Reporting an Injury or Accident
The person in charge must report all injuries and accidents to the Insurance Department. Serious accidents should be reported immediately by phone, email, or other electronic communication. Follow up with written reports. See
Work-Related Injury Reporting for injuries and accidents involving employees.
Notice requirements
The person in charge at the location must:
- Notify parents/guardians of any minors/students of injuries to their minors/students; locations should maintain a complete and current Emergency Card for each minor/student
- For non-employee accidents, complete the
Incident/Accident Report (Non-Automobile) and send it to the
Insurance Department
- For employee accidents, refer to Section 5.2.8
- Report all serious injuries immediately by phone, email, or other electronic communication to the
Insurance Department,
Office of the Legal Counsel, and
Communications Department
- In addition, report all serious injuries involving schools immediately by phone, email, or other electronic communication to the
Department of Catholic Schools at 213-637-7300
- In addition, report all non-employee serious injuries involving cemeteries or mortuaries to the Cemeteries and Mortuaries Department at 323-524-7691
- Notify appropriate governmental entities (e.g., the Department of Building and Safety, Department of Public Health)
- Relay all press inquiries to the
Communications Department for a response.
Forms to CompleteWhen an employee is injured, the matter is handled through
workers' compensation. See
Section 5.2.8. Contact the
Insurance Department at the archdiocese for assistance related to handling and reporting the injury.
When a student in a school or religious education program or a participant in any youth activity sustains a minor injury, complete the
Notice to Parent/Guardian of Injury to Minor. For serious injuries or accidents, complete the
Incident/Accident Report (Non-Automobile), and for school students, complete the Myers-Stevens
Student Insurance Claim Form as well. See
Student Accident Insurance.
When a volunteer is injured, the person in charge must complete the
Incident/Accident Report (Non-Automobile) and submit it to the Insurance Department. Make a copy for record-keeping.
When a third person (e.g., a visitor, parent/guardian, or bingo player) is injured, the person in charge must complete the
Incident/Accident Report (Non-Automobile) and submit it to the Insurance Department. Make a copy for record-keeping.
When a volunteer, student, or third person slips/trips and falls at the location, also complete the
Slip/Trip & Fall Accident Evaluation Checklist.
If the injury or accident involves a vehicle, the person in charge must complete the
Accident Report - Auto and Truck and submit it to the Insurance Department. If the injury or accident involves an archdiocesan vehicle, the person in charge must also complete the
DMV SR 1 and submit the forms to the Insurance Department. The Insurance Department will fill out the following sections of the DMV SR 1: vehicle owner [leave date of birth blank], insurance company name, policy number, policy period and policy holder name.