Utah Department of Administrative Services

Division of Archives & Records Service

School District Schedule 8 Risk Management Records

 

DISASTER PLANNING FILES (Item 8-1)

These files are used to prepare district-wide plans for action to address emergency conditions (e.g., fire, flood, earthquake, and other disasters). They include studies and evaluations undertaken by the county and the completed disaster plan.

RETENTION

Retain for 5 years after being superseded and then destroy.

SUGGESTED PRIMARY DESIGNATION

Public.

SUGGESTED SECONDARY DESIGNATION

Protected:UCA 63G-2-305 (10) (2008)

(Approved 06/97)

GENERAL LIABILITY ACCIDENT REPORT (Item 8-2)

This is a report form completed and sent to the district's insurance carrier on accidents where a student or patron was seen or treated by a medical provider (or absent for more than one-half day) or where school liability is an issue. This report includes policyholder name, address, and telephone number; accident's date, time, location, first notification, and name of person making notification; description of accident or occurrence; injured person's name, marital status, age, address, telephone number(s); nature and extent of injuries; name of doctor or hospital; probable cause of accident or occurrence; property damage; names, addresses, and telephone numbers of witnesses; name, position, and telephone number of person completing form; name of person reporting incident; name of person receiving report; date; signature of person completing report; and any remarks.

RETENTION

Retain for 5 years or until all litigation is resolved and then destroy.

SUGGESTED PRIMARY DESIGNATION

Public.

SUGGESTED SECONDARY DESIGNATION

Private:medical information, home address and telephone numbers,

(Approved 06/97)

HEALTH AND ACCIDENT INSURANCE RECORD (Item 8-3)

These are application forms completed by district employees enrolling into health and accident insurance. The original is sent to the insurer. Includes district name; specific job title; date of employment; policy number; employee name, social security number, address, birthdate, telephone number(s); beneficiary and contingent beneficiary and relationships; information on other insurance and employment; information of coverage requested; optional waiver of group insurance; listing of family members to be covered containing name, sex, birthdates, physicians names and addresses; employee's signature authorizing deductions for insurance; date; effective date and approval signature.

RETENTION

Retain until insurer changed or employee separation and then destroy.

SUGGESTED PRIMARY DESIGNATION

Private.

(Approved 06/97)

INSURANCE POLICY FILES (Item 8-4)

These are insurance policy contracts between the district and private insurers.

RETENTION

Retain for 18 years after expiration of policy and settlement of all claims and then destroy.

SUGGESTED PRIMARY DESIGNATION

Public.

(Approved 06/97)

LIABILITY RISK MANAGEMENT CASE FILES (Item 8-6)

These case files document the reporting, investigation, and settlement of liabilility claims filed against the district.

RETENTION

Retain for 10 years after case closed and then destroy.

SUGGESTED PRIMARY DESIGNATION

Public.

SUGGESTED SECONDARY DESIGNATION

Protected:UCA 63G-2-305 (23) (2008)

(Approved 06/97)

MEDICAL AND DENTAL INSURANCE CLAIM FILES (Item 8-7)

These files contain medical and dental claims for school district employees. They are used to track claims and for cost analysis of insurance programs.

RETENTION

Retain for 3 years after all claims settled and then destroy.

SUGGESTED PRIMARY DESIGNATION

Public.

SUGGESTED SECONDARY DESIGNATION

Private:UCA 63G-2-302 (1)(a) (2008)

(Approved 06/97)

SAFETY SELF-INSPECTION REPORTS (Item 8-8)

These self-inspection survey reports are completed annually by each school on forms provided by the State Division of Risk Management. There are three separate required survey forms including the general survey, cafeteria/kitchen survey, and playground survey. The purpose of this report is to identify potential hazards within school buildings and on school sites. If the school completes these reports, it may receive a 15 percent discount on its insurance premium after a follow-up survey has been conducted. These safety inspections are submitted to the District Office, accumulated, and sent to the State Risk Management for evaluation by April 1st. These survey forms includes district name, date, school, name of person completing survey, and responses to survey questions (yes, no, not applicable). The State Division of Risk Management retains the record copy for twelve years.

RETENTION

Retain for 1 year or until superseded and then destroy.

SUGGESTED PRIMARY DESIGNATION

Public.

(Approved 06/97)

STUDENT INJURY REPORT (Item 8-9)

This report is completed by school personnel immediately after a severe student injury and a copy is then submitted to the State Child Injury Prevention Program. An injury is considered severe if it requires the loss of a half day or more of school or warranted medical attention or was required to be reported by district policy. The form includes child's name, parent's name, district name and number, and school name and number; student's sex, birthdate, and grade; accident's date and time; number of days absent; action taken by school and parent; nature of injury; area affected; contributing factors; period; surface; location; activity; equipment; injury description; signature of person making report; title code; and principal's signature. The state's copy is retained for five years.

RETENTION

Retain for 7 years and then destroy provided there is no pending claim or litigation and then destroy.

SUGGESTED PRIMARY DESIGNATION

Private.

(Approved 06/97)

WORKER'S COMPENSATION EMPLOYEE'S FIRST INJURY REPORT (Item 8-10)

This report must be submitted to the Industrial Commission in connection with UCA 35-1-97 and 35-2-103 (1993). The forms are prescribed by the Commission to report any work-related fatality, injury, or any occupational disease resulting in medical treatment, loss of consciousness, loss of work or restrictions of work. The report is completed for cases involving an employee who is injured on the job and/or meets one of the criteria specified in UCA 35-2-103 (1993). The district completes, signs, and mails the report to the Industrial Commission as prescribed by law. The report must be filed with the Commission within (7) days of the occurrence. The Commission maintains their copy for seven years.

RETENTION

Retain for 3 years or until final report filed and then destroy.

SUGGESTED PRIMARY DESIGNATION

Private.

(Approved 06/97)