Motor Accident Personal Injury Claim Form

Motor Accident Personal Injury Claim Form – 1 Personal Injury Claim Form Pre-Accident Procedures Please read, complete and return this form so we can follow the pre-accident procedure for personal injury claims set out in the Civil Procedure Rules 1999 and fully investigate your claim. given address. comply with legal requirements and comply with regulatory protocols; Requests cannot be accepted via electronic communication (internet or otherwise). print this form; It must be filled out and signed. Acceptance of perfect form should not be understood as an admission of our responsibility. Its purpose is to collect information to help us deal with your request. Please note that there is no automatic right to compensation. Part 1: Personal data Full name Address Postal code Date of birth Phone N.I. ARE NOT. Part 2: accident details Date of accident Time of occurrence Ask for house number. Provide the exact location of the accident, including names of stores or other prominent landmarks. at the following locations: Please provide an area diagram showing the error location. If possible, attach photos of the incident scene.

2 Describe exactly what happened below. Were you aware of the defects before the accident? Yes/No (delete as applicable) Please describe the size and depth of the object or surface you tripped on. Did you include images? YES / NO (delete as appropriate) Please provide the names and addresses of all witnesses to the incident described below. SECTION 3: LOSS AND DAMAGES Please see below; below, Please provide a brief description of all injuries listed below. DETAILS OF ANY LOSS BELOW DISCLAIMER OF FACTS The above information is to the best of my knowledge and belief.

Motor Accident Personal Injury Claim Form

3 Completed application forms, together with all photographs, must be returned to: Highways Claims, Highways and Engineering Department 4th Floor, The Wellsprings Bolton BL1 1US Please send to We correct postage when you submit your claim. All mail sent without proper postage will not be accepted by the secondary postal service.

Car Accident Claims & Injury Compensation Amounts

4 Understanding highways requirements Introduction As the local highways authority, Bolton Council is responsible for the proper maintenance of over 1000km of highways (roads and platforms) across the borough. A pre-planned inspection program will be carried out to determine the level of maintenance required. The frequency of these inspections depends on the classification of the road or footpath. If a defect is discovered during inspection or otherwise reported, the necessary repairs will be made or the area will be made safe. If you are involved in an incident caused by Bolton Council, you may be able to make a claim for compensation. But remember, there is no automatic right to compensation. Such compensation shall not include any amount of inconvenience. Bolton Council is responsible and it is important to have some understanding of how the civil complaints process works. By law, Bolton Council, as the highways authority, is responsible for the maintenance of highways (as defined in section 41 of the Highways Act 1980). The law defines the definition of maintenance and excludes certain things: for example, this does not include clearing mud roads. If you think the council has somehow failed to maintain the highway, you will have to prove it. You must prove that the road is not properly maintained relative to its importance and use and is therefore dangerous. If you can prove this, you must prove that it was the cause of the accident and that you suffered direct damages. Even if these facts are proven, the law protects highways authorities from claiming compensation if they can demonstrate that they took all reasonable steps in the circumstances to ensure ensure highway safety. You can refer to section 58 of the Highways Act 1980 for details on this matter. This means that all inspections and repairs have been carried out according to the plan or report. Unfortunately, incidents do happen, but they are rare due to negligence on the part of highway authorities. Most of the claims against Bolton Council were defended. Note: If your claim involves a highway fault that resulted in subsequent repairs. This does not mean that Bolton Council accepts responsibility for the claim.

5 May I ask? Think carefully before making a request. It is our responsibility to protect the public funds at our disposal. The cost of processing unsuccessful or fraudulent claims diverts these funds from valuable frontline services. Fraud Unfortunately, like many other councils, we receive a large number of complaints suspected of fraud and therefore fully investigate each complaint to protect public funds. I will contact the competent police agency and file a complaint. We may use the information provided in your request to prevent and detect fraud. We may also share this information with other organizations that manage public funds for similar purposes. If you wish to make a claim for vehicle damage, you will need to fill in the attached claim form and provide full details of your claim, including a diagram or photograph showing the exact details of your claim. exact location of the accident. In relation to a damaged vehicle, we will not consider claims relating to the gradual nature of wear and tear or deterioration of your vehicle. If you accept responsibility. The compensation offer will only reflect the property damaged and not any additional costs caused by the incident – eg. Any inconvenience or loss incurred in proving your loss. If you want to start a claim for damages to the vehicle; If immediate repair is not required; You will need to provide 2 separate estimates for the repair; For example. Replace cracked windshields or tires immediately. All bills must be submitted with the personal injury claim. Please completely fill out the relevant application form. As with personal injury claims, the council will ask for your permission to access your medical records. On receipt of your request, we will: Acknowledge receipt of the request within 21 days. Carefully investigate the details of the claim. In the event of a personal or property injury claim, we will provide sufficient evidence to dismiss your claim or accept your claim through an external claims resolution agency within 90 days from the date we receive it. Claims for damage to a vehicle of modest value are usually dealt with internally by the council and aim to make a decision on liability within 14 days wherever possible.

6 There may be circumstances where Bolton Council is not responsible for the location or type of work carried out – for example; gas, electricity, water, We will try to advise you as soon as possible in cases of utility works such as private roads, etc. so that it can be done reasonably. Contact details If you would like to contact us about your enquiry: Telephone: highways@bolton.gov.uk To report an issue or concern on a highway: Telephone: highways@bolton.gov .uk Web:

The 1999 Vehicle Damage Claim Form allows us to follow pre-accident procedures for property damage claims and allows us to investigate your claim.

Injury Scales Used By Board Certified Personal Injury Lawyers And Insurance Adjusters

Highway or footpath claims causing bodily injury and/or property damage Introduction This document relates to claims for incidents;

Public Liability Claim Form This form must be completed for personal injury and property damage claims. The problem with this model is that the council does not accept it. There is no automatic right to compensation.

Authorities responsible for additional costs; copies of documents; waste of time We will not pay for photography or other costs ourselves.

Tree root damage Online claim form via email Audit and Risk Management Unit Salford City Council Insurance Group 1st Floor, Unity House Chorley Road, Swinton M27 5AW will not be accepted via email.

Personal Injury Claim Checklists, Worksheets, And Guides

Basildon Council – Public Liability Claim Form Please read the following information carefully before completing this claim form and ensure that you fill this form carefully and that you do not miss the completion into form.

Basildon Council – Vehicle Registration Form Please read the following information carefully before completing this application form and ensure that you fill in this form carefully and do not miss completing the form.

Page 1 of 6 Accident Report Form HIGHWAYS Please report the hazardous incident to Surrey Highways as soon as possible by recording the information provided before completing this form.

Liability complaint instructions It is important that you read and understand these instructions before making a complaint to the council. Complete the claim form to make a successful claim.

If You’re Injured In A Car Accident: Common Questions

The highway accident claim form is a provision of this form.

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