Print
out copies of this Accident Checklist to keep in every vehicle your family owns.
[ ] Safety First
Call 911
[ ] Date _____________________ Time ____________________
[ ] Where accident occurred (street names) ___________________________
[ ] Were there any
injuries?
Pedestrians? ___________________________________________
Passengers? ___________________________________________
Name _________________________________________________
Address _______________________________________________
Phone _________________________________________________
In addition to getting information from other drivers, be sure to get at least the names and phone number of any witnesses or people who stopped to help.
| Driver 1 Name ___________________________________ Address _________________________________ Phone ___________________________________ Driver's License Number ___________________ Exp. Date _______ Date of Birth ______________ Their insurance company __________________________________ Their insurance policy number ______________________________________ Registered owner of their vehicle ___________________________ License No. of their vehicle ______________ State __________________ Year ________ Make/ Model __________________ Color ____________ Number of passengers __________________ Driver 2 Name ___________________________________ Address _________________________________ Phone ___________________________________ Driver's License Number ___________________ Exp. Date _______ Date of Birth ______________ Their insurance company __________________________________ Their insurance policy number ______________________________________ Registered owner of their vehicle ___________________________ License No. of their vehicle ______________ State __________________ Year ________ Make/ Model __________________ Color ____________ Number of passengers __________________ Driver 3 Name ___________________________________ Address _________________________________ Phone ___________________________________ Driver's License Number ___________________ Exp. Date _______ Date of Birth ______________ Their insurance company __________________________________ Their insurance policy number ______________________________________ Registered owner of their vehicle ___________________________ License No. of their vehicle ______________ State __________________ Year ________ Make/ Model __________________ Color ____________ Number of passengers __________________ Witness |
Do NOT discuss responsibility with anyone except a positively identified representative of your insurance company. Provide only your driver's license and registration to the other driver, injured persons, or police officers. Do NOT discuss the circumstances of the accident with anyone except the police.
Don't sign any towing release that authorizes repair of your vehicle unless you have decided to have your car repaired by the facility where the towing company will take your car.
Write down as many details as possible that you can remember about the accident. Revisit the scene at a later time to take pictures if necessary.
Draw a diagram of the accident marking the vehicles involved (A, B, C, etc.) and show the direction the vehicles were traveling and where accident occurred. Mark street names, stop signs, traffic lights, and other landmarks. Describe all pertinent information: |
___________________________________________________ |
Illinois State Law requires that all accidents involving injury/death or property damage in excess of $500.00 be reported within ten (10) days to the Department of Motor Vehicles.
Date and Time Called: ____________________________________________
Your Claim Number is: _______________________________________
According to Illinois law, you have the right to take your vehicle to the repair facility of your choice. You are not obligated to use the repair shop mandated by your insurance company. Make sure all necessary repairs are fully itemized. Ask questions about any and all repairs.
Visit our web site at www.carstarmundelein.com for more helpful tips on how to evaluate and select a collision repair facility.