Form FR 521. Self-Insured Crash Involvement Quarterly Report - Virginia

Form FR 521. Self-Insured Crash Involvement Quarterly Report is used by self-insured entities to report crash involvement and demonstrate their financial ability to respond to claims. The primary purpose of this form is to provide the Virginia Department of Motor Vehicles (DMV) with information about the self-insured entity's crash history and financial stability.

The parties involved in this form are the self-insured entity submitting the report and the Virginia Department of Motor Vehicles (DMV). The form sections consist of fields where the self-insured entity provides crash data, financial statements, and other relevant information.

Important fields in this form include the self-insured entity's name, contact information, and a detailed report of all crashes involving its vehicles during the specified quarter. The form may also require financial statements or proof of funds to demonstrate the entity's ability to handle potential claims.

An example scenario where this form would be used is when a large company or government agency self-insures its fleet of vehicles and needs to comply with the reporting requirements set by the DMV. By using this form, the self-insured entity can provide crash data and demonstrate its financial capacity to meet potential liabilities.

When completing this form, the self-insured entity must ensure accuracy and completeness in providing crash data and financial information. It is essential to maintain sufficient funds to respond to potential claims promptly.

No specific additional documents are mentioned for this form. Related forms could include other reporting forms required for self-insured entities. An alternative could be obtaining traditional insurance policies from licensed providers instead of self-insuring.