General Liability Incident Form Help

This application is "Incident Record" based.

This page includes all the fields of information required to complete the General Liability Notice of Occurrence report.

Unlike the OSHA Workers Comp incident data entry forms  these fields match the order of the printed form and are grouped likewise.

The “Form Assistant” does NOT complete any fields at this time Enter appropriate information in any empty fields.

All fields on the form except "User Defined Fields" are used to complete the report and are stored in your account database. You are responsible for the completeness and accuracy of the information you enter and report.

It is not necessary to complete every field to generate a report. Fields that you leave blank can be completed later. Entries can be corrected or embellished by you later.  Fields bordered in red are required in order to save the record in FROL (FirstReport Online). 

Only the latest saved version of the data is stored, not revision histories. Generated reports are not stored. They are deleted when you exit the login session.

Function

• Navigation
• Data validation
• Verification data
• Data input groups
• Buttons
• Sample  Incident form in HTML format 

Navigation

The incident record data is all entered on one web page.

• There are no "Previous" or "Next" buttons needed.
• Attempts to "back" up may cause loss of data. 
• "+" buttons display groups of data fields by topic.
• "-" hides the data fields by group.
• The "Security Log-out" 30 minute timer requires you to save your work to refresh the timer.
• If "Logged Out" by the timer on this form you may login again to access the form without losing your work. 
  • Re-enter your UserID and Password
  • Select "Save" at the bottom of the form
• There is always only one data field per row
• Context "Help" is displayed in 3 rows below the Incidents >> Reports>> Manage>> commands.
  • Click the cursor in the data entry field to have the "Help" text presented.

Data validation

There is no validation of the accuracy of your data input. There is validation of the format of the data type such as date, time or number of characters.

The required fields in red boxes are for the software system not regulation compliance.

Verification data

The first section of fields in light gray (Employer Name...) cannot be edited. They are there for you to verify that your data is being entered in the correct area of the database.

The FROL ID # is also displayed. It is..

• System generated
• Universally unique
• Can not be changed. 
• Not required by any regulation.
• Useful for recalling the record quickly

Data input groups

Will hold all the incident record specific data. This is the heart of the recordkeeping database.

• Basic Case Information
  • Report Number
    • System generated sequentially at the Employer Level for all locations
    • User edits permitted
  • Date Prepared
    • Use the MM/DD/YYYY format for best results
  • Date Of Loss
    • Use the MM/DD/YYYY format for best results
    • Keyed to by management reports
  • Time Of Loss
    • Use the HH:MM AM (PM) format for best results
  • For Information Only
    • Select the “For Information Only” checkbox to print “For Information Only – Do Not File” on the printed first report form.
    • Often used if your company pays small claims out of pocket.
  • Claim Status
    • Change to Closed, Open is the default value.
    • Searchable criteria in management reports
  • Carrier Number
    • Input manually when notified by carrier after reporting
• Agency Information
  • Self-explanatory
• Insured Information
  • Self-explanatory
• Contact Information
  • Self-explanatory
• Occurrence Information
  • Self-explanatory
• IType of Liability Information
  • Self-explanatory
• Injured / Property Damage Information
  • Self-explanatory
• InjuryInformation
  • Self-explanatory
• Witness Information
  • Self-explanatory
• Remarks
  • Self-explanatory
• Additional Remarks - Sheet 1 (101 form)
  • Will 3500 characters including spaces in the count
  • Will not be included in the "Generated PDF" report unless content was entered.
• Additional Remarks - Sheet 2 (101 form)
  • Will 3500 characters including spaces in the count
  • Will not be included in the "Generated PDF" report unless content was entered.
• Identification Code
  • Used often by carriers and employers for cost codes or management reports.
  • Pre-loadable in Setup Form
  • Not required by regulation
• User Defined Fields
  • Not required by regulation
  • Text 1 & 2 fields may be customized

Buttons

Mouse over the button to see a "Help Text" description near the top of the page.

• Show All / Hide All
  • Displays or hides all fields in all categories
• Help
  • Displays KnowledgeBase Article for this form
• Last Report Generated
  • Link to the most recent report generated in this session
  • Click to display report in new window
  • Right click mouse on link to "Save Target As" the file locally without opening
• Click here to create and email notification
  • Will create a "Mail to" email message with basic incident data included
  • To: email addresses may be pre-loaded in the Setup Form
  • Appears after record has been saved once
• Begin Transmit Process
  •  Optional feature. Visible only if activated for the UserID
  • Appears after record has been saved once
• Export Data
  • Produces a complete export of the record data to a "CSV" file
• Top Of Page
  • Auto-scrolls to top of form
• Cancel
  • Leaves the incident form. Similar to selecting "Home"
• Report Type
  • Report selection for OSHA 301 or the FROI
  • Works with the "Report" button
• Analyze
  • Optional feature. Visible only if activated for the UserID
  • Open the CPA root cause analysis tool for that record
  • Leaves the Incident record with no direct return button
• Reset
  •  Restores data to the original value last saved
• Hide
  • Hides this record from being included in management reports and logs
  • Can "Unhide" in the future using the "Edit" "Search" "Hidden" function
• Delete
  • Deletes this record and returns to "Home"
  • Can "Undelete" until midnight EST using the "Edit" "Search" "Deleted" function
• Report
  • Select type then click on "Report"
  • "Last Report Generated" will display link at top of this form
• Notes
  • Case Notes may be created for each incident record
  • Select "Notes" and you will proceed to the Case Notes form
  • Notes can be created as Pubic or Private
• Save
  • Will save edits
  • Resets Security Log-out Timer to 30 minutes
  • Returns to top of this form
  • If User is "Read-Only" the page will refresh without saving any edits
• Report History
  • An extended list of reports generated in this session prior to the "Last Report Generated"
  • Click to display report in new window
  • Right click mouse on link to "Save Target As" the file locally without opening
  • Reports will be deleted at the end of this login session