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Damage claim form?

TechGuy

Member
Does anyone have a damage claim form you'd be willing to share? I'm looking for something that will collect the obvious information, but also include a nice write up explaining to the customer that we WILL pay for damage caused by a mistake on our part, etc. Thanks for any suggestions!
 
I have a form. PM me with your e-mail and I will send. Important points.

#1. I call it an "Alleged Incident report". I don't want anyone to think we regularly encounter damage claims.
# 2. It clearly states "Completion of this report is not an admission of liability by the facility or customer."
#3 It requires the VIN so I can run a car fax. Sometimes there were prior repairs or issues that even the current owner was not aware of.
4. I require their insurance information. If I settle with them I don't want to get a claim for the same thing from theior insurance company. If the driver is not the owner I require the owner info and any payment is made to the owner.
5. It contains my disclaimer language from y signs " CUSTOMER HAS ASSUMED RESPONSIBILITY FOR LOOSE, DEFECTIVE, PREVIOUSLY DAMAGED, OR NON-FACTORY ORIGINAL ITEMS AS WELL AS UN-LOWERED ANTENNAS. "

#6 I would not include any language on the form stating what you will do . There is a place to record what the Determination / action was.
 
Earl I like the "alleged incident" and "Completion of this report is not an admission of liability by the facility or customer." Very succinctly said.
 
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