Areas of Practice

 

WHAT TO DO IF YOU HAVE AN AUTO ACCIDENT

50 QUESTIONS AND ANSWERS

 

TABLE OF CONTENTS

 
Introduction 1
1. The Accident 1
1.1 Injuries 2
1.2 Witnesses 3
1.3 Photographs 3
2. The Police Report 3
2.1 Seat Belt 4
2.2 Fault / Liability 4
2.3 Insurance 4
3. Car Repair 4
3.1 Rental Car 5
4. Injuries 5
4.1 Lost Wages 5
5. Drinking and Driving 6
6. Legal Representation 7
6.1 Legal Fees 7
6.2 Lawsuit v. Settlement 8
7. Damages 8
7.1 Property Damage 8
7.2 Injuries 8
7.3 Pain and Suffering 8
7.4 Future Earnings 9
8. Insurance 9
9. Accident Scene Forms 10
 

INTRODUCTION

 
Automobile accidents are a regrettable part of modern life. Whether you drive in a large city or a small town, sooner or later, you can expect to be involved in one. Even the most careful, defensive driver cannot always avoid the actions of another driver. Knowing your rights and obligations when an accident occurs increases the likelihood that you will minimize the aggravation and expenses associated with automobile accidents. Knowing your rights helps you be ready to act to protect them. Carry this booklet in the glove compartment of your car and use the forms in it to collect information about the accident.
 
The information in this booklet is designed to help you in case you have an accident. It cannot replace the careful consideration of your case by a qualified attorney, who is able to apply the relevant law to the circumstances of the accident and advise you as to tell you your legal rights and what to expect as your case proceeds. He or she can value your case and represent your interests aggressively so that you receive the amount necessary to compensate you fully for the accident.
 
1. THE ACCIDENT
 
I've just had an accident. What should I do first?
Answer: The first thing you must do if you are involved in an automobile accident is to stop. Accidents happen to even the most careful drivers, but no one can ever have a valid excuse for failing to stop after an accident. Hit and run offenses are felonies, with increases penalties if someone was injured in the accident.
 
After I have stopped what should I do?
Answer: Check each person involved in the accident to see if they have been hurt. Call the police. Call an ambulance if necessary.
 
What information about the car do I need?
Answer: You need to note the make, model and year, its color and license plate number. Be sure to check the expiration date of the license plate. The form in the back of this booklet provides space to record all the necessary information.
 
Should we move the cars?
Answer: Whether you should move the cars depends on the severity of the accident and where it occurred. A serious accident with injured people should be left alone until the police arrive. You may have to direct traffic around the accident, set flares or station someone in a position to warn oncoming motorists. A fender-bender during rush-hour that threatens to tie up traffic for miles might be moved out of the driving lanes after you have determined that no one is hurt.
 
What should I do if I have an accident in a parking lot?
Answer: In most states the police will not respond to an accident in a parking lot that does not involve personal injury. The parking lot is private property and minor accidents there are generally outside the jurisdiction of the police. You should exchange personal, driver's license and insurance information with the other driver.
 
Do I need to get the same sort of information from the passengers in the other car?
Answer: Yes. You need to obtain the name, address and telephone number of each passenger in the other car. Take a moment to observe each of the passengers, where they were sitting or riding and whether they appear injured or unharmed by the accident. Look for slurred speech, glassy eyes and difficulty in remembering when you talk to them and note how they appear on the form provided.
 
What should I do about the people in my car?
Answer: Take down the same information (use form in the back of this booklet) that you gathered from the passengers in the other car. (Name, address, telephone number, where sitting.) Take a moment to observe each of them as they tell you their names and addresses to see whether they are exhibiting signs of injury.
The injured person has been taken care of. What next?
Answer: You and the other driver(s) must exchange information. You will want the other driver's name, address, phone numbers, driver's license number, insurance carrier, policy number, agent, and a phone number for the agent. You will be expected to provide the same information to the other driver(s).
 
1.1 INJURIES
 
If someone is hurt should I try to help?
Answer: Yes. If the person is seriously injured, do not attempt to move him or her unless it is absolutely necessary to protect him or her from further injury. Get someone to call the police or 911 of an ambulance is needed. Do what you can to make the injured person comfortable until paramedics or the police arrive.
 
1.2 WITNESSES
 
What should I do if there are witnesses?
Answer: Before the witnesses leave you should obtain their names, addresses and telephone numbers. You should record where the witness was when the accident occurred and if possible obtain a short statement of what the witness observed.
 
1.3 PHOTOGRAPHS / DIAGRAM
 
I've got the witness information, the other driver's information and a list of passengers. What now?
Answer: If you have a camera, take pictures of the accident scene. Take pictures of the cars, the street in both directions of the accident (including skid marks, if any), any stop signs or other traffic signals or signs. Also take pictures of the accident from the direction of travel of each of the automobiles involved. A video camera is especially useful in recording the behavior of the other driver, which may be useful if the other driver has been drinking or using drugs.
 
What should I do if I do not have a camera with me?
Answer: Make a diagram of the accident, indicating the direction each car was traveling, the speed of each, and what happened. Measure any skid marks. Record the condition of the street (wet, dry, under construction, lots of gravel, big potholes) and any signs restricting the free flow of traffic. Record the posted speed limit and anything else that will help you remember later what occurred prior to the accident.
I can get a camera when I get home. Is there anything I need to take a picture of then?
Answer: Take pictures of the damage to your car as soon as you can. Take close-up and farther away pictures to show the damage. Take pictures of yourself and any passengers in your car who were injured. Again take full body pictures and close-ups to show injuries.
 
2. THE POLICE REPORT
 
What happens when the police arrive?
Answer: You will be asked to show a valid driver's license, current registration for your car and proof that the car is insured. Answer the questions the police officer asks and try to remain calm.
 
If the police do not come and investigate the accident what should I do?
Answer: You should make a report of the accident within 24 hours at the nearest police station. The counter report, sometimes called a cold report, should explain the accident and identify persons involved.
 
Anything else I should do?
Answer: Make a note of the investigating officer's name, and badge number and whether he or she is a city police officer, highway patrol, or county sheriff deputy. Ask for a report or case number and where and when you can pick up a copy of the report. Be polite at all times.
 
2.1 SEATBELT
 
Do I have to be able to prove I was wearing my seat belt?
Answer: Make sure the police officer notes in the report that you were wearing your seat belt. You will probably be asked if you had it on as part of the report procedure. If you noticed the other driver was not wearing a seat belt, mention this to the investigating officer.
 
2.2 FAULT / LIABILITY
 
Is there anything I should not do?
Answer: Do not admit fault for the accident to anyone. Do not tell anyone how much insurance you carry. Do not sign anything. (You will have to sign the citation if you are issued a traffic ticket by the investigating officer. This signature is not an admission of guilt you are merely acknowledging that you received the ticket.)
 
If the other driver gets a ticket does that mean that he or she caused the accident and has to pay for it?
Answer: No. The fact that the police officer issues a citation to the other driver does not assign blame for the accident. The investigating officer is only giving his opinion as to what happened and whose fault he or she thinks it was. The officer still has to convince a judge or jury that the ticket was justified if the driver does not plead guilty. The ticket has no bearing on your case. The same result occurs if you are ticketed; the ticket is not proof that you caused the accident.
 
2.3 INSURANCE
 
How soon do I need to tell my insurance company that I have been in an accident?
Answer: You should notify your insurance carrier as soon as you can. The sooner they can begin processing your claim, the smoother the process can be. Be prepared to tell them the investigating officer's name and badge number, the report number and what happened.
 
Is there anything else I should expect?
Answer: You will be required to prove that you are financially responsible after you have been involved in an accident. You might have to submit proof of insurance coverage or proof that you have sufficient assets to cover any damages you might cause as a driver.
 
3. CAR REPAIR
 
Where do I have to take my car to get it repaired?
Answer: It is up to you to decide who you want to repair your car. Do not be bullied by the insurance company into thinking you have to have your car repaired by the shop giving the lowest bid. You are entitled to have your car repaired to the same condition it was in before the accident.
 
How many estimates do I have to get?
Answer: You are not obligated to obtain more than one estimate. You might want to get more than one estimate if you are not sure where you want to have your car repaired and you want to compare shops. 
 
3.1 RENTAL CAR
 
Can I get a rental car while my car is being repaired?
Answer: Yes. There are companies specializing in providing cars to people whose cars are being repaired. Look for them in the Yellow Pages or ask your attorney.
 
4. INJURIES
 
If I have been injured what should I do?
Answer: For any injury, no matter how slight you think it might be, you need to have qualified medical examination. The examination will help you get the medical assistance you need as soon as possible.
 
What if I haven't been injured?
Answer: There are many injuries in an automobile accident that are not apparent at the time of the accident. It is a good idea to get a medical examination after an accident to be sure that you have not suffered an injury that will not manifest itself until some time in the future, and then you wonder why all of a sudden your back hurts or you can't move your neck.
 
If I have been hurt who will pay for my treatment?
Answer: The person who caused the accident, or his or her insurance company, is responsible for paying for your treatment. Your insurance carrier will also be involved in paying your medical claims in some cases. That is why it is important to identify any medical problems caused by the accident as soon as possible.
 
Does the insurance company pick the doctor I have to see?
Answer: No. You can use your own doctor. No one can tell you what doctor you have to use.
 
What else should I do if I have been injured?
Answer: You need to keep a daily log of your medical condition. List each day any symptoms you have. Include descriptions of the pain you feel and any restrictions on your normal activities. You also need to keep a record of your trips to see the doctor or anyone else he or she sends you to see. Keep track of the mileage and the time it takes and any money you have to spend because of the trips.
 
What do I do with all the bills that come after the accident?
Answer: Talk with your attorney about the bills. He or she can negotiate to have them paid by the insurance company directly or, in other cases, postponed until after your case has been resolved. Don't let the bills worry you.
 
4.1 LOST WAGES
 
What do I do if I have to take time off work?
Answer: Keep a record of the time you miss from work, even if you still get paid because you use sick time or vacation. Keep track of the amount of money you lose by not being able to work. All this time you cannot work has to be paid for by the person who caused the accident.
 
5. DRINKING AND DRIVING
 
What should I do if I've had a couple of drinks and I am stopped?
Answer: The penalties for driving under the influence of alcohol or other drugs are increasing in their severity every year. Mandatory revocation of your driver's license is common upon conviction. If you are guilty of driving while impaired by alcohol and you cause an accident that results in injury or death, you can be charged with a felony. To protect yourself, you must know your rights and be prepared to exercise them if you are stopped by a police officer who suspects you are intoxicated.

Most state have a dual system of drunk driving laws. A blood alcohol level of a certain amount is conclusive proof that you are guilty of drunk driving. The amount of alcohol in your blood necessary to reach the conclusive level is being revised downward in almost every state from 0.1% to 0.08% or even lower.

If your blood alcohol level is under the legal limit you can still be charged with the offense of operating a motor vehicle while under the influence of alcohol. At issue is the degree of impairment to your driving ability caused by the alcohol. This is a subjective decision made by the officer who stopped you. To aid in determining whether you are impaired, or under the influence, the officer will ask you to answer questions or perform tests to evaluate your fine motor skills and balance. These tests are generally call “field sobriety tests.”

You are under no legal duty to take a field sobriety test. Your obligation when you are stopped for a moving violation are (1) to show the officer a valid driver's license and registration for the car you are driving and (2) if requested, to take a test to determine your blood alcohol level. The three tests currently employed are the breath test, blood and urine test. In most cases, the urine test should be chosen. Failure to take a test results in automatic suspension of your driver's license for up to one year.

If stopped because a police officer suspects you of being under the influence of alcohol or another drug, you must remember your rights and exercise them. Produce your driver's license, registration and proof of insurance and take the alcohol test if requested. Do not engage the officer in friendly chit-chat or offer any information. He or she is evaluating your speech and behavior, making notes to justify your arrest for driving while impaired. The less information you provide, by talking or taking the field sobriety test, the less evidence that can be introduced at your trial later when the officer has to prove that you were legally impaired at the time you were arrested. Protect your rights by insisting on them in a calm manner.

 
How much can I drink before I'm breaking the law by driving?
Answer: The amount of alcohol that you can consume and still be able to drive varies with each person. It depends on gender, body metabolism, food consumption, mental and physical health (i.e., depressed, agitated, taking medication, etc.), and the amount of time over which the alcohol is consumed. Obviously, the more alcohol you consume the greater the chances that your driving ability is impaired, and if you drive you subject yourself to being arrested for drunk driving. You must know your limits and respect them by not driving when you are impaired.
 
What will happen if I am arrested for drunk driving?
 
Answer: You will be jailed for a minimum length of time for you to sober up. In some states you will not be released for 24 hours. Your car will be impounded and you will have to pay the towing and storage fees before you can recover it. Your insurance rates will increase, and some companies will drop your coverage upon conviction for drunk driving. The consequences of drinking and driving are severe and to be avoided. If arrested for drunk driving, call your attorney. Your rights need to be protected by an experienced practitioner.
 
What should I do if the other driver has been drinking?
Answer: If you notice the other driver appears intoxicated or smell alcohol on him or her, be sure to mention this fact to the investigating officer.
 
6. LEGAL REPRESENTATION
 
Do I need a lawyer?
Answer: No matter what kind of accident you have been involved in, you should get a competent legal opinion on your rights and responsibilities that were affected by the accident. Legal rights are affected by any accident and it is in your best interests to have a knowledgeable attorney review the facts of your case before deciding what course of action to pursue. An experienced attorney can evaluate your case and tell you what to expect. The attorney can recommend appropriate medical treatment, negotiate a replacement automobile, negotiate a fair and full settlement with the insurance company that takes into account all of your damages, including your pain and suffering. And you can find out all this in an initial, no cost, no-obligation consultation.

The other option open to you is to attempt to negotiate for yourself. Against the battery of lawyers and claims adjusters who get paid, praised and promoted for keeping their side's costs down. They know the business, know what to look for that might be hidden, waiting to be discovered only after the settlement check has been cashed and your rights to a full and fair compensation irretrievably thrown away.

 
6.1 LEGAL FEES
 
What will this cost me?
Answer: Using an experienced attorney can actually increase the amount of money you will be paid to compensate you for the accident, so that even after the attorney's fee is paid you will have more money in your pocket than if you attempted to represent yourself. An experienced trial attorney knows what you are entitled to receive to put you back in the position you were in immediately before the accident, and the insurance companies knows this. Having an experienced trial attorney on your side representing only you, tells the insurance company that you are serious about protecting your rights. Peace of mind from knowing your interests are being protected allows you to get back to your life with as few delays as possible and with a settlement that fairly compensates you for the accident.
 
What is a contingency fee?
Answer: A contingency fee has been called the “poor man's key to the courthouse.” You agree to pay a percentage of the amount your attorney obtains for you in exchange for the legal representation and expertise of the attorney. This fee is paid from the proceeds of the settlement, so you do not have to pay any money out of your own pocket to get aggressive protection of your rights. If there is no recovery, there is no fee.
 
6.2 LAWSUIT V. SETTLEMENT
 
Will I have to sue?
Answer: Sometimes a lawsuit is the only option when the insurance company offers an unfair settlement amount. It is then necessary to sue to protect your rights to full and fair compensation. An experienced trial attorney can calculate the value of your case so you will know whether the offer from the insurance company is adequate or not.
 
Isn't it better to take the insurance company's settlement offer instead of risking a trial where I might lose and get nothing?
Answer: Your attorney can advise you, but it is your claim and your injury so you have to make the final decision of whether to settle or go to trial. Your attorney's experience can guide you in making your decision. He or she know the chances of success at trial and how far below a full and adequate settlement the insurance offer is.
 
7. DAMAGES
 
What can I expect to get from the insurance company?
Answer: You are entitled to 'be made whole,' which is legal language for your right to be put back in the same position after the settlement as you were in immediately before the accident. Some of the process of making you whole is easily calculated and other aspects are more difficult.
 
7.1 PROPERTY DAMAGE
 
What will I get for my car?
Answer: You will get the amount of money necessary to repair your car to the condition it was in immediately before the accident. At times the amount of money necessary for repairs exceeds the value of the car, in which case the insurance company may opt to declare the car as a total loss. You would then be offered the amount the car was worth, based on industry price-setting guides (like the Kelly Blue Book and/ or advertisements for cars similar to yours.), and the car would not be repaired.
 
7.2 INJURIES
 
What will I get for my injuries?
Answer: You are entitled to be fully compensated for your injuries. The amount necessary to compensate you fully obviously causes the most problems in arriving at a settlement figure acceptable to both sides. There is usually little argument over the compensation for time missed from work and lost wages, doctor and hospital bills, rehabilitation costs, transportation to and from the doctor and therapists. You will have receipts for these expenses. The controversy arises when you attempt to put a dollar value on the more intangible injuries you have suffered, such as loss of consortium, loss of sexual capacity or desire, emotional distress, pain and suffering, loss of future earnings and loss of future enjoyment of life.
 
7.3 PAIN AND SUFFERING
 
How do you know what pain and suffering is worth?
Answer: Finding an acceptable amount for your pain and suffering requires experience with many similar cases. Pain and suffering awards are necessarily subjective and usually are based on similar cases, so the attorney's knowledge of the community and insurance companies is most important here.
 
What is loss of consortium?
Answer: Your husband or wife has a right to your company that has been damages by the accident. Based on the time spent in the hospital or disabled, your husband or wife is entitled to recover from the person causing the accident for the loss of your companionship.
 
You can put a value on the loss of sex?
Answer: Yes. If the accident has disrupted your sex life, the person who is responsible for the accident should pay for what he or she caused. It is your right to enjoy your sex life without interference.
 
What is emotional distress?
Answer: An accident is a traumatic event that causes emotional distress to those involved. Obviously not every fender-bender causes distress to the persons involved, but major accidents can well cause severe emotional distress. It is a serious problem in some accidents.
 
7.4 FUTURE EARNINGS
 
What is loss of future earnings?
Answer: If you have been seriously injured, you may not be able to resume the same type of work you did previously or be able to work as long or as hard. Since your decreased ability to work was the result of the accident, the person who caused the accident should compensate you for your loss in earning potential. In the same way, you have the right to be compensated for any decrease in your ability to enjoy the things you did before the accident that are now not possible for you (loss of future enjoyment of life).
 
How do I know how much money I should get?
Answer: Insurance companies count on you not knowing the true value of your claim. They try to tell you what it is worth and settle with you before an experienced attorney reviews the facts of your case. Your attorney knows how much money will be necessary to fully compensate you for your injuries and the insurance companies know that. Talk with your attorney so that you will know how much is fair in your case.
 
8. INSURANCE
 
What kind of insurance should I have on my car?
Answer: Many states set minimum mandatory insurance requirements that you must meet to drive your car in that state. The terms used by the insurance industry include:

Liability--protection for the person or property that you unintentionally damage when driving your car. In states that require insurance coverage, liability coverage for bodily injury and property damage of a certain amount is required.

Collision--pays for damage to your car whether caused by you or someone else who cannot be found.

Comprehensive--pays for fire, theft or vandalism of your car and contents.

Medical payment--covers medical expenses for any one in your car.

Uninsured motorist--pays if the driver at fault is not insured.

Underinsured motorist--pays your expenses above the amount the other driver's insurance covers.

Determining the appropriate amount of insurance protection to carry depends on the circumstances of your life. The more wealth you have, the more insurance can benefit you by protecting your wealth from the astronomical costs of a serious automobile accident. Adequate insurance coverage that can pay for the damages of an accident permits you to devote your energies to getting well again, knowing that you do not have to worry about how you will pay for your necessary medical treatment and living expenses. Your attorney can help you calculate the amount and types of insurance coverage you and your family need to protect yourselves.

 

ACCIDENT SCENE FORMS

 

DRIVERS

 
OTHER DRIVER
Name:_______________________ Date of Birth:________________ 
Address:_____________________ Telephone # (home)____________
City:_____State:__ Zip Code:_____ Telephone # (work)_____________
Driver’s License #_____________ State:_______________________
Expiration Date:_______________ Restrictions:__________________
Injured in Accident? (describe)_____________________________________
 
INSURANCE INFORMATION
Policy Number:________ Expiration date:________ Company:____________
Agent:_________________________________ Telephone #__________
 
AUTOMOBILE INFORMATION
Make of car:_________________ Model:____________ Color:____________
License Plate_________________ Expiration Date:____
Owner:________________________________________________________
Address:______________________________________ Restrictions:_______
Condition of car (describe)_________________________________________
 

INFORMATION ON PASSENGERS

 
OTHER CAR
 
Name:____________________ Where sitting:__________________
Address:__________________ Telephone # (home)_____________
City:_______ State:____ Zip Code:____ Telephone # (work) 
Injured in accident? (describe)____________________________________
 
Name:____________________ Where sitting:__________________
Address:__________________ Telephone # (home)_____________
City:_______ State:____ Zip Code:____ Telephone # (work) 
Injured in accident? (describe)____________________________________
 
Name:____________________ Where sitting:__________________
Address:__________________ Telephone # (home)_____________
City:_______ State:____ Zip Code:____ Telephone # (work) 
Injured in accident? (describe)____________________________________
 
Name:____________________ Where sitting:__________________
Address:__________________ Telephone # (home)_____________
City:_______ State:____ Zip Code:____ Telephone # (work) 
Injured in accident? (describe)____________________________________
 
YOUR CAR:
 
Name:____________________ Where sitting:__________________
Address:__________________ Telephone # (home)_____________
City:_______ State:____ Zip Code:____ Telephone # (work) 
Injured in accident? (describe)____________________________________
 
Name:____________________ Where sitting:__________________
Address:__________________ Telephone # (home)_____________
City:_______ State:____ Zip Code:____ Telephone # (work) 
Injured in accident? (describe)____________________________________
 
Name:____________________ Where sitting:__________________
Address:__________________ Telephone # (home)_____________
City:_______ State:____ Zip Code:____ Telephone # (work) 
Injured in accident? (describe)____________________________________
 
Name:____________________ Where sitting:__________________
Address:__________________ Telephone # (home)_____________
City:_______ State:____ Zip Code:____ Telephone # (work) 
Injured in accident? (describe)____________________________________
 
WITNESSES
 
Name:____________________________
Address:__________________________ Telephone # (home)_________
City:_____ State:___ Zip Code:________ Telephone # (work)_________
Location when accident occurred:_______
Did you see the accident?_____________
What happened?____________________
 
Name:____________________________
Address:__________________________ Telephone # (home)_________
City:_____ State:___ Zip Code:________ Telephone # (work)_________
Location when accident occurred:_______
Did you see the accident?_____________
What happened?____________________
 
Name:____________________________
Address:__________________________ Telephone # (home)_________
City:_____ State:___ Zip Code:________ Telephone # (work)_________
Location when accident occurred:_______
Did you see the accident?_____________
What happened?____________________
 
YOUR INFORMATION
 
Name:__________________ Date of Birth:________________
Address:________________ Telephone # (home)___________
City:______ State:____ Zip Code:_____ Telephone # (work)___________
Driver’s License #_________________ State:______________________
Expiration Date:___________________ Restrictions:_________________
 
OWNER OF AUTOMOBILE
 
Name:________________
Address:____________________ Telephone # (home)________
City:________ State:_____ Zip Code:______ Telephone # (work)________
 
AUTOMOBILE INFORMATION
 
Make of car:_____________ Model: Color:_________
License Plate_____________ Expiration Date:_______
Special option:____________
 
AUTO INSURANCE INFORMATION
 
Policy Number:____________ Expiration date_______ Company:________
Agent___________________ Telephone #________
 
HEALTH INSURANCE INFORMATION
 
Policy Number:_______________________ Expiration date____________
Company:___________________________ Telephone #______________
Doctor’s name:_______________________ Telephone #______________
Blood type:__________________________ Organ Donor:_____________
Allergies to medication__________________
 
EMERGENCY CONTACT
 
Name:___________________
Address:_________________ Telephone # (home)_____________
City:______State:____ Zip Code:_____  Telephone # (work)_____________
Relation ship to you:________________
 
Name: ___________________
Address:_________________ Telephone # (home)_____________
City:______State:____ Zip Code:_____  Telephone # (work)_____________
Relation ship to you:________________
 
ACCIDENT INFORMATION
Date:________________ Time of Day:___________
Weather Conditions________________ Traffic Conditions________
Road Conditions___________________ Location_______________
Type of Street (divided highway, parking lot, etc.)_______________________
Direction of Travel (your car)_____________ Direction of Travel (other car)________
Was either car turning?____________ Which car?______________
Obstructions?___________________ Restrictions on visibility?________
Speed of your car?_______________ Speed of other car?____________
Any traffic signs?_________ Controlling your car?___________
Controlling other car?__________ 
Traffic signals?___________ Your car, color____________
Other car, color____________
Seat belts in use:__________ Your car______________
Other car ____________
Headlights on____________ Your car______________
Other car____________
Turn signals on___________ Your car______________
Other car____________
Back up lights working______________ Your car______________
Other car____________
Brake lights working________________ Your car______________
Other car____________
Street lights on:___________________ Any other illumination:__________
Length of skid marks:____________ Your car______________
Other car____________
Distance away from other car you first noticed it:  ____________________
Was either car behaving in an erratic manner? ____________________
Did the other driver appear to have been drinking  ____________________
Were pedestrians involved?  ____________________
Was there a marked crosswalk?  ____________________
Describe accident:  ____________________
 
POLICE REPORT
 
Officers name:____________ Badge #______
Jurisdiction:______________ Telephone #:_______
Station or substation address:_______________________ Date of report:_____
Action taken: Arrest made_______________________
Citation issued (To Whom)____________
Offense Charged___________________
Investigation Ordered_______________
Medical assistance: Company________________________
Time Arrived______________________
Action Taken_____________________
Your car towed Company________________________
Location_________________________
Telephone #_______________________
Other car towed Company_________________________
Location__________________________
Telephone #_______________________
 

BODY DIAGRAM

 
Circle the areas of your body that were injured in the accident. Describe any swelling, bruises. loss of mobility or function, cuts, etc.
 
 
 
 
 
 
 
 

AUTOMOBILE DIAGRAM

 
Circle the parts of your car that were damaged in the accident.
 
 
 
 
 
 
 
 

STREET DIAGRAM

 
Use this diagram to show the accident. Show direction of travel with arrows. Mark traffic signals and signs, pedestrian crosswalks and any other distinguishing marks. Draw your own diagram if one of those provided does not fit your accident.
 
 
 
 
 
 
 
 
 
 

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