Vehicle Details

  • Make and Model of Vehicle

  • Vehicle Registration Number

Times

  • What time did the driver start work?

  • What time did the journey start ?

  • What breaks did the driver taken?

  • Was the employee driving their normal vehicle?

  • What was the time of the incident?

Location

  • Location of the incident?
  • Type of road

  • Road Junction Type

  • Road Condition

  • Weather Conditions

  • Speed Limit

  • Traffic Density?

Approach

  • Was the driver wearing a seat belt?

  • What lights were switched on?

  • Did the driver have a clear view through the windscreen?

  • Vehicle speed?

  • How far was the driver behind the vehicle in front?

Actions

  • Own signalling?

  • Other drivers signalling?

  • Horn use

  • Braking?

  • Brake lights on other vehicles?

  • Where did the driver look before performing the manoeuvre?

  • Which mirrors did the driver check?

  • Was the driver using a hand held phone?

  • Was the driver using a hands free phone?

  • Was the driver looking at the sat nav?

  • Any other distractions?

Post Collision

  • Was the employee injured?

  • Was anyone else injured?

  • Details of damage to the company vehicle?

  • Details of damage to the third party vehicle?

  • Does the driver wear glasses?

  • Was the driver wearing glasses?

  • When did the driver last have an eyesight test?

  • Did the driver record witness details?

  • Did the driver take photographs?

  • Did the driver make a sketch of the scene?

  • Were there any passengers in own vehicle?

  • How many were there?

  • Were there any passengers in the other vehicle?

  • How many were there?

  • Were there any injuries?

  • Who's fault did the driver think it was?

  • Is the driver aware of any policies relevant to the incident?

  • Is there anything the driver could have done to avoid the incident?

Reporting

  • Was the MV accident form completed?

  • Was photo of completed accident reporting form sent to Transport & FOM?

  • Was the incident reported to the transport department?

  • Was a copy of the MV accident form given to the third party?

  • Was bump card given to other vehicle?

  • Date reported to the transport department?

  • Was the incident reported to the insurers?

  • Were photos taken and sent to Transport & FOM?

  • Date reported to the Insurers?

Signature

  • Ask the employee to sign the document on which you have recorded the interview and explain the significance of this decaleration.

  • Was this form completed via a phone call with the engineer?

  • Employee Signature if Present

  • Managers Signature

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