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  • Damage report for possible insurance claims processing

Damage report for possible insurance claims processing

The following report is to be filled out and submitted to Risk Management for all damages, including but not limited to automobile accidents and damage to state-owned property, state-owned buildings (including water damage) or personal property.

If the loss was due to criminal activity (graffiti, theft, vandalism) or involves a vehicle accident or injury, please contact NAU Police Department dispatch FIRST at 928-523-3611 to file a police report and then follow up with filing this report.

Instructions:

  • Fill out all fields as completely as possible
  • Remember to include descriptive information
  • In the event of water damage to state facilities, refer to the “WATER DAMAGE RESTORATION GUIDELINE” procedures
  • Move from one field to the next by pressing the “TAB” key or use your mouse. DO NOT PRESS ENTER or this will close and submit the form.
  • A copy of the information you enter on this form will be sent to the email address you entered after you click “SUBMIT”
  • If you have any questions or concerns about this report or the process for damaged property, please contact Risk Management at (928) 523-2009
  • If necessary, a representative from Risk Management will contact you for additional information

NAU (State-owned) Property: When property of the state (Northern Arizona University) is damaged, this online Damage Report must be completed to initiate the claim process with State Risk for reimbursement.

Personal Property: If you feel your personal property was damaged or you were injured as a direct result of University responsibility, you may file this online damage report. Any additional forms you may need to file a claim against the State will be sent to your attention. For example, an NAU employee accidentally damages your electronic equipment while repairing your residence hall room.

For more information on coverage please review the information at the Risk Management website.

 

  • Check type of report

  • Date & location information

  • NAU campus location

  • Reporting party information

  • Name * Required
  • Driver and state vehicle information

    The following information must be provided for damage to state vehicles or damage to rental vehicles used for university business
  • Home address
  • NAU department address
  • Information on state vehicle damaged

  • Describe damage to State vehicle or property: (example: windshield cracked by rock, or DELL OptiPlex GX1p Computer received water damage.)
  • Narrative

  • State property losses that are not reported to Insurance and Claims Services in a timely manner may not be covered. State property losses not reported to State Risk Management within 90 days of the incident will not be covered.
  • To be used for reimbursement.