All lawfully enrolled students are insured for the duration of the academic year and according to the concluded policy terms and conditions against: Physical accidents: on the regular, direct way to and from Howest or any other location where an activity takes place within the framework of school activities; during teaching and evaluation activities; in all the rooms of Howest where students are present for their studies; during journeys and stays at home and abroad, organised by Howest and/or in the framework of exchange programmes, whether or not during holidays, from the moment of departure until the moment of return; during the implementation of all assignments given by Howest (including traineeships). civil liability during an assignment within the framework of the school activity. guarantee of goods entrusted (by third parties and on the occasion of traineeships) If a company/traineeship location requires proof of insurance within the framework of a school assignment or a traineeship assignment, an insurance certificate can be delivered to the company/traineeship location. Fill in the report form Questions? verzekeringen [at] howest.be (verzekeringen[at]howest[dot]be) Algemene diensten Marksesteenweg 58 - 8500 Kortrijk 056/24 12 90 Guarantees and policies Below follows an overview of the applicable guarantees and policies. Civil Liability and/or legal assistancePhysical accidents to and from school or traineeship locationPhysical accidents during school activity/traineeshipTravel AssistanceMaterial damage to own car (journey in the course of employment)Howest student in BelgiumSchool activity45.262.21245.262.21245.262.212//Unpaid traineeship45.262.21245.262.2126.569.874//Howest student abroadStudy trip (incl. private)45.262.21245.262.21245.262.21245.052.701to be applied for/Study trip (incl. private) USA/Anglo-Saxon/ non-European countries45.262.21245.262.21245.262.21200.000.000to be applied for/Study (incl. private)45.262.21245.262.21245.262.21200.000.000to be applied for/Unpaid traineeship (incl. private)45.262.21245.262.2126.569.87400.000.000to be applied for/Paid traineeship (incl. private) remuneration > expense allowance45.262.21245.262.212To be insured by traineeship site00.000.000to be applied for/VolunteersIn the event of a Howest activity45.262.21245.152.21445.152.214//You can report physical accidents using the online form below.The form can only be sent if all mandatory fields (marked with an *) are filled in and if a scan of the medical certificate is uploaded (see at the bottom of this form). After completing the form, click on the 'send' button.If the student does not yet have a medical certificate in which the doctor certifies that the injuries are the result of the accident, a blank medical certificate can be downloaded. This form must be completed and signed by the attending physician.Upon receipt of the online declaration from the student, a Howest employee reports the accident to Ethias within a reasonable period of time on the basis of the form filled in by the student and the accompanying medical certificate. The Howest employee sends additional information to the student’s Howest e-mail address regarding the settlement of the claim/file as well as a digital printout of the declaration. General information Campus at which the person affected is enrolled - Select -Howest Bruges - SpoorwegstraatHowest Bruges - RijselstraatHowest Bruges - Sint-JorisstraatHowest Bruges - SportinnovatiecampusHowest Kortrijk - Kortrijk weideHowest Kortrijk - Campus BudaHowest Oudenaarde Study department Date and time of the accident Date and time of the accident: Date Date and time of the accident: Time Date and time of reporting the accident to the student administration desk Date and time of reporting the accident to the student administration desk: Date Date and time of reporting the accident to the student administration desk: Time Type of accident Physical Material of a student of an insured person (e.g. staff member, student,...) of a third party It concerns an accident at the traineeship company Traineeship company Name Address Postal code City/Town/Municipality Country Start date traineeship End date traineeship Schedule of the person affected on the day of the accident Function on the traineeship The student First name Name Language Dutch English French Other language Other language Address Postal code City/Town/Municipality Country Date of birth Phone number Identification number Social Security (= national registry number) IBAN Bank account for refund With which insurance company is the student insured for his/her civil liability (family insurance, car, motorcycle, etc.)? Insurance company Policy number File number The accident Where (neighbourhood or type of place) was the person affected situated when the accident happened? e.g. maintenance area; office; hospital; car park; sports hall; motorway; etc. Identify the general activity (type of work) or task (in the broad sense) that the injured person was performing when the accident occurred for example: processing products, storage, care, assistance to a person or persons, training, office work, purchase, sales, etc. or the secondary activities of these different activities, such as installation, detaching, maintenance, repair, etc. Identify the specific activity that the injured person was performing when the accident occurred for example: filling the machine, working with hand tools, driving a means of transport, gripping, lifting, rolling an object, carrying a load, closing a box, walking, sitting down, etc. And the objects involved for example: tools, machine, equipment, materials, objects, instruments, substances, etc. What events deviating from the normal course of work led to the accident? for example: electrical failure; explosion; fire; overflowing, tilting, leaking, gassing, bursting, falling or collapsing object; abnormal starting or functioning of a machine; loss of control of a means of transport or an object; slipping or falling of a person; improper action; incorrect movements; surprise; fright; assault; being assaulted; etc. List all events AND the objects that played a part in the accident for example: tools, machinery, equipment, materials, objects, instruments, substances, etc. Third parties Is there a third party involved in the accident? Please give all information available to you regarding the other parties involved in the accident. First name Name Language Dutch English French Other language Other language Name of the legal representative in case of a minor Address Postal code Gemeente Country Phone Function Date of birth With which insurance company is he/she insured for his/her civil liability (family insurance, car, motorcycle, etc.)? Insurance company Policy number File number Vehicle brand License plate Chassis number Driver’s name Driver’s first name Language driver Dutch English French Other language Other language Address Postal code City/Town/Municipality Country Witness Fill in the details of possible witnesses. Do not always answer "no" to the question whether there were witnesses. We know from experience that a seemingly trivial accident can turn into a liability case after several months. At that moment, the presence of surveillance data and witnesses is essential in order to optimise your defence. You can fill in the details of three witnesses. Is there a witness? First name Name Language Dutch English French Other language Other language Address Postal code City/Town/Municipality Country Function Reporting authority In case an official report has been drawn up, the insurance company will usually ask for a copy of that official report. Have particulars been taken down by a reporting authority? Yes No Not known By whom? Number of the official report Date of the official report Medical certificate Has medical care been provided at the school/traineeship company? Yes No Not known Date and time Date and time: Date Date and time: Time Capacity of the caregiver Description of the care given Has medical care been given by an external doctor? Yes No Not known If so, date and time If so, date and time: Date If so, date and time: Time Name and first name of the external doctor Address Postal code City/Town/Municipality Country Nature of the injury Place of the injury Do you have a medical certificate? An accident with physical damage can only be reported if you have a medical certificate filled in by a doctor. You must attach a scanned copy of the medical certificate as an annex. Upload medical certificate Leave this field blank