Injury Claim Review

How would you summarize the accident? *

Were the police present, and is there a police report? *

Yes

No

I don't know

Was the accident your fault, or were you issued a ticket? *

No

Yes

I don't know

Were you physically injured or in pain? *

Yes

No

How would you describe the severity of your injuries? *

Mild (Minor pain or discomfort)

Moderate (Impacts daily life and work)

Severe (Life-altering, significant trauma)

Did an ambulance or medical team help you at the scene? *

Yes

No

Did you go to the emergency room after the accident? *

Yes

No

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