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KAISER UNIVERSITY 20222023 ACCIDENT ONLY INSURANCE ENROLLMENT FORMUNDERWRITTEN BY AXIS SECURITY INSURANCE COMPANYPOLICY# COSBAGIIFS0002PLEASE PRINT CLEARLY FAILURE TO PROVIDE ALL INFORMATION MAY DELAY
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How to fill out request for accident only

01
Provide detailed information about the accident, including date, time, and location.
02
Include information about the parties involved, such as names, addresses, and contact details.
03
Describe the circumstances leading up to the accident and any contributing factors.
04
Provide any relevant documentation, such as photos, witness statements, and police reports.
05
Submit the request to the appropriate authority or insurance company.

Who needs request for accident only?

01
Individuals who have been involved in an accident and need to report the incident for insurance purposes.
02
Employers who need to file a workers' compensation claim on behalf of an injured employee.
03
Legal representatives who are assisting clients with filing a claim for damages resulting from an accident.
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Request for accident only is a form filed to report accidents that involved only property damage.
Drivers involved in accidents that only resulted in property damage are required to file a request for accident only.
Request for accident only can be filled out by providing details of the accident, including the date, time, location, and description of the property damage.
The purpose of request for accident only is to document accidents where only property damage occurred and to assist with insurance claims.
Information such as the date, time, location, description of property damage, and contact information for all parties involved must be reported on a request for accident only.
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