Accident Claim Worksheet
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- Product Details
- This form is for your personal reference, to help you stay on top of matters; it’s not part of your claim.
- Get witness statements in writing as soon as possible.
- When you're ready to inform the appropriate insurance company of an accident, use the "Notice of Insurance Claim."
If you’re injured in an accident, it can be hard to keep track of all the details. What day was it that you called the insurance company, and who did you talk to? Where’s the phone number of the bystander who saw the car that plowed into yours? When did the doctor say to make another appointment? There are so many names, numbers, dates, and forms.
Whether you’re in a car crash, “slip and fall” accident, or other mishap, you need to keep all this information straight. Having it could mean the difference between asserting a successful claim with your insurance company (or in court) and being uncompensated for your loss or injury.
Use this form to record the names, addresses, and phone numbers of the other person or business involved, witnesses, your insurance company, and others. You can also make notes of communications with them, dates of various events, conversations, details from insurance companies, and other information you will need to get compensation for your loss.