Get Road Accident Questionnaire

The Road Accident Questionnaire is a crucial document that helps you capture all necessary details related to your accident. This guide will provide step-by-step instructions on how to accurately fill out the form online, ensuring that you provide comprehensive information for your claim.

Follow the steps to complete the Road Accident Questionnaire online.

1. Click ‘Get Form’ button to access the Road Accident Questionnaire and open it in your editor.
2. Fill out your details in the first section. Include your title, name, middle name, surname, date of birth, occupation, vehicle registration number, and National Insurance Number (NIN). If you do not have a NIN, please provide an explanation. Be sure to include your address, telephone number, and email.
3. In the defendant's details section, indicate the defendant's status and then input their title, name, middle name, surname, and address. Additionally, include the driver's name, policy reference number, and vehicle registration number, noting whether it is used for private or business purposes.
4. For injury and medical details, specify the type of injury you sustained. Provide a brief description of the injury, and indicate if you took any time off work as a result. If applicable, note the duration, whether you attended the hospital, and any subsequent medical attention you received.
5. Address vehicle damage by indicating if you are claiming for damage to your vehicle and if insurance coverage is held. Include if your claim is proceeding through your insurer or an alternative company, and indicate if the vehicle is a total loss.
6. In the alternative vehicle provision section, clarify if you have been provided a vehicle by your insurer or elsewhere, and whether you require its use. If applicable, include details about the vehicle's provider and the hire dates.
7. Detail the accident circumstances, including your role (driver, passenger, etc.), the number of occupants, whether a seatbelt was worn, and the time and location of the accident. Provide a brief description of the incident.
8. If the accident involved a bus or coach, answer accordingly and describe the vehicle, including route number, direction of travel, and any available evidence of travel.
9. Document any other parties involved or witnesses, including their full names, addresses, and contact numbers. Also provide additional relevant information about them.
10. In the liability section, explain why you believe the defendant was responsible for the incident. Provide any other relevant information that may support your claim.
11. Finally, sign and date the form to certify that the information provided is accurate. Upon completion, you may save your changes, download or print the form, or share it as needed.

Complete your Road Accident Questionnaire online today to ensure all necessary details are captured for your claim.