Accident / Incident Cost Calculator

General Information

Site / Project:

Country:

Business:

LTI Report No:

Name of Person Involved:

Name of Person Completing Form:

Dealing with Accident / Incident (immediate action)

Rate
Category Time (Hrs)/ Unit (Currency) Cost

First Aid Treatment 0 0 0

Taking injured person to hospital/home 0 0 0

Making the area safe (Total time taken by all persons involved) 0 0 0

Putting-out fires 0 0 0

Immediate staff downtime (e.g. work activitiy stopped) 0 0 0

Investigation of accident / Incident

Category Time (Hrs)/Unit Rate (Currency) Cost

Staff time to report and investigate accident / incident 0 0 0

Meetings to discusss the accident / incident 0 0 0

Time spent with local regulatory inspector 0 0 0

Consultants fees to assist company in investigation 0 0 0

Expenses of the visit from Head office to assist investigation 0 0 0

(e.g. flight, accommodation etc.)

Getting Back to Business

Category Time (Hrs)/Unit Rate (Currency) Cost

Assessing/rescheduling work activities 0 0 0

Recovering work/production (including staff costs) 0 0 0

Cleaning up site and disposal of waste, equipment, products, etc 0 0 0

Bringing work up to standard (e.g. product reworking time/costs) 0 0 0

Repairing and damage faults 0 0 0

Hiring or purchasing tools, equipment, plant, services, etc 0 0 0

Business Costs

Category Time (Hrs)/Unit Rate (Currency) Cost

Salary costs of injured person 0 0 0

Salary costs of replacement workers 0 0 0

Lost work-time (people waiting to resume work, delays, reduced 0

productivity, effect's on other peoples productivity etc.

Overtime costs 0 0 0

Recruitment costs for new staff 0 0 0

Contract penalties 0 0 0

Cancelled and/or lost orders 0 0 0

Action to Safeguard Future Business

Category Time (Hrs)/Unit Rate (Currency) Cost

Reassuring customers 0 0 0

Providing alternative sources of supply for customers 0 0 0

Sanctions and Penalties

Category Time (Hrs)/Unit Rate (Currency) Cost

Compensation claim payments 0 0 0

Solicitor's fees and legal expenses 0 0 0

Staff time dealing with legal cases 0 0 0

Fines and costs imposed due to criminal proceedings 0 0 0

Increase in insurance premiums 0 0 0

Other

Category Time (Hrs) Rate (Currency) Cost

1 0

2 0

3 0

Total

Time Spent Cost

Totals 0 0