MPSC Damage Prevention Complaint Form


This Damage Prevention Complaint Form is to be utilized for both damages and events not involving damage; such as near misses or downtime incurred as the result of an event. “Event,” as used in these instructions, includes all occurrences for which this form will be submitted. If more than one event is to be reported, complete a separate form for each event.

Damage User Manual

These instructions were created to guide users of the Michigan Public Service Commission (MPSC) Damage Complaint Form to select the appropriate entries. Consistency in the selection of entries ensures a more meaningful data analysis and hastens complaint resolution.

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**Before filing a complaint, be aware that some form of resolution process must have taken place between the parties involved. If this process has not taken place or the MPSC views the attempts as inadequate, your complaint may be found without merit by the MPSC. At a minimum, the resolution process should include an in-person meeting or discussion between the claimant and the potential respondent, where a discussion of the claim(s) and evidence of liability and damages occurs in an attempt to resolve the issue amicably without the involvement of the MPSC. This resolution meeting can be facilitated formally, but that it is not a requirement.
**If the attempts at resolution are unable to be conducted, either through any party’s unwillingness to engage in a discussion or lack of responsiveness, such attempts at engagement are to be documented and provided in Part 5 of the form.


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