Spot Survey Checklist / Document

Vehicle No-

Policy no-

Deputed by-

1. Date of accident

2. Time of accident

3. Place of accident. If vehicle found shifted from

the place of accident, then pls give reason for
shifting.
4. Cause of Loss-

5. Starting place of the vehicle

6. Destination of the vehicle

7. Name of Road where accident happened

8. Type of Load carried at the time of accident

9. Weight of load carried at the time of accident

10. If no load carried then where the last load
emptied.
11. Name of driver
12. Driver License details
13. Injury to driver

14. Injury to other occupants

15. No. of persons sitting in the vehicle at the time
of accident
16. Details of third party injury- yes/no, details

17. Details of FIR , yes/no, FIR number

18. Police station details
19. Copy of RC----YES/NO
20. Copy of DL---YES/NO
21. Copy of Load Challan----yes/no
22. Reason of not providing the documents. Please
take a photo of the person present along with
vehicle at spot.