DO I HAVE A CASE?

Smart Form

Welcome to 4LAWSUPPORT.COM "Do I have a Case?" submission form.
Use this form to explain the facts of your accident.

How do I know if I have a case?

The investigating officer may have ticketed one of the parties at the accident site. This is generally an indication that a particular law was broken, but does not necessarily establish who caused the accident. Sometimes the police report will reveal which driver, in the investigator's opinion, should be held responsible for the accident.

To have a personal injury case, not only must you be able to show that you have been injured, you must also be able to show the extent of your injury. In some cases, it may be necessary for you to show that the other party is more at fault for the injury than you are. Determining fault is important because this will generally place either your insurance company or the adverse insurance company in a position that requires them to cover the losses.

 

Please complete the following questions so that we know how to best respond to your inquiry. Keep in mind, the more information you provide, the easier it will be for us to make a determination as to the viability of your claim. Regardless of who caused the accident, you may be able to recoup at least your property damage, lost wages and medical expenses, depending on the insurance coverage available.

Click on Definitions at any time you feel it is needed. If you have any suggestions or questions regarding this page or its content please inform us by clicking on the Suggestion Box. We should get back with you within the next 24 hours.

Your name Make sure we have your phone# at the bottom of this form

Registered owner: Driver Passenger Rental Other (Please explain) Date of accident

Was there a ticket issued?  No Yes to whom?

You were the: driver front passenger rear passenger

Number of people in the vehicle (including you) Number of vehicles involved

Police report?: Yes No    Paramedics?: Yes No

Does the other party have Insurance? I don’t know No Yes insured by

Do you have Insurance: No Yes by
Full Coverage   Liability only   UM/UIM   PIP (medical pay)

Prior injuries/accidents: I was in an accidinet but no injury was claimed I have claimed injury prior to this recent accident Propterty damage only Work related injury No prior accident claims

Describe the accident               List your injuries          Explain your prior claims for injury, if any              

Have you visited a hospital or been treated at other facilities?  No Yes

Are you presently undergoing medical treatment in relation to this accident? No Yes

We will call you: Day Phone: Evening Phone:

Best time to call: Am Pm

   

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