D-2 Report of Personal Injury or Loss of Life

Form Template

The D-2 Report of Personal Injury or Loss of Life app is a personal injury claim report.

5,000 Companies save time and money with GoCanvas

Lumen Logo Post Consumer Brands Logo Saluda Hill Landscapes Logo Te3co Logo Two Men and a Truck Logo VIP Lighting Logo
Created by: Team GoCanvas
Type: Claims
Language: English
Country: United States of America

This form can be submitted to the Deputy Commissioner of Maritime Affairs as soon after the incident as possible. The app details information regarding the personal injury case, such as: vessel information, injured/missing person information, and injury/death details. This app makes it easy to fill out information about any accident that involves damages, bodily injury, and/or death. Work-related injuries and illnesses are more common in maritime environments, and, when injuries occur, can be more serious. This app is important for documenting damages, vessels where injury and illness occurred, and the nature of incidents leading to injuries or death.

  • Signature Capture
  • Image Capture
  • Conditional Fields
  • Submission Editing
Read More
  • iPhone
  • iPad
  • Android
  • Windows
Read More
  • Quickbooks
  • Salesforce
  • Google Docs
  • Dropbox
Read More
*The Capterra SoftwareAdvice ​and GetApp logos are a service mark of Gartner, Inc. and/or its affiliates and is used herein with permission.*

Don't take our word for it...

“I’m not a tech guy and I was able to pick this thing up in probably an hour, and actually start to build apps. I’ve done them over lunch when I’ve gotten frustrated with a process that didn’t exist in our company. So for non tech people who’ve got a problem, the support here is awesome and I’d recommend it to anybody, not just in our industry.”

Dave Kramer, PennLine Service

Connect with one of our experts today.

We’ll help you put together the right solution for your needs.

Contact Us