Claim Form - Auto Accident

This Claim Form for an Auto Accident is for use by an attorney representing a client or an individual who has incurred injuries from an automobile accident. This claim form will serve as formal notice of the accident and is sent to the other driver’s insurance company. This form contains all pertinent information regarding the auto accident including where it occurred, date of occurrence, the facility where treatment was received and the names of any treating physicians. It also contains a short description of the injured party and how the auto accident has affected his or her life. (continued ...)