| Aspect | Details |
|---|---|
| Purpose | Report workplace accidents causing death, serious injury, or dangerous occurrences to trigger official investigation |
| Filing Requirement | All employers must report accidents within 4 hours (fatal) or 48 hours (non-fatal) to authorities |
| Non-Compliance Penalty | ₹50,000 fine + ₹1,000 daily charges + up to 3 months imprisonment |
| Form Validity | 5 years retention for audit compliance and investigation reference |
Why Form OSH-2 is Critical:
Immediate accident reporting is legally mandatory and protects both employers and workers. Delayed or false reporting leads to severe penalties and complicates worker compensation claims. This form triggers official investigations that prevent future accidents and ensure workplace safety improvements.
ACCIDENT REPORT FORM
PART A: ESTABLISHMENT DETAILS
Company Name: ______________________________________
Factory/Office Address: ____________________________
Pin Code: _____________ District: ___________________
Occupier Name: ____________________________________
Contact Number: ___________________________________
Email Address: ___________________________________
PART B: INCIDENT INFORMATION
Date of Accident: _________________________________
Time of Accident: _________________________________
Location Within Premises: __________________________
Weather Conditions: ______________________________
Shift Details: __________________________________
PART C: VICTIM DETAILS
Employee Name: ____________________________________
Age: _______ Gender: □ Male □ Female □ Other
Department: _____________________________________
Job Title: ____________________________________
Experience in Role: _____ years _____ months
PART D: ACCIDENT DESCRIPTION
Nature of Accident: ________________________________
□ Fatal □ Serious Injury □ Minor Injury □ Dangerous Occurrence
Body Parts Affected: _______________________________
Equipment/Machinery Involved: _______________________
Witness Names: ___________________________________
PART E: INJURY CLASSIFICATION
Medical Treatment Required: □ Yes □ No
Hospital Name: ___________________________________
Doctor’s Name: ___________________________________
Expected Recovery Time: ____________________________
Work Days Lost: __________________________________
PART F: CAUSE ANALYSIS
Surface Causes:
Root Causes:
PART G: CORRECTIVE ACTIONS
Immediate Actions Taken:
Preventive Measures Implemented:
PART H: ATTACHMENTS CHECKLIST
□ Accident site photographs from multiple angles
□ Medical certificate and treatment records
□ Witness statements with signatures and dates
□ Equipment inspection reports if machinery involved
□ Safety training records of affected employee
□ Previous incident reports if pattern exists
PART I: DECLARATIONS
Reported By: _____________________________________
Designation: ___________________________________
Signature: ____________________________________
Date: ________________________________________
When workplace accidents happen, time and accuracy are the most crucial aspects. Organizations must respond instantly, capture every detail, and stay compliant with strict reporting details, while focusing on worker safety.
Keka turns this complex process into a streamlined, transparent system that ensures nothing slips through the cracks.
From small facilities to multi-state operations, Keka empowers organizations to respond faster, investigate deeper, and prevent future accidents—without the administrative burden.
Any injury preventing work for 48+ hours, causing permanent disability, or requiring hospitalization must be reported using Form OSH-2.
Yes, digital submission is accepted through Shram Suvidha and state portals but maintain physical documentation for inspector visits.
Submit amended Form OSH-2 through same portal clearly marked as revision with updated investigation findings and evidence.