HDVI Accident Card.pdf
Accident scene checklist
Immediately following an accident, do the following:
Call Police: Call 911 and request that an accident report be completed.
Ensure safety: Make sure you and others involved are safe. Set emergency signals to prevent further damage or injury.
Contact company: Contact your dispatcher or safety manager to report the accident to your company.
Document the scene: Take photos, videos, and exchange information with other drivers involved.
Only speak with your company representatives, the police, or your insurance provider about the accident.
Report to your insurance: You may report claims 24 hours a day, 7 days a week, 365 days a year.
• HDVI Fleet Portal Submit your claim at https://login.hdvi.com
• Email Submit your claim to claims@hdvi.com
• Phone Report your claim to 708-816-4384
Scan the QR code or visit
the HDVI claims page
to download the form
fillable PDF document.
Do NOT:
Admit fault or say “I’m sorry.” This can be taken as an admission of guilt.
Overreact: Try your best to remain calm.
Witness information
Name
Address
Phone
Email
License plate no. & State
Vehicle Description
Name
Address
Phone
Email
License plate no. & State
Vehicle Description
Accident Data
| Date | (MM/DD/YYYY) |
|---|---|
| Time | (AM/PM) |
| Location | |
Injuries/Fatalities
Persons injured
Fatalities
Treatment needed
Who? Where were they taken?
Investigation
| Was accident investigated by police? | |
|---|---|
| Department | |
| Officer | Badge # |
| Citation issued? |
Vehicle no. 2
| Type | Make |
|---|---|
| Model | Year |
| Driver | |
| Address | |
| License Plate No & State | |
| Owner | |
| Address | |
| Phone | |
| Insurance Company | |
| Policy # | |
| Towed? | |
| Wrecker Service Info | |
| Damage to Vehicle |
Vehicle no. 3
| Type | Make |
|---|---|
| Model | Year |
| Driver | |
| Address | |
| License Plate No & State | |
| Owner | |
| Address | |
| Phone | |
| Insurance Company | |
| Policy # | |
| Towed? | |
| Wrecker Service Info | |
| Damage to Vehicle | |