ACCIDENT REPORT FORM & INSTRUCTIONS

Following details are essential requirement for any case. Otherwise case will not be legitimate and will be considered incomplete & invalid.

1. Car Owner Details:

·         Full Name

·         Date of Birth

·         Address

·         Postal Code

·         Contact Number

·         Name of Insurance Company

2. Driver’s Details: (If not same)

·         Full Name

·         Date of Birth

·         Address

·         Postal Code

·         Contact Number

·         Name of Insurance Company

3. Third Party Details:

·         Full Name

·         Car Registration Number

·         Name of Insurance Company

4. Accident Details:

·         Date of Accident (e.g. September-2009)

·         Place of Accident

5. At fault Party?
6. Circumstances of Accident
7. Injuries Sustained?
8. Hospital Attended; if any