Damage report for possible insurance claims processing
following report is to be filled out and submitted to Insurance and Claims Services
for all damages, including but not limited to automobile accidents and damage
to state-owned property, state-owned buildings (including water damage) or
loss was due to criminal activity (graffiti, theft, vandalism) or
involves a vehicle accident or injury, please contact NAU Police
Department dispatch FIRST at 523-3611 to file a police report and then follow
up with filing this report.
out all fields as completely as possible
to include descriptive information
- In the
event of water damage to state facilities, refer to the “WATER DAMAGE RESTORATION GUIDELINE” procedures
from one field to the next by pressing the “TAB” key or use your mouse. DO NOT PRESS ENTER or this will close and submit the form.
- A copy
of the information you enter on this form will be sent to the email address you
entered after you click “SUBMIT”
- If you
have any questions or concerns about this report or the process for damaged
property, please contact Insurance and Claims at (928) 523-2009
necessary, a representative from Insurance and Claims Services will contact you
for additional information
(State-owned) Property: When property of the state (Northern Arizona
University) is damaged, this online Damage Report must be completed to initiate
the claim process with State Risk for reimbursement.
you feel your personal property was damaged or you were injured as a direct
result of University responsibility, you may file this online damage report. Any
additional forms you may need to file a claim against the State will be sent to
your attention. For example, an NAU employee accidently damages your electronic
equipment while repairing your residence hall room.
more information on coverage please review the information at the Insurance and Claims Services website including the Frequently Asked Questions section.
Check type of report
Date & location information
NAU campus location
Reporting party information
Driver and state vehicle information
Information on state vehicle damaged
ESTIMATED amount of loss?
Description of damaged property
State property losses that are not reported to Insurance and Claims Services in a timely manner may not be covered.
State property losses not reported to State Risk Management within 90 days of the incident will not be covered.