Automobile Claim Telephone Reporting Guide

Account Information

Provide Company Information if vehicle is owned by a business
Your business name & address (include specific division if applicable and mailing address)
If accident occurred at different address, supply address of accident (include identifiers, e.g. intersection)

Accident Information

Date & time of accident
Detailed description of accident
Witnesses including specifics on where they were at time of accident, any relationship to involved parties and means of contact (address, phone #, best time and place)
Authorities (ambulance, police, fire) include address, report #, and any violations/citations that may have been issued

Insured Vehicle Information

Year, make, model, vehicle I.D., plate #, state & color
Vehicle ownership information if different than account info
Driver's information including, name, address, phone #, date of birth (age), Social Security #, and driver's license # and state (include information on best time and place to contact driver)
Any damage to insured vehicle - be specific (Note: If you carry collision coverage, advise if you are making a claim for auto damage)
Location of vehicle, is it drivable, or at a body shop/garage (provide location; name, address & phone #)
Permission to move vehicle
Estimate of damage
Contact info for further details (Name, address & phone #)
Additional comments: (e.g. vehicle collecting storage, etc.)

Nature of Accident

Were there complaints of injuries (any medical treatment)? if yes, refer to info needed in injury section
Were any other vehicle involved in accident? if yes, refer to info needed in other vehicle section
Was there damage to property other than vehicles? if yes, refer to info needed in property damage section

Injuries

Name, address, home & business phone # for injured
Occupation (if provided)
Date of birth (age),
Description of injury
Was medical treatment received? If so, from who
- Name, address and phone # of hospital/clinic/doctor
- Type of treatment, length of stay, specialty of doctor
- First day of treatment

Is injured represented by an attorney
- name, address and phone number
- Was a lawsuit served? If yes, date of service

Employer Information (name, address and phone number)
Where was injured at time of accident (advise # from below)
1. Insured driver
2. Guest in insured auto
3. Pedestrian
4. Driver or occupant of other vehicle (If multiple injuries repeat above section)

Other Vehicles Information

Year, make, model, vehicle I.D., plate #, state, color
Vehicle ownership information
Driver's information including, name, address, phone #, date of birth (age), Social Security #, driver's license # and state (include information on best time and place to contact driver)
Any damage to other vehicle (be specific)
Location of vehicle, is it drivable or at a body ship/garage (provide location; name address and phone number)
Permission to move vehicle
Estimate of damage
Contact info for further details (Name, address and phone number)
Additional comments: (e.g. old damage, rental needed, etc.)
Available info on other party's insurance co. (Include address, phone #, policy #, claim #, agent name) (If multiple vehicles involved repeat above section)

Property Damage Information (other than vehicle)

Property owner's name, address, home and business phone
Description of damage (include both description of item and damage to that item)
Estimate of damage, if available (If other property damage repeat above section)

Account Contact Information

Commonwealth of Massachusetts Motor Vehicle Crash Operator Report (http://www.mass.gov/rmv/forms/accident.htm) (.pdf format)