Research Corporation of the University of Hawaiʻi

Incident/Accident Report (RML-001)
The Incident/Accident Report (RML-001) is an internal form to be completed by State employees only. The reporting of incidents and accidents is considered a very important function. Use RML-001 to report all incidents or accidents that occur at a State location or resulting from a State activity/function. The incident can involve property damage, bodily injury or relay a concern that needs to be documented. Immediate completion of this form will capture the most accurate information before submitting the form to the R.M.O. This form is not to be provided to a claimant or the general public. Please note that page 4 is to be completed in the event preventative measures need to be taken. If none is needed, note “N/A”.
No liability is to be admitted by anyone involved in any accident or loss. Nor should any commitments be made to pay for any medical or other expense, even ambulance services. The State does not have any provision to pay these expenses simply because an injury or damage occurs on their property. The State Tort Liability Act makes the State responsible for payment of losses where it or its employees were negligent, and when that negligence caused the injury or damage.
ALWAYS secure the names, addresses, and phone numbers of any witnesses. This information may be invaluable if a lawsuit results from the incident/accident.
Refer to the RULES FOR HANDLING REPORT when dealing with the general public.
Examples: an employee finds their personal property missing from the desk, a person falls down on State property, or any employee receives a threatening phone call or client in the office.
When in doubt, contact the Risk Management Office at 586-0547 for instructions and/or advice.