DO I HAVE A CLAIM?

Most people have heard the term "Personal Injury", but do not fully understand what it means. "Personal Injury" includes all claims resulting in bodily injury, including psychological problems.

Some examples of, but not limited to, personal injury are;
Injuries sustained in an automobile collision
Air bag fails to deploy
Seat belt failure
Slip and fall on slippery surfaces

INJURY INFORMATION FORM

Injury Information
In what state did the injury occur?
Injury Description
How were you injured?
Personal Information
Name:
E-mail:
Address:
City:	State: Zip:
Home Phone Number: