DIHAC

Save Interview Please Wait..

Auto Negligence

0 / 20

Were you involved in an automobile accident?

Did the accident take place in the last 3 years?

Were you injured in the accident?

Did you have automobile insurance at the time of the accident?

Were you driving your own vehicle without automobile insurance?

What best describes you at the time of the accident: (Only choose 1)

Were you involved in an accident with another vehicle?

Were you issued a traffic ticket for the accident?

Who do you believe was responsible for causing the accident?

Which part of your body was the most severely injured as a result of the accident?

Did you suffer a fracture (broken bone) as a result of the accident?

Did you see a doctor (or hospital) within 48 hours of the accident?

Have you been seen by a doctor for injuries, conditions or symptoms arising from this accident?

Has any doctor recommended you undergo surgery for your injuries?

Have you ever been treated for the same or similar injuries or conditions to those suffered as a result of this accident?

Have you incurred medical expenses as a result of this accident?

Were you employed at the time of your accident?

Have you missed time from your job or lost income due to the automobile accident?

How much time have you missed from your job?

Are your injuries permanent in nature?

A message with a new password and an activation
         password link will be sent to your email.