INTERSTATE®
A SAFE WORKPLACE
SAFETY
MANUAL
Revised April 2013
2/9/2016 2:43 PM
TABLE OF CONTENTS
SAFETY POLICY STATEMENT............................................................................................ 3
COMPANY SAFETY STATEMENT ....................................................................................... 4
SAFETY PHILOSOPHY ........................................................................................................ 4
SAFETY COMMITTEE ......................................................................................................... 5
DISCIPLINARY PROCEDURES ............................................................................................ 5
ALCOHOL & CONTROLLED SUBSTANCES ......................................................................... 6
SAFETY TRAINING ............................................................................................................. 7
SAFETY TESTING GUIDELINES ......................................................................................... 8
TEAM MEMBER SAFETY INVOLVEMENT & RESPONSIBILITIES ..................................... 8
SAFETY RULES & POLICIES ............................................................................................... 9
FIRE PROTECTION & PREVENTION ................................................................................ 11
OFFICE SAFETY ................................................................................................................ 11
SAFE LIFTING GUIDELINES ............................................................................................. 12
DRIVING A COMPANY VEHICLE ...................................................................................... 13
RULES & POLICIES ................................................................................................... 13
CELL PHONE/TEXTING POLICIES ......................................................................... 14
CONCEALED WEAPON POLICY ............................................................................. 15
AUTO ACCIDENT PROCEDURES ...................................................................................... 16
ACCIDENT INVESTIGATION PROCEDURES .................................................................... 17
WORKER’S COMPENSATION: ACCIDENT REPORTING & RECORD KEEPING ............... 18
CASUALTY INSURANCE CLAIMS PROCESS SUMMARY ................................................... 19
INSURANCE CONTACTS ................................................................................................... 21
2
SAFETY POLICY STATEMENT
Interstate Batteries’ (Interstate) safety program is based on the belief that each one of our
team members is entitled to a safe and healthy working environment. Our Safety Program
is designed specifically for the protection of our team members and customers. All team
members are directed to make safety and loss control a matter of equal or more
importance to any other Company activity.
I believe that our team members know our safety guidelines and policies are for their
protection. The goals that we have set for our Safety Program can only be achieved
through a cooperative effort between all team members and leadership. Safe working
habits and an awareness and thorough knowledge of all safety rules and policies are a
condition of your employment with any Interstate-affiliated company. Each team member
must be familiar with every rule and policy set forth and must abide by them. These rules
and policies will be enforced just as any other Company policy. Failure to comply can
result in reprimand, suspension or termination.
All team members are encouraged to suggest ways that will help us maintain safe
working conditions and to inform their supervisor of any unsafe working conditions.
Through our joint participation, we can prevent accidents. But only you, the individual,
can make safe work practices a habit.
Accidents cause pain and suffering, wasted time and money, and could even cost
someone their life. Interstate is committed to providing you a safe place in which to
work, as well as safe vehicles to operate. We require your assistance and participation in
keeping it that way. We will never ask you to commit an unsafe act, drive an unsafe
vehicle or violate a safety rule. We therefore expect the same from you.
Our policy toward safety is in no way limited to the rules that follow, and any unsafe
practices, whether listed here or not, will be addressed. Let’s work together to make
Interstate a safe place to work!
Scott Miller
President
Throughout this manual “the Company,” “Interstate,” “IBI”, “Interstate Batteries,” “we,”
or “our” refers to Interstate Batteries, Distributor Operations, Inc., Interstate Battery
System of Canada, Inc., Battery Acquisition & Development, Inc., San Francisco Battery,
Inc., Interstate Battery System of Hawaii, Inc., D.-T. DO, Inc., All Battery Centers, Inc.,
Retail Acquisition and Development, Inc., and PowerCare and Service Solutions, Inc.
The words “employee(s),” “team member(s),” “you,” “your,” and “you’re” refer to
persons employed in any manner (including part-time, full-time, internships, etc.) by the
Company.
3
COMPANY SAFETY STATEMENT
The success of any safety program is based on concern, cooperation and commitment.
The leadership and team members of the Company have a genuine concern for safety: for
team members, their families, and our customers. Safety is a priority for the Company.
Without cooperation, this concern cannot be translated into an effective safety program.
The Company recognizes that safety is everyone’s responsibility. Each team member has
a direct relationship to safety, and the emphasis is on cooperation between the Company
and team members for maximum safety efforts.
Finally, to ensure a continuing and improving safety program, there must be
commitment. The Company confirms its commitment to safety by the leadership’s
involvement on a day-to-day basis with the needs and direction of the Safety Program.
The commitment is reflected in an increasing amount of emphasis on the development of
the Company’s Safety Program.
We are committed to providing a safe environment in which team members can work.
Your cooperation is needed. Safety is not simply numbers and statistics and it never
reflects complacency. Everyone within the Company is responsible for the prevention of
accidents and injuries.
SAFETY PHILOSOPHY
1. Accidents resulting in personal injury and damage to property represent needless
human and economic waste and must be prevented by every reasonable means
available.
2. Most personal injuries can be prevented. The protection of people’s lives demands
a complete and continuing effort to eliminate or reduce exposure of team
members to accidental injury or to conditions adversely affecting their health.
3. Managers and supervisors at all levels have, as a primary responsibility, the safety
and well-being of all persons who report to or are assigned to them.
4. Each team member has an important place in the safety effort and must assume a
responsibility for full cooperation in the measures taken for loss prevention.
5. Safety and efficient production go hand in hand; it is our belief that good safety
performance is clear evidence of a good operation.
6. Each team member must develop and maintain a safety-conscious attitude toward
his/her workplace.
7. All applicable state and provincial laws apply and are in no way superseded by
the terms of this Safety Manual.
4
SAFETY COMMITTEE
The Safety Committee is a group of individuals, including Company team members and
other professionals, that meets together on a regular basis to review various safety issues.
The responsibilities of the Safety Committee are to:
1. Analyze safety issues that concern the Company and its team members;
2. Provide recommendations for policy changes, program modifications and
education;
3. Review accident data.
DISCIPLINARY PROCEDURES
The Company is committed to do whatever it can to provide a safe workplace for all
team members. To achieve this end, the Company provides on-the-job training and
retraining as well as Worker’s Compensation Insurance.
Responsibilities, however, go beyond Company leadership. Team members are
responsible for obeying all Company rules and working in such a manner as to
prevent injury to themselves or fellow workers.
The Company’s intent is not to discipline team members who are involved in nonpreventable accidents. Our position is to work with those team members toward
making them safer workers. Disciplinary procedures are established so that managers
and supervisors know how to deal with any team members who disregard Company
policies and rules. The Company will not permit people to be negligent and
repeatedly injure themselves or others.
Should the cause of an accident, whether an injury occurred or not, be attributable to
a team member’s violation of Company safety procedure, immediate termination may
result. The Company, at its sole and absolute discretion, may take the following
actions for safety violations in the order identified or in any other manner deemed
appropriate:
1. First Offense: The team member will be given a written reprimand and safety
instruction regarding the unsafe action or actions that led to the incident.
Notification of such will be placed in his/her team member file.
2. Second Offense: Any continued unsafe actions will be followed by additional
personal safety training and a written reprimand, including the possibility of
termination.
3. Third Offense: Cause for probation or immediate termination.
5
ALCOHOL & CONTROLLED SUBSTANCES
The Company requires a drug-free, healthy and safe workplace. Alcohol, drug or other
controlled-substance abuse by team members will impair their ability to perform properly
and will have serious adverse effects on safety, efficiency and the productivity of other
team members and the Company as a whole.
A “controlled substance” is any drug, narcotic, inhalant, hallucinogen, barbiturate,
amphetamine, mixture or compound not prescribed by a licensed physician for the
legitimate treatment of a specific team member’s medical condition.
Using or being under the influence* of drugs on the job may pose serious safety and
health risks. To promote this goal, team members are required to report to work in
appropriate mental and physical condition to perform their jobs in a satisfactory manner.
While on Company premises, using Company equipment and/or taking breaks or meal
periods, no team member may use, possess, distribute, sell, or be under the influence of
alcohol or illegal drugs. The legal use of prescribed drugs is permitted on the job only if it
does not impair a team member’s ability to effectively perform the essential functions of
the job in a safe manner so as not to endanger other individuals in the workplace.
Violations of this policy may lead to disciplinary action, up to and including immediate
termination of employment, and/or required participation in a substance abuse
rehabilitation or treatment program. Such violations may also have legal consequences.
All team members are subject to drug testing at random intervals at the Company’s
discretion. Those team members who operate Company owned or leased vehicles or who
have safety sensitive positions may be subject to more frequent testing at the Company’s
discretion.
The Company may request team members to submit to drug testing as a result of finding
alcohol, drugs or other controlled substances on Company premises and/or in Company
owned or rented vehicles, or if a team member exhibits erratic, suspicious or bizarre
behavior.
Team members with questions or concerns about substance dependency or abuse should
discuss these matters with their manager or supervisor or any appropriate individual
within the Talent Group. Talent Group can provide assistance or referrals to appropriate
resources in the community. Team Members may also voice their concerns anonymously
through www.ReportIt.net or by calling 1-877-788-5463.
Team members with drug or alcohol problems that have not resulted in, and are not the
immediate subject of, disciplinary action may request approval to take unpaid time off to
participate in a rehabilitation or treatment program, and such program may be covered in
whole or in part through the Company’s team member health insurance plan (regular fulltime team members who have elected health coverage).
6
For leave to be granted, a team member must perform the following steps:
 Abstain from use of the problem substance;
 Abide by all Company policies and rules relating to conduct in the workplace;
 Submit to random, but repetitive drug screenings upon returning to work for a
period of not less than six (6) months;
 Refrain from causing the Company any undue hardship.
*NOTE: “Under the influence” is defined as having any detectable illegal substance
and/or alcohol in a team member’s system.
The Company Fitness for Duty Program shall apply to all team members employed
by Interstate Battery System of Canada, Inc. or housed in Canadian operations.
The Fitness for Duty Program supersedes and replaces the Alcohol, Controlled
Substances & Safety Testing Guidelines.
SAFETY TRAINING
Safety training is not a one-time occurrence, but involves continual education,
communication and accident and injury prevention efforts.
Repeated disregard for safety will not be tolerated and may result in disciplinary action
up to and including termination.
The Company is committed to quality safety training in order to positively develop an
attitude in all team members to recognize and embrace safety awareness.
7
SAFETY TESTING GUIDELINES
The Company may require various tests to be performed, both pre and post employment.
The following tests may be required, dependent upon your job position and
responsibility.
 Potential team members are subject to drug tests and, depending upon the job
applied for, may be subject to an MVR check.
 If an MVR check reveals the existence of DUI conviction, the Company will
either refuse to hire a potential team member, or on a limited basis, hire the
individual subject to multiple conditions and/or restrictions.
 As required by job classification, the following may be obtained from a team
member upon hire: DOT physical; Class B Commercial Drivers License.
 The Company will run an annual MVR Check on all team members who drive
regularly on Company business.
 Approval of use of Company vehicles for personal use is contingent upon an
acceptable MVR check of the requesting team member. Costs associated with
MVR checks may be the responsibility of the Team Member.
 A potential or current team member in a job that requires driving on Company
business cannot have three or more tickets for moving violations during the
immediately preceding three-year period (whether on the job or not).
TEAM MEMBER SAFETY INVOLVEMENT & RESPONSIBILITIES
The leadership of the Company recognizes the success of any Company-wide endeavor is
largely dependent upon all team members. Therefore, team members are expected to:





Utilize established avenues to solicit and receive comments, information and
assistance where safety and health is concerned;
Perform their job duties in a manner that is safe for themselves, as well as those
around them;
Adhere to the safety and health regulations established by federal, state and local
agencies;
Adhere to all aspects of the Company’s safety program;
Take part in the implementation of the safety program in his or her respective
area.
Your continued employment is contingent upon you recognizing and abiding by the
safety and health policies, procedures and rules established as part of the safety program.
The Company may also from time to time reward team members for specific acts of
safety awareness or for suggestions that improve overall safety effectiveness.
8
SAFETY RULES & POLICIES
Team members are expected to be familiar with and abide by all of the following
guidelines. The Company’s safety policy is in no way limited to the guidelines listed
here. Any unsafe practices will be addressed, whether or not they are listed in this policy.
Failure to comply with any safety regulation is considered cause for disciplinary action
up to and including termination.
1. Report every on-the-job injury, regardless of its nature or extent, to your manager
or supervisor and complete a First Report of Injury Form within 24 hours of the
incident. Failure to do so could delay appropriate remedial measures and lead to
other injuries and increased expense as well as governmental fines and penalties.
2. Wear safety equipment, such as eye protection, when in a designated area.
3. Wear steel-toe shoes when handling batteries.
4. No persons other than the driver are allowed on forklifts at any time.
5. Team members operating forklifts must wear seat belts at all times.
6. Team members operating forklifts are required to have current forklift
certification, renewable every three (3) years.
7. Always work clear of suspended loads. If a load is being moved overhead where
you are working, move aside until clear of the area.
8. Do not remove, displace, damage, destroy or carry off any safety device,
safeguard, notice or warning.
9. Do not attempt to lift anything that may be too heavy or bulky for your physical
capacity. If in doubt, get help.
10. Maintain good housekeeping in all work areas. Clean up waste materials
correctly, promptly and completely after a job is completed.
11. Never use a box, bucket, chair, shelf, etc., as a ladder. Use only approved step
stools or ladders.
12. Observe and obey all safety signs and procedures in any area where you are
assigned to work.
13. Report all damaged or faulty equipment to your manager or supervisor. Repairs
should only be made by authorized persons.
14. Unauthorized persons may not make electrical or mechanical repairs or
adjustments on equipment.
9
15. Do not hang articles from building fire sprinkler system, insulated steam lines,
eyewash stations, or waterlines.
16. Do not block or obstruct an aisle, passageway, hallway, stairway, escape route or
exit. Do not use these areas for storage.
17. Do not block access to electrical panels.
18. Do not block or cover fire extinguishers, fire alarms, eyewash stations or sprinkler
heads.
19. Approach doors slowly and open them with caution; someone may be on the other
side.
20. When using stairs, do not carry loads so large that the view of the stair treads is
obscured. Keep one hand free for the handrail.
21. Keep stairs clear of all objects. Pick up anything you find on the stairs and
properly dispose of it.
22. Know where the fire extinguisher is in your area, how to use it, and for what types
of fires it is rated.
23. Do not use gasoline or other flammable solvents to clean floors, walls, your skin
or other surfaces.
24. Do not run power cords, computer cables or telephone wires across walkways.
This creates a tripping hazard.
25. Do not use extension cords as a substitute for permanent electrical wiring. The
only exception to this are “fused” multi-outlet strips, which are “UL listed.” If
extension cords are necessary for short-term use, use only heavy-duty cords.
26. Wipe up all spilled liquids immediately to prevent falls on polished floors. Place
some type of warning marker near wet spots until dry.
27. Do not remove labels from chemical containers unless the containers are empty
and have been thoroughly cleaned. You may use clean, empty containers for other
materials if proper new labels are affixed.
28. Clean machine parts using only approved solvents and parts-washing baths
specifically designed for such use. Use with adequate ventilation. Dispose of
waste solvents in a manner consistent with federal or local regulations.
29. Practical jokes and horseplay can lead to accidents and will not be tolerated.
10
FIRE PROTECTION & PREVENTION
1. Mount fire extinguishers on a wall in compliance with OSHA guidelines where
they are easy to find and use.
2. Do not remove fire extinguishers from their assigned stations.
3. Do not return a fire extinguisher to its holder if it has been used or if the seal has
been broken. Notify your manager or supervisor immediately.
4. Report the use of any fire extinguisher to a manager or supervisor.
5. Know how to properly operate fire extinguishers.
6. Do not smoke or use open flames inside the building or where “NO SMOKING”
signs are posted.
OFFICE SAFETY
The Company recognizes the necessity for all team members, even those who do not
work in areas perceived as dangerous, to make safety a priority. All team members
are expected to follow specific standards as outlined by the property guidelines at
their worksite. The following general guidelines will help guide team members in
making safe decisions at work:
1. Arrange desks and file cabinets so that drawers do not open up into aisles or
walkways. Close desk and file drawers when not in use.
2. Place heavier items and folders towards the bottom of file cabinets, so the
cabinets do not become top-heavy
3. Make sure all paper cutters are locked when not in use.
4. Keep all wastebaskets, briefcases, and other objects out of walkways and aisles.
Keep floors clear of loose objects that could become tripping hazards.
5. Do not climb on chairs or other office furniture. If you must reach something, use
a stepladder.
6. When using approved UL labeled extension cords or multi-outlet strips, make
sure cords do not run across walkways, under carpets. In addition, periodically
inspect all plugs and discontinue use of any equipment with faulty wiring or
plugs.
11
SAFE LIFTING GUIDELINES
The Company is committed to your safety and well being. The American Red Cross has
developed guidelines concerning safe practices in lifting objects. Please follow their
guidelines as outlined below.
1. When a large or heavy load must be moved to another location, first inspect the
route over which the object will be moved to make sure that there are no
obstructions or spills that could cause slipping or tripping injuries. If the path is
not clear, take a different route.
2. Inspect the object to be moved to determine how it should be grasped or if there
are any sharp edges, slivers or other things that could cause injury. If it is wet or
greasy, wipe it dry so it will not slip. If the object is too heavy or bulky to be
handled by one person, seek help.
3. When lifting an object, use the following techniques:

Spread feet comfortably apart, one alongside and one behind the object.

Keep your back straight, nearly vertical if possible.

Keep elbows and arms in, holding the object close to your body.

Grasp the object securely.

Tuck in your chin.

Keep body weight directly over feet.

Lift smoothly by straightening your legs.

Reverse the procedures when lowering an object.

When changing direction while carrying an object, never twist. Turn the
entire body, including your feet.
4. Seek assistance when necessary. Use mechanical lifting devices such as
handcarts, dollies, overhead hoists, forklifts and cherry pickers as necessary.
5. When carrying loads with other workers, always give adequate warning of any
action on your part, such as dropping your end of the load. Keep in step, making
the load easier to handle.
12
DRIVING A COMPANY VEHICLE
RULES & POLICIES
1. Observe all laws and regulations when operating any Company-owned or
Company-leased vehicles (“Company vehicle”).
2. Seat belts should be worn in all vehicles and must be worn if state law requires it.
3. The Company’s policy on handling team member traffic violations is as follows:
A. One violation within three-year period: A defensive driving class is suggested;
B. Two violations within three-year period: Team member is placed on written
probation and will have semi-annual MVR checks;
C. Three or more violations: The appropriate disciplinary action will be taken, up
to and including termination.
4. All accidents and traffic violations will be a significant part of evaluations.
5. Company vehicles borrowed for personal use may be driven only by the approved
team member driver and are contingent upon an acceptable MVR check of the
requesting team member. Costs associated with the MVR may be the
responsibility of the Team Member.
6. Non-authorized personnel (non team members including, but not limited to,
spouses, children, vendors, business associates, former team members) are
prohibited from driving Company vehicles.
7. Team members are responsible for the general maintenance of Company vehicles
that they regularly drive, including general care and reporting of any maintenance
issues.
8. Team members are responsible to follow the “GOAL” safe backing procedure,
which requires that they “Get Out And Look” before backing, to ensure adequate
clearance on every side of the vehicle.
9. Team members are required to allow at least eight to ten seconds of clear
following distance between their vehicles and the vehicles in front of them.
10. Team members are required to drive at or below the posted speed limit or at a
speed that is safe for the road conditions.
11. Cars should always remain locked when they are parked in the lot/garage. Keys
should not be left in the car. Valuables should be kept out of sight.
For information on the Company’s policy on cell phone use, see DRIVING A
COMPANY VEHICLE CELL PHONE/TEXTING POLICIES.
For information on the Company’s policy on weapons, see the CONCEALED WEAPON
POLICY.
13
CELL PHONE/TEXTING POLICIES
Cell phones are extremely popular in our fast-paced world and can improve productivity.
But, when combined with driving, they can make the roadway a dangerous place. Team
Members are expected to adhere to this policy and follow the guidelines when using cell
phones in a vehicle. Please note that certain jurisdictions have passed laws making it
illegal to use a cell phone while a vehicle is being operated. Be aware of the laws in your
area.
1. Bring your vehicle to a complete stop before placing calls. Plan to make your
calls before you begin your trip or when you are stopped at a stop sign, red light
or otherwise stationary. Do not dial your phone while your vehicle is moving.
2. Use a hands-free device. A number of hands-free wireless phone accessories are
readily available. Take advantage of an installed, mounted device or a speaker
phone accessory. If you don’t have a hands free device, don’t use your cell phone
while operating a vehicle on Company business.
3. Position your wireless phone within easy reach where you can grab it without
removing your eyes from the road. If you get an incoming call at an inconvenient
time (or if you don’t have a hands free device), let your voice mail answer it for
you.
4. Suspend conversations during hazardous driving conditions or situations. Let the
person with whom you are speaking know you are driving; if necessary, suspend
the call in heavy traffic or hazardous weather conditions. Rain, sleet, snow and ice
can be hazardous, but so is heavy traffic. As a driver, your first responsibility is to
pay attention to the road.
5. Do not take notes or look up phone numbers while driving. If you are reading an
address book or business card, or writing a “to do” list while driving a vehicle,
you are not watching where you are going. It’s common sense. Don’t get caught
in a dangerous situation because you are reading or writing and not paying
attention to the road or nearby vehicles.
6. Do not engage in stressful or emotional conversations that may be distracting.
Stressful or emotional conversations and driving do not mix! They are distracting
and even dangerous when you are behind the wheel of a vehicle. Make people
you are talking with aware you are driving and, if necessary, suspend
conversations that have the potential to divert your attention from the road.
7. Texting or emailing while driving a Company vehicle is prohibited.
As with all other policies, failure to comply with the cell phone usage policy could
result in disciplinary action, up to and including termination.
14
CONCEALED WEAPON POLICY
The carrying of any weapons onto Company property, including vehicles leased or
owned by the Company, whether concealed or otherwise, is strictly prohibited.
“Weapon” means any device or object capable of causing serious bodily harm or death to
another person, including, but not limited to, handguns, shotguns, rifles, automatic, semiautomatic or other firearms and/or knives with blades more that three (3) inches in length.
The rule applies even if the team member is licensed under any applicable state concealed
handgun law to carry a concealed weapon.
The Company reserves the right to conduct searches or inspections of Company property
and premises where it is deemed necessary to determine whether a team member is in
possession of any type of weapon. Searches may be conducted at the Company’s
discretion at any time without prior announcement. Any such search shall comply with
all applicable laws and/or regulations specific thereto. A team member who refuses to
cooperate with a search or inspection may be terminated. Any team member who is
aware of a violation of this policy should report the violation immediately to his or her
manager or supervisor.
Any team member who reports to any Company location carrying a weapon is subject to
disciplinary action up to and including termination.
15
AUTO ACCIDENT PROCEDURES
1. Make sure there is a fully stocked Accident Reporting Kit in your Company
vehicle at all times.
2. Completely gather all the information in the kit (at the time of the accident, if
possible) and have your manager or supervisor submit an Interstate Batteries
Auto Accident Report to the Insurance Administrator within 24 hours. This
form may be found on Intercom on the Casualty Insurance Center Page.
3. Contact your manager or supervisor immediately following the accident.
4. Steps to follow in case of an accident:
A. STOP: Turn off ignition. Do not smoke.
B. PROTECT: Guard the scene from further damage.
C. CALL: Notify a law officer and emergency personnel if personal injury is
involved. Cooperate with the authorities if notified.
D. OBTAIN: If possible get names, phone numbers and addresses of anyone
involved in or witnessing the accident. Also get insurance information
from anyone involved with the accident.
E. AVOID: Do not accept responsibility or discuss the accident except with
a law officer, your supervisor or a Company insurance agent.
5. Submit completed Auto Accident Report (next page) to
accident.reports@ibsa.com.
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ACCIDENT INVESTIGATION PROCEDURES
The leadership of the Company accepts the responsibility for minimizing losses due to
unsafe practices by promptly and accurately investigating all accidents whether or not an
injury occurs. Accurate information, properly used, leads to prevention of repeated or
similar incidents and reduced costs.
Accident investigation is a vital part of our safety program and is designed to prevent or
control unsafe practices. The information obtained in a thorough investigation will assist
us in determining why an accident occurred and then give us a basis for taking corrective
action. The investigation must include a written report.
The following information is important to the investigation: who was involved, where the
incident took place, when it occurred, the nature of the injury, any property damage that
might have occurred, and a complete description including a statement from any
eyewitnesses.
All team members are required to report any of the following to their immediate manager
or supervisor:

Accidents/incidents with injury/illness of any magnitude (including first-aidrelated cases);

Accidents/incidents resulting in property or equipment damage of any
magnitude;

Any near-miss incidents that could potentially have resulted in injury/illness or
property damage.
17
WORKER’S COMPENSATION: ACCIDENT REPORTING &
RECORD KEEPING
When an accident or injury occurs, promptly and accurately report it and keep a record of
it. This will enable the Company to determine the cause of an accident and also to spot
any trends that may be developing regarding certain types of injuries. This information
makes it possible to develop corrective plans and programs to reduce and prevent
recurrence.
Employer’s First Report of Injury
To ensure that any medical cost arising from a work-related injury is paid in a timely
manner and that team members receive all applicable benefits, a Workers Compensation
First Report of Injury must be completed pursuant to applicable provincial or state law
and filed with the Talent Group. Failure to report in a timely manner may result in
governmental penalties and fines.
The Company’s policy regarding the filing of Worker’s Compensation First Report of
Injury is as follows:
1. All reports will be completed and filed within 24 hours of notification of an
injury. The Workers Compensation First Report of Injury form may be found on
Intercom under Forms → Team Member Information, and, when completed,
should be submitted or faxed to Talent Group.
2. The Worker’s Compensation Commission requires that all cases involving more
than one day of lost time be reported. Copies are to be filed with the applicable
State/Provincial Worker’s Commission and the insurance carrier, with one copy
retained for Company records. Any lost time should be reported to the Talent
Group immediately.
Complete a Worker’s Compensation First Report of Injury even for minor injuries
requiring only in-house first-aid treatment. It is not necessary to file such reports
with the Worker’s Compensation Commission or the insurance carrier, but they
must be sent to the Talent Group and will be useful in determining trends in minor
accidents and in follow-up treatment.
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CASUALTY INSURANCE CLAIMS PROCESS SUMMARY
Claim
Type
Claim
Description
Team member
injured during
the scope of
their job
regardless of
location
Workers
Comp
Auto
(NOTE: An Auto
Accident Form
must also be
filed for
employees
injured while
driving a
companyowned vehicle
or a vehicle
rented by
Interstate for
business)
Company-owned
or vehicle rented
by Interstate for
business is
involved in an
accident that
results in bodily
injury and/or
property damage
(NOTE: A
Workers Comp
Notice of First
Injury must
also be filed for
injured team
members)
General
Liability
Claims by a third
party against
Interstate for
injury or property
damage not
involving a
company-owned
vehicle or a
vehicle rented by
Interstate for
business
What To Do After an
Accident
Claim Report
Form
1. Immediately obtain the
appropriate medical care
for the injured team
member
2. Secure the injury scene to
prevent injury to another
team member
3. Determine if there were
any witnesses (both team
members and non-team
members) and obtain
statements
4. Take pictures of the scene
5. Gather appropriate
information
6. Report claim within 24
hours (or next bus. day)
1. Go to Intercom
2. Go to the
Casualty Insurance
Center under Help,
Security & Safety.
3.Click on Workers
Compensation 1st
Report of Injury
under Accident
Reporting Forms.
1. Turn off ignition, set brake,
turn on flashers
2. Communicate calmly and
with empathy to others
involved in the accident
but never admit liability
3. If there are any injuries,
immediately call 911
4. Secure the scene and
locate witnesses
5. Take pictures
6. Gather information listed
on Accident Reporting
Card (copy available on
Intercom) located in the
glove box including
witness statements
7. Report claim within 24
hours (or next bus. day)
1. Communicate calmly and
with empathy to others
involved in the accident
but never admit liability
2. If there are any injuries,
immediately call 911
3. Secure the scene and
locate witnesses
4. Take pictures
5. Gather information
including witness
statements
6. Report claim within 24
hours (or next bus. day).
1. Go to Intercom
2. Go to the
Casualty Insurance
Center under Help,
Security & Safety.
3. Click on Auto
Accident Report
under Accident
Reporting Forms.
1. Go to Intercom
2. Go to the
Casualty Insurance
Center under Help,
Security & Safety.
3. Click on General
Liability Accident
Report under
Accident Reporting
Forms.
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How to File Claim
1. Fax to Compliance
Coordinator, or
2. Scan and e-mail to
compliance.coordinator
@ibsa.com
For Additional
Information
Nancy King
Home Office
nancy.king@ibsa.com
972-715-6660 (work)
469-374-6113 (fax)
E-mail the completed
form as an attachment
to:
1. accident.reports
@ibsa.com
and
2. Others in your group
who should also be
notified
Patrick Fletcher
Home Office
pat.fletcher @ibsa.com
972-715-6790 (work)
972-455-6008 (fax)
E-mail the completed
form as an attachment
to:
1. accident.reports
@ibsa.com
and
2. Others in your group
who should also be
notified
Patrick Fletcher
Home Office
pat.fletcher @ibsa.com
972-715-6790 (work)
972-455-6008 (fax)
Claim
Type
Claim
Description
What To Do After an
Accident
Claims by
Interstate for
property damage
not caused by a
company-owned
vehicle or a
vehicle rented by
Interstate for
business
1. Assess the damage
2. Notify authorities if
necessary (e.g.,
vandalism, breaking &
entering, etc.)
3. Secure the scene to
protect the property from
further damage and keep
a record of expenses
4. Take pictures
5. If possible, set the
damaged property aside
for examination by the
insurance company
6. Prepare a list and value of
the damaged property
(Note: Typical deductible
is $10,000)
7. Report claim within 24
hours (or next bus. day).
Property
Claim Report
Form
1. Go to Intercom
2. Go to the
Casualty Insurance
Center under Help,
Security & Safety.
3. Click on Property
Loss Notice under
Accident Reporting
Forms.
20
How to File Claim
For Additional
Information
E-mail the completed
form as an attachment
to:
1. accident.reports
@ibsa.com
and
2. Others in your group
who should also be
notified
Patrick Fletcher
Home Office
pat.fletcher@ibsa.com
972-715-6790 (work)
972-455-6008 (fax)
INSURANCE CONTACTS
Type of Claim
Contact /Company
Phone Number
Fax Number
Workers Comp
Nancy King Interstate
nancy.king@ibsa.com
972-715-6660
469-374-6113
Automobile
Pat Fletcher
972-715-6790
accident.reports@ibsa.com
972-455-6008
General Liability
Pat Fletcher
972-715-6790
accident.reports@ibsa.com
972-455-6008
Property
Pat Fletcher
972-715-6790
accident.reports@ibsa.com
972-455-6008
All claims must be reported within 24 hours of occurrence except for severe injuries
(e.g., fatalities, head traumas, spinal cord injuries, amputations, serious burns), which
must be reported immediately.
All applicable state and provincial laws apply and are in no way superseded by the
terms of this Safety Manual.
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