Get Unfallanzeige - Neufassung Ab 01082002 - Version 10 - Luk Hamburg

Filling out the Unfallanzeige is a crucial process in reporting workplace accidents. This guide provides clear and supportive instructions for users to complete the form accurately online, ensuring all necessary information is included.

Follow the steps to complete the form effectively.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the name and address of the company where the incident occurred. Make sure to include complete and accurate information.
3. Input the company number assigned by the accident insurance provider. This can typically be found in official correspondence or account summaries.
4. Select the appropriate recipient. If the responsible location is in Hamburg, ensure you mark 'Unfallkasse Nord - Standort Hamburg.' If not, select the correct location.
5. Provide the insured person's first and last name. It is vital that this information is correct and matches official documents.
6. Input the birth date of the insured person. This helps verify their identity.
7. Enter the street name and house number of the insured person’s address, along with postal code.
8. Select the gender of the insured person by marking the relevant option.
9. Indicate the nationality of the insured person.
10. Specify if the person is an apprentice. Provide the relevant answer based on their status.
11. Indicate if the insured individual is a temporary worker by checking the appropriate box.
12. Mark if there is entitlement to continued payment of wages in the event of an accident and specify the duration in weeks.
13. Provide details on the health insurance company of the insured, including name, postal code, and location. If applicable, indicate the type of insurance.
14. Record the time of the accident, including the date, hour, and minute. This is essential for processing the claim.
15. Enter the exact location of the accident, providing a detailed address including street and postal code.
16. Provide a comprehensive description of the accident, detailing how it occurred, the environment, any equipment involved, and relevant hazards.
17. List any body parts that were injured as a result of the accident.
18. Record the type of injury that the insured sustained, choosing from predefined categories.
19. Indicate if there were any witnesses to the accident and provide their names and addresses.
20. Provide contact information for the first treating physician or hospital to facilitate communication.
21. Indicate the employment status of the individual at the time of the accident, detailing their role.
22. Specify the start and end times of the work shift at the time of the accident.
23. Indicate how long the insured person has been working in their current role at the company.
24. Confirm if the person has stopped working due to the accident.
25. State whether the insured person has resumed their work.
26. Provide a contact number for follow-up inquiries related to the report.
27. Finally, review all provided information for accuracy. Once satisfied, you can save changes, download, print, or share the completed form as necessary.

Start filling out your Unfallanzeige online today to ensure your incident is reported accurately.