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