Automobile Loss — for claims involving a university-owned or rented/leased vehicles
To File a Claim
- Complete Form RMA-001 (PDF) and Driver’s Report of Accident (PDF)
- Photograph all damage (wide-angle; including license plate):
- UH vehicle
- Other vehicle involved
- Other property damage
- Submit Form RMA-001 and photographs to the UH Office of Risk Management within 5 working days of the accident.
- If the UH vehicle involved is a rental, attach a copy of the car rental agreement and travel authorization documents.
Claim Payments to UH
Claim payments are made by RMO-DAGS on a reimbursement basis:
- Two estimates are required; repair at the lower estimate
- Only one estimate is required if less than $1,000
- $500 deductible will be applied to preventable losses
Claim Payments to Others (e.g. Rental Car)
- Claim payments are made by RMO-DAGS
- RMO-DAGS will investigate, determine liability, and secure release of all claims with rental agency or third party
Reasons for Denial of Liability Coverage
- Unauthorized use
- Illegal activity (e.g. driving under the influence)
- Not within the scope of employment
Property — for losses to university-owned property
To File a Claim
- Complete and submit Form RMP-001 (PDF) to UH the Office of Risk Management
- For claims involving theft or burglary: a police report or police report number must be submitted
- If RMO-DAGS determines your claim is covered, you will receive instructions on how to receive reimbursement
- Copy of UH inventory listing or purchase documents to establish existence and ownership
- Copy of paid invoice and payment for replacement item
Claim Payment
Claim payments are made by RMO-DAGS on a reimbursement basis.
Examples of Paid Claims
- Computer stolen from a room
- Water leaks onto equipment
- Windstorm damage
Examples of Claims Denied
- Petty cash
- Equipment left in the field
- Missing inventory
- Employee’s personal property
Third Party Claims — to file a claim for bodily injury and/or property damage against the University of Hawaiʻi
To File a Claim for Damage or Injury
- Complete and sign Form 67. (PDF)
- Your form must be signed by the owner of the property or the injured person, or by a parent in case of a minor.
- Attach supporting documentation (please refer to the Instructions).(PDF)
- Submit claim form and supporting documentation to the UH Office of Risk Management.
- Please keep copies of everything you submit to UH. Documents will not be returned.
Additional Information
- The State of Hawaiʻi Risk Management Office (RMO-DAGS) will adjust your claim on behalf of the University, up to their statutory limit of $10,000.
- RMO-DAGS will send an acknowledgement letter to you, identifying the name of the adjust handling your claim and their contact information.
- The adjuster will initiate an investigation with the assistance of the UH department involved.
- RMO-DAGS takes approximately 60–90 days to conclude the investigation and make a decision on your claim. In the meantime, you should mitigate your damages and keep your expenses related to the loss at a minimum.
- You have two (2) years from the date of the incident to finalize your claim. If you are not satisfied with the outcome of your claim and you decide to sue, a lawsuit must be filed within the two (2) year period, otherwise the statute of limitations will prevent your claim from being considered or settled.
For more information, visit the FAQ section of the RMO-DAGS website.
Major Property Loss — procedures and guidelines for major property losses
Property Claim Damage Information
The State of Hawaiʻi Risk Management Office (RMO-DAGS) is the point of contact for any large property loss, or disaster, in order to coordinate claims against the property insurance carrier and/or with State Civil Defense. UH Office of Risk Management (ORM) will forward UH claims to the State RMO. UH Campuses are responsible for tracking property losses and completing claim forms. Initial reports and claim forms should be submitted to UH ORM within 5 working days after the loss.
Major Property Loss Forms
- Campus Damage Assessment Form (DOC)
- Campus Damage Assessment Q&A (DOC)
- FEMA Applicant<92>s Benefits Calculation Worksheet (XLS) (RM-ABCW)
- Instructions (PDF)
- Force Account Labor Summary Record (XLS) (RM-FALSR)
- Instructions (PDF)
- Force Account Equipment Summary Record (XLS) (RM-FAESR)
- Instructions (PDF)
- Material Records Summary (XLS) (RM-MSR)
- Instructions (PDF)
- Rented Equipment Summary Record (XLS) (RM-RESR)
- Instructions (PDF)
- Contractor Work Summary Record (XLS) (RM-CWSR)
- Instructions (PDF)
- Other Extra Expenses Summary Record (XLS) (RM-OEESR)
- Instructions (PDF)
- Personal Property Damage Summary Record (XLS) (RM-PPDSR)
- Instructions (PDF)
Incidents/Accidents — reporting incidents resulting in bodily injury or property damage
In the event an incident occurs that results in damage or loss to property, or which results in injury to third parties (visitors, guests, or in some cases students) a risk management incident report (PDF) must be completed and filed with the Office of Risk Management to record the incident.
