Items
A. Replacement costs of items that do not fit in any other category may be included here, however, if the price of any one item is more than $100.00 you should submit a list of the items you are considering as "other". The list should include:
1. A description of item(s)
2. The replacement price of the item(s) (The amount of insurance you need for the item(s))
3. The building name and location where the item is normally located should be indicated on the list.

B. Some examples of non-category items are:
1. Exterior Equipment
a. Water reservoirs located on top of buildings
b. Heating or air conditioning equipment attached to a building by cables or ducts, but not within the building (Please note: If heating or air conditioning equipment serves more than one building and is located on the exterior of the building, it should be listed as a separate structure).
c. Satellite dishes or antennas attached to a building or structure, usually on the roof or on a tower (Please note: If a satellite dish or antenna is not attached to a structure or anything other than cables and it serves more that one location (building), it should be listed as a separate structure.)
d. Exterior security cameras or surveillance equipment
e. Exterior building enhancements such as fences, flagpoles, lights, etc. (Please note: When these items cannot reasonably be considered part of the building/structure enhancement, then they should be listed as a separate location. For example: A fence that surrounds a compound which has several buildings/structures should be listed as its own location, because each building would be listed separately and the fence could not be identified with any one building. Another example: Parking lot lights, gate arms surveillance equipment, etc. which serve a defined area such as a parking lot should be listed as separate structure/location.)
2. Expensive Interior Items – such as fine arts, antiques, telephone systems, etc.

PROPERTY LOSS

Be sure you have reported, to Risk Management, the property to be insured. Property is covered on a repair or replacement basis for reported locations unless specifically excluded, limited, or placed on Actual Cash Value. Repair or replacement is limited to the actual costs of repairs or replacement or the reported value, whichever is less. Be sure to report the replacement value of the contents, computers and other items. Check to insure your reported values are correct.

Have an accurate, up-to-date inventory. In the event of a loss of contents, computers, or other items, you will be required to provide Risk Management with a current inventory. Your inventory for insurance purposes should include all items that cost in excess of $100.00. Recent pictures, videos or copies of purchase orders may be used to establish ownership for items that are not on your inventory. You may be asked to provide copies of original purchase specifications, purchase orders and invoices for electronic items, computers, machinery, and other large costs items. Update your inventory at least yearly and make more that one copy. Keep one copy at another location.

Make sure any contractors performing new construction or renovation on your buildings is adequately insured. Risk Management does not provide "Builders Risk" insurance.

Maintain records of dates of any maintenance performed on your building or equipment. If you are in a leased location, maintain records of any maintenance requested by you and if the action taken was sufficient to correct the problem.

Keep current architectural plans of your building in a safe place with a copy stored at another location.

Have a plan of action prepared prior to a property loss. Personnel should be assigned to supervise repairs, make purchases, track expenses, and submit your claim.

When a Loss Occurs (Norman Campus)

When a property loss occurs, follow these procedures:

1. Report the loss immediately to the proper authorities, such as police, fire department and appropriate University Administration.
2. Report the loss to Risk Management by phone 325-2981 within 24 hours. The Risk Management office will be responsible to notify the appropriate State Risk Management office and other state agencies. Risk Management must submit a written Property Loss Notice within 10 days. Coverage will be denied for incidents that were not reported within 90 days of the date of the occurrence.
3. Make sure the area is safe for personnel to enter. Have qualified personnel check for the following:
A. Potential for structural collapse
B. Necessity of shoring
C. Potential for falling debris
D. Integrity of electrical and gas lines
E. Does the area have hazardous materials or debris? If so, place temporary barriers around the hazard areas until cleanup can be completed and the area is safe for personnel to enter.
4. Take pictures of the scene before cleanup begins.
5. Take all necessary steps to minimize the loss and insure safety, such as:
A. Temporary boarding up of openings in the roof, walls, or windows
B. Use plastic or drop cloths to cover furnishings when there is a potential for further water damage. Be sure to raise or place the furnishings on pallets when there is a potential for further water damage. Be sure to raise or place furnishings on pallets when there is standing water. Use pumps, if necessary, to remove standing water.
C. Determine the need for emergency heat to prevent freezing.
D. Immediately dry off any wet wooden objects or machinery to prevent warping or further damage. Oil machinery or metal objects, if necessary, to prevent rusting.
E. Have qualified personnel or technicians check all equipment, machines, or motors before energizing. Computer equipment is very prone to damage by contaminants of any type. No such equipment should be energized if there is any evidence of contaminates until a qualified computer technician has thoroughly checked such equipment. Make sure any drying-out or maintenance has been completed before turning anything on.
F. Replace all filters in HVAC equipment to prevent soot dispersion or mold/fungus contamination of other areas. Temporary repairs may be necessary to prevent further damage. Failure to protect exposed property from further damage in a timely manner may result in a separate incident and or loss, and a separate deductible, or reduced recovery values.
6. If cleanup must proceed before inspection of the loss by Risk Management due to the threat of further damage or safety of personnel, do not dispose of any damaged items without Risk Management’s approval.
7. Take the necessary steps to track your claims expenses carefully. Keep accurate records of labor, purchases, equipment usage, etc. Any internal labor expense must have the following documentation:
A. Record the name, title, and hourly salary of any employee working on the loss.
B. Record the date(s) and times the employee worked. For example: May 3, 2002, 10:00 to 12:00 and 1:00 to 3:00 – 4 hours.
C. Provide a detailed description of the duties the employee preformed. For example: cleaned up debris from Room 300, Union.
D. Include any materials used. For example: Replaced wet ceiling tiles in Room 300, Union – 10 Armstrong Century tiles, 2’x 4’ each.
E. You will be required to provide to Risk Management, copies of payroll records and/or time sheets, purchase orders, inventory to document all in-house labor.
F. Keep copies of all purchase orders and invoices for items bought or used in conjunction with the claim. Document where the items were used and for what purpose. For example: 5 cases of Armstrong Century Ceiling tiles, 2’x4’ - @24.00 per case – used to replace wet ceiling tiles in the Union rooms, 300, 302, and 304.
G. Construction specifications MUST be reviewed by State Risk Management and/or their reinsurer PRIOR to being let for bid or before in-house repairs are begun in order to determine if the proposed plan or bid meets the adjusted scope of repair and to determine what portions of the bid or plan will be recoverable expenses for the University. Bid specifications, architectural drawings, plans, requisitions, etc. should be prepared so as to reflect a true replacement of the original roof, building, material, or piece of equipment. Improvements or code upgrades mandated by law must have a copy of the law submitted with the specifications. Improvements, changes from the original item or building, and/or code upgrades are to bid separately or as alternates. Bid specifications should be designed with a base bid to show replacement "as was" and an alternate bid for any improvements or changes desired or required. A bid for salvage recovery or trade-in should be obtained when practical.
8. During the process of cleanup, construction, repairs and/or replacement of lost or damaged items or structures, stay in constant communication with Risk Management. If additional damage is found, notify Risk Management immediately.
9. You will need to provide Risk Management with a copy of any police or fire department reports as soon as you receive them.

Submitting Claim For Payment

When all repairs and/or replacements have been completed and you are returned to an "as was" condition, prepare your claim for reimbursement. If you do not intend to repair or replace damaged structure or items, you may request Actual Cash Value (ACV) for all or any portion of your claim. You may request partial reimbursements while the claim is in process, however, please limit the partial reimbursement to no less than _ of the total anticipated claim.

1. Organize your claim documentation into separate, distinct sections such as:
A. Services – these are performed by outside contractors
a. Cleanup and demolition – include copies for any outside contractor temporary repairs, deodorizing, water removal, etc. – copies for services to clean the site or dispose of debris – an explanation of any items that may not be clear to Risk Management – any other documentation you think will clarify the amount claimed.
b. Temporary Services – include copies of invoices and an explanation of why the services were necessary – for example, you hire a security guard to stand watch until temporary repairs can be made and the building secured.
c. Building Repairs – include copies of invoices for outside contractor’s repairs or replacement of the structure – include an explanation of the work the contractor performed.
d. Contents or Equipment Repairs – include copies of invoices for any repairs made by contractors or vendors – include any reports on the condition of the equipment or item that the vendor may provide you, for example, your telephone system was hit by lighting, you have Southwestern Bell Telephone inspect and repair the system – include a copy of the invoice and the report of the damage found by Southwestern Bell Telephone – include a copy of your inventory with the item repaired highlighted – indicate on the inventory that the item was repaired.
B. Material – include copies of invoices and purchase orders for any material purchased to make repairs – also include warehouse warrants or other documentation for items on hand at the time of the loss that were used to make repairs – include explanation of where and why the material was used.
C. Labor – include any labor performed by in-house personnel – include copies of the time sheets and/or other documentation to support in-house labor – include a copy of the payroll to document the rate of pay charged – include an explanation of what duty was performed. Please note: In-house labor is limited to actual time spent on the claim-related activities, internal overhead is excluded, fringe benefits are limited to FICA and the State’s share of retirement and labor expense recovery is limited to an amount that could reasonably be charged by an outside contractor – time spent preparing the claim is excluded.
D. In-house vehicles and/or equipment – include records of when and where the vehicle or equipment was used, by whom it was used, what type of vehicle or equipment it was, and for what purpose it was used – include any supporting documentation to justify the rate charged. Please note: The transportation of personnel from one place to another is limited to the amount allowed in the Travel Reimbursement Act and is recoverable only when the destination is not a normal site that the employee would reasonably be required to travel – mileage must be indicated on any documentation for vehicles used to transport personnel.
E. Travel and/or Lodging Expenses – include an explanation of why these expenses were necessary - provide supporting documentation such as travel claims or invoices.
F. Contents – include a copy of your inventory with items that are being replaced highlighted – include copies of invoices – if a replacement item has been upgraded or is a betterment, include documentation to explain why a replacement "as was" was not possible – if the University replaces an item with a betterment as a matter of choice, only the actual cost to replace "as was" is recoverable.
G. Other – include any other claimed items you feel are necessary to clarify your claim – provide copies of invoices, explanations or other documentation to support the amount claimed.
2. Prepare a spreadsheet outlining your claim.
3. Number your supporting documentation and indicate on the spreadsheet the document number(s) for each cost claimed.
4. Submit two copies of your claim and all supporting documentation to Risk Management. Please note: Claim reimbursement cannot be made on estimated costs. Any request for final payment or partial payment must have all supporting invoices and documentation unless you elect to take ACV (actual cash value) for your loss or you have reached a settlement with State Risk Management. At the discretion of State Risk Management, payment for a settlement agreement may be delayed until a substantial portion of the repair or replacement of the loss has occurred. The President of the University or other University Officer will be required to complete a "Sworn Proof of Loss" and "Release of All Claims" for any partial or final payment before reimbursement by State Risk Management and/or the reinsurer.