Insurance Information

The State of Maine government is self-insured for its vehicular liabilities.  Please direct any questions regarding insurance coverage or this accident to:

	Risk Management Division
	85 State House Station
	Augusta, ME  04333-0085

	Toll Free within U.S. & Canada 1-800-525-1252
	FAX (207) 287-4008

Accident / Incident Report
to
Risk Management Division
85 State House Station
Augusta, Maine 04333-0085
1-800-525-1252 

IMPORTANT!

The DRIVER of a State vehicle involved in an accident / incident is responsible for obtaining and reporting all facts and information.  In the event of an accident / incident, please use the following instructions as a guide.  If you have any questions, please call Risk Management Division at the toll-free number above.

AT THE SCENE 
 
1.  Take immediate action to prevent further damage.

2.  If anyone is injured, call 911 for an ambulance and assist in the prevention of further injury.  DO NOT MOVE THE INJURED UNLESS NECESSARY.

3.  You must contact the police if anyone is injured or if the total property damage exceeds $1000. You can call the police by dialing 911 on any cell or regular phone.  

4.  Be sure to obtain all facts and information about the accident / incident.  Obtain the names and addresses of all witnesses before they leave the scene.

5.  DO NOT argue or admit blame for the accident.  Be courteous.  Show your license and registration papers willingly.

REPORTING PROCEDURES 
  
1.  YOU MUST CALL Risk Management Division and your supervisor IMMEDIATELY if there is ANY injury or if there is SERIOUS property damage.  (The toll-free number listed above is answered 24 hours a day & 7 days a week.)

2.  DO NOT discuss the accident with anyone or sign any papers for anyone unless they are your supervisor, a police officer, or a properly identified Risk Management Division investigator.

3.  This form must be completed in its entirety (please print in ink) and sent to Risk Management Division within 24 hours of the accident.  All vehicle incidents must be reported including minor property damage.  

RMD 039 18R 1002                                                1/05