INCIDENT REPORT

The health and safety of our team members and the communities we serve is our first priority each and every day. We implement comprehensive behavior-based safety systems across the entire enterprise and work tirelessly to build and improve through training, technology, and consistent oversight.

If you have been involved in an incident, please fill out this form and one of our Risk Claims Adjusters will contact you.

Please include accident photos, videos, and insurance cards in your form submission.

Type of Incident:(Required)

Motor Vehicle

Property

Injury

Spill

First Name:(Required)

Last Name:(Required)

Phone Number:(Required)

Email:(Required)

Date Incident Occurred:(Required)

Time Incident Occurred:(Required)

Address of where incident took place:(Required)

Include borough and intersection if applicable

Brief description of incident:

Supporting Documents (Photos, Video, Insurance Card)

Drop files here or

Max. file size: 100 MB.

Was a Risk business card provided:(Required)

Yes

IWS Truck/Equipment #:

IWS Truck License Plate:

CAPTCHA

INCIDENT REPORT

1-866-DIAL-IWS

1-866-270-9900

1-866-DIAL-IWS

1-866-270-9900