Property Loss & Auto Claims

All claims and insurance are managed and procured through the Office of Insurance & Risk Management. It is our goal to recover losses on all liabilities as a form of asset protection.

DID YOU KNOW?

While conducting university business, Collision and Liability insurance coverage are included in the car rental rate via the State Contract. Make sure to place a copy of the State of Georgia Government Vehicle Liability Insurance Identification Card in the vehicle.

Auto Accident Report

Auto Accident Reporting

University Owned Vehicles and Rentals through Statewide Contract

All GSU-owned and leased vehicles are covered under the State of GA’s vehicle insurance program. Click here to view Georgia State University Policy On Driving for University Business and University Vehicle Guidelines. Click here to view Georgia Hands-Free Law FAQs. Click here to view Driver Safety Tips.

Please follow the instructions below when involved in an accident involving a GSU owned vehicle or a vehicle rented through the statewide contract:

Dial 911 if emergency medical care is needed
Contact the local police department from the scene to obtain a police report
- Georgia State University police should be called for all accidents on GSU property and can be reached at 404-413-3333. All auto accidents of GSU property call 911
Do not admit fault
Complete the Auto Accident Reporting Form located in the glove box of the University vehicle. Also, report all accidents immediately to your Supervisor. Always use the Auto Accident Report Form to record the particulars of the accident.
Report the accident to NetClaims by dialing 877-656-7475 and provide information from the Auto Accident Report Form:
- Georgia State University’s agent number: 7206 (also located on the Auto Accident Report Form)
- Obtain names and addresses of witnesses
Submit the completed Auto Accident Report Form within 24 hours to the Office of Insurance & Risk Management.

Personal Vehicles Driven on GSU business

Personal vehicles used for GSU business should have a copy of the State Liability Insurance Card in the car. The State only provides auto liability coverage when you cause damage to another’s vehicle or property while on GSU business. The State does not cover physical damages to personal vehicles. Report the accident to your auto insurance carrier.

Click here to view State of Georgia Government Vehicle Liability Insurance Identification Card

Please contact Lajanda at [email protected] or 404-413-9546 with any further questions.

General Incident Report Form

This General Campus Safety Concern Report Form is for reporting general incidents only. For example, slip & fall, tripping, or reporting a hazard. All incidents must be reported within 24 hours to the Department of Safety & Risk Management.
General Information
Department*
Name of Person Reporting Incident*
Title
Email*
Phone*
Fax
Incident Information
Date of Incident*
Date Format: MM slash DD slash YYYY
Time of Incident
Address of Incident
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Campus
Building
Affected Rooms
Affected Floors
Incident Description
Has area been secured?
- Yes
- No
If no, what is being done to secure area?
Has the incident been reported to the police?
- Yes
- No
If yes, please provide Police Report #
Witness Information
Witness 1
First Last
Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Witness 2
First Last
Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Upload Photo

Certificate of Insurance

Requests to Evidence GSU Insurance Coverage

Participants of University-sponsored activities or events are often required to provide the host venue or sponsoring organization with a certificate of insurance to evidence coverage. Please use the following form to request GSU coverage:

Certificate of Insurance Request Form

Fine Arts Coverage

Use this form below to request coverage for art exhibits. This will cover works of art for faculty, staff, and students.

Please contact Lajanda at [email protected] or 404-413-9546 with any further questions.

Art Exhibit Coverage Request Form

Department Information
Today's Date:*
Date Format: MM slash DD slash YYYY
Department Name:*
Email:*
Phone:*
Exhibit Information
Exhibit Name:*
Installation Date:*
Date Format: MM slash DD slash YYYY
Removal Date:*
Date Format: MM slash DD slash YYYY
Insurance Start Date:*
Date Format: MM slash DD slash YYYY
Insurance End Date:*
Date Format: MM slash DD slash YYYY
Exhibit Value:*
Transient Insurance Needed?*
- Yes
- No
Explain:
Exhibition Location:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Upload Art Exhibit Schedule
File

Transient State Property

Transient State Property (Off-Campus Equipment Use)

Removing GSU Property

Whenever University-owned property is removed from campus, please complete the mandatory off-campus equipment use form and submit to the Office of Insurance & Risk Management and Accounting. This form expires on August 31st and MUST be completed and approved annually. Please contact Lajanda Casey [email protected] or 404-413-9546 with any further questions.

Off-campus Equipment Use Form

Off-Campus Equipment Use Form

All college/department equipment assigned to an employee that is utilized away from the normal institutional environment must be reported and available for inventory. The individual requesting the Off-campus use of equipment will complete the form. The Dean/Department Chair/Designated Representative will approve the use before the equipment leaves the University campus.

College/Department Name*
Equipment Record
GSU Decal #*
Description*
Original Cost:*
From (Bldg & Room#)
To (Sch#/Dept.#/Bldg#/Room#)
Requestor*
First Last
Title*
Requestor's Email*
Purpose
Date Requested*
Date Format: MM slash DD slash YYYY
Use Period From Date*
Date Format: MM slash DD slash YYYY
Use Period To Date*
Date Format: MM slash DD slash YYYY
Address at which equipment is to be used*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Requestor Signature:*
Certify Requestor's Signature*
- I certify that I am the above signed requestor, that the signature is mine.
Chair/Supervisor/Dean's Office Designee Signature:*
Designee's Email
Certify Chair/Supervisor/Dean's Office Designee Signature:*
- I certify that I am the above signed requestor's Chair/Supervisor/Dean's Office Approver Designee, that I approved the Off-campus Use.

Off-campus Equipment Return Form

Off-Campus Equipment Return Form

When the equipment is returned, the approved individual will complete this form, and the College/Department Property Coordinator will certify that the equipment has been returned to campus, indicate the date returned and the location the equipment is being placed.

College/Department Name*
Equipment Record
GSU Decal #*
Description*
Original Cost:*
Use Period From Date*
Date Format: MM slash DD slash YYYY
Use Period To Date*
Date Format: MM slash DD slash YYYY
Address at which equipment was used*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Purpose:
Return Individual*
First Last
Title*
Return Individual's Email:*
Date Returned:*
Date Format: MM slash DD slash YYYY
Received back on-campus location:*
College/Department Property Coordinator:
First Last
Title
Coordinator's Email
College/Department Property Coordinator Certify*
- I hereby certify that the above equipment has been returned to the assigned University location in satisfactory condition.

Additional Information

Georgia Department of Administrative Services FAQs

Our Staff

Frederick Bibbs
Director, Insurance & Risk Management
Tel: 404-413-9548
[email protected]

Lajanda Casey
Insurance & Risk Coordinator
Tel: 404-413-9546
[email protected]

Vacant
Administrative Specialist, Administrative
Tel: 404-413-9545

Crystal White
Occupational Health and Safety Officer
Tel: 404-413-9547
[email protected]

Office Hours

Monday-Friday,
8:30 a.m.-5:15 p.m.

Fax: 404-413-9550
Email: [email protected]

Office Location

Citizens Trust Building
75 Piedmont Avenue
Suite 506
Atlanta GA 30302

Emergency Numbers

Emergencies: 911
Campus Police: 404-413-3333

Mailing Address

Georgia State University
Department of Insurance & Risk Management
P.O. Box 3961
Atlanta GA 30302-3961

Insurance and Risk Management

Claims and Insurance

Property Loss & Auto Claims

Auto Accident Report

Auto Accident Reporting

Property Damage Report

Property Damage Report

Property Damage Report Form

General Information

Incident Information

Incident Description

General Incident Report Form

General Incident Report Form

General Information

Incident Information

Witness Information

Certificate of Insurance

Certificate of Insurance

Art Exhibit Coverage Request Form

Upload Art Exhibit Schedule

Transient State Property

Transient State Property (Off-Campus Equipment Use)

Off-campus Equipment Use Form

Off-Campus Equipment Use Form

Off-campus Equipment Return Form

Off-Campus Equipment Return Form

Additional Information

Additional Information

Our Staff

Office Hours

Office Location

Emergency Numbers

Mailing Address

Main navigation

Property Loss & Auto Claims

Auto Accident Reporting

Property Damage Report

Property Damage Report Form

General Information

Incident Information

Incident Description

General Incident Report Form

General Information

Incident Information

Witness Information

Certificate of Insurance

Art Exhibit Coverage Request Form

Upload Art Exhibit Schedule

Transient State Property (Off-Campus Equipment Use)

Off-Campus Equipment Use Form

Off-Campus Equipment Return Form

Additional Information

Our Staff

Office Hours

Office Location

Emergency Numbers

Mailing Address