Incident Report (New Zealand)

An Incident Report in New Zealand records the hazards, risks, controls, or incident details for a workplace activity to support a safe system of work under the Employment Relations Act 2000.

WorkSafe New Zealand is the primary regulator for workplace health and safety in New Zealand, established under the WorkSafe New Zealand Act 2013. WorkSafe NZ has wide powers to investigate workplace incidents, issue improvement notices and prohibition notices, and prosecute PCBUs and officers for breaches of the HSWA 2015. Officers of a PCBU — including company directors and senior managers — have personal due diligence duties under section 44 of the HSWA 2015.

Section 56 of the HSWA 2015 imposes a duty on PCBUs to notify WorkSafe NZ as soon as practicable after becoming aware of a notifiable event — which includes notifiable injuries or illnesses (such as in-patient hospitalisation, amputation, serious head or eye injury, or loss of consciousness), notifiable incidents (near misses that expose a person to serious risk), and workplace deaths. Failing to notify WorkSafe NZ of a notifiable event is a breach of the HSWA 2015 and can result in infringement fees or prosecution.

Beyond WorkSafe NZ notification, workplace incident reports are essential for supporting Accident Compensation Corporation (ACC) claims. The Accident Compensation Act 2001 establishes New Zealand's no-fault ACC scheme, which provides cover for work-related personal injuries including medical treatment, weekly compensation (up to 80% of pre-injury earnings), rehabilitation, and lump-sum independence allowance for permanent impairment. A completed incident report supports the ACC claim process by documenting the circumstances of the injury.

Internal incident reports also form the basis of workplace health and safety investigations under the HSWA 2015, helping PCBUs identify hazards, assess risks, and implement corrective actions consistent with their risk management obligations. The Employment Relations Act 2000 and the Health and Safety Representatives provisions of the HSWA 2015 give health and safety representatives and workers the right to participate in hazard identification and incident investigation. The Privacy Act 2020 governs how personal information about injured workers is collected, stored, and used in incident reports. The forms-legal.com Incident Report (New Zealand) template meets the requirements of the HSWA 2015 and supports both WorkSafe NZ notification and ACC claim processes.

Section 56 of the Health and Safety at Work Act 2015 requires PCBUs to notify WorkSafe New Zealand as soon as practicable after a notifiable event. Section 44 of the HSWA 2015 imposes personal due diligence duties on officers of a PCBU, including company directors. Sections 30 to 36 of the HSWA 2015 set out the risk management obligations of PCBUs — including the duty to identify hazards, assess risks, and implement control measures. Accurate incident reports demonstrate compliance with these obligations and support a due diligence defence if WorkSafe NZ investigates.

A New Zealand Workplace Incident Report must be completed immediately after any workplace incident under the Health and Safety at Work Act 2015 (HSWA 2015). Specific circumstances requiring completion of an incident report include the following.

Notifiable events requiring WorkSafe NZ notification under section 56 of the HSWA 2015: workplace deaths; notifiable injuries or illnesses (in-patient hospitalisation, amputation, serious head or eye injury, serious burns, degloving, spinal injury, loss of consciousness, or acute respiratory illness requiring treatment); and notifiable incidents (near misses that expose a person to serious risk from an unplanned or uncontrolled release of energy, for example an explosion, structural collapse, or vehicle rollover). WorkSafe New Zealand must be notified immediately by the fastest available means — typically phone — followed by written notification within 48 hours for deaths and serious injuries.

ACC claims for work-related injuries: any work-related personal injury covered by the Accident Compensation Act 2001 should be documented in an incident report to support the injured worker's ACC claim. ACC cover includes medical treatment costs, weekly compensation, and rehabilitation support. The incident report provides ACC with the factual record needed to assess the claim.

Non-notifiable incidents and near misses: even where a HSWA 2015 notification is not required, PCBUs should complete an internal incident report for all incidents — including near misses and dangerous situations that did not result in injury — to satisfy their hazard identification and risk management duties under sections 30–36 of the HSWA 2015. Property damage incidents should also be recorded to support insurance claims.

Regulatory and legal proceedings: if WorkSafe NZ investigates an incident, the incident report is a key document. If prosecution follows under the HSWA 2015, the incident report may be used as evidence in the District Court of New Zealand. Accurate, contemporaneous incident reports demonstrate that the PCBU took its health and safety obligations seriously and may support a due diligence defence under section 44 of the HSWA 2015.

Section 44 of the Health and Safety at Work Act 2015 requires officers of a PCBU to exercise due diligence, including taking steps to verify that the business has appropriate incident recording and reporting systems. WorkSafe New Zealand can request incident records during an inspection or investigation under Section 170 of the HSWA 2015.

A New Zealand Workplace Incident Report that satisfies the requirements of the Health and Safety at Work Act 2015 and supports ACC claims under the Accident Compensation Act 2001 must include the following key elements.

Incident identification: the date, time, and precise location of the incident within the workplace (including address, department, specific area such as loading dock or production floor). The type of incident — injury, near miss, dangerous incident, property damage, or occupational illness — should be clearly stated.

Persons involved: the full name, job title, employment status (employee, contractor, visitor), and contact details of each person injured or affected. For injured workers, their ACC customer number and employer name should be included to helps the ACC claim under the Accident Compensation Act 2001.

Witnesses: the full names and contact details of all witnesses to the incident. Witness statements should be obtained as soon as possible after the incident while memories are fresh.

Description of what happened: a factual, chronological account of the sequence of events leading to the incident, the incident itself, and the immediate aftermath. Avoid speculation or attribution of blame at this stage.

Nature and extent of injuries or damage: a description of all injuries sustained (body part affected, nature of injury), treatment provided on-site (first aid), and whether the injured person was referred to a doctor, hospital, or ACC provider. Property damage should be described with an estimated value.

Immediate actions taken: first aid measures, emergency services called (including New Zealand Police at 111 or WorkSafe NZ on 0800 030 040 for notifiable events), equipment isolated, and workplace area secured.

Hazard and contributing factors: identification of the hazards and contributing factors — such as inadequate training, faulty equipment, environmental conditions, or procedural failures — that led to the incident, consistent with the PCBU's risk management obligations under the HSWA 2015.

Corrective actions: specific corrective actions to prevent recurrence, the person responsible for each action, and the completion deadline. Actions should be reviewed by the health and safety representative or committee.

WorkSafe NZ notification status: whether the incident is a notifiable event under section 56 of the HSWA 2015, and if so, the date and time WorkSafe NZ was notified and the name of the WorkSafe NZ officer contacted.

Signature and date: the report must be signed and dated by the person completing it (typically the supervisor or health and safety officer), with a countersignature from management. The forms-legal.com Incident Report (New Zealand) provides a ready-to-use template covering all these elements under the HSWA 2015 and Accident Compensation Act 2001.

Section 56 of the Health and Safety at Work Act 2015 notification: a clear statement of whether the incident is a notifiable event requiring immediate phone notification to WorkSafe New Zealand at 0800 030 040, followed by written notification. Section 44 HSWA 2015 due diligence: a management sign-off confirming that an officer of the PCBU has reviewed the report and confirmed corrective actions are underway. Accident Compensation Act 2001 claim reference: the ACC claim number for any injured worker, supporting coordination between the employer, ACC, and the treating medical practitioner. Privacy Act 2020 compliance: personal information about injured workers must be handled in accordance with the Information Privacy Principles (IPPs) under Section 22 of the Privacy Act 2020, administered by the Office of the Privacy Commissioner. WorkSafe NZ investigation liaison: contact details for the WorkSafe New Zealand officer assigned to any investigation, and records of all communications with WorkSafe NZ. The forms-legal.com Incident Report (New Zealand) provides a ready-to-use template covering all elements required under the Health and Safety at Work Act 2015 and Accident Compensation Act 2001.