Riehl & Knode Insurance Agency, Inc.
Email:  agent@rkinsurance.net
410-239-0720 office
410-239-0724  fax

What to do if You're Involved in an Accident
Being involved in an accident can be a nerve-wracking, disorienting experience. This accident report guide is intended to help you gather the information needed in the event of an accident. While we hope you never need this information, it's here if you do.

It may be helpful to print this page and keep it in the glove compartment along with your insurance ID cards. 

In the event of an accident, please remember to:

NEVER "Make a Deal" for damages

NEVER leave the scene of even a minor accident

NEVER accept an offer of cash, check or "private" settlement

NEVER disavow inury to you or your passengers

NEVER offer to pay ANYTHING even if you think you are at fault

NEVER administer first aid unless you are LICENSED to do so.

ALWAYS (when conditions permit) move to shoulder or other "safe area" to prevent futher damage

ALWAYS ask someone to summon the police and seek medical assistance. 

ALWAYS remember the 3 C's: Remain CALM, COURTEOUS, and CONSISTENT in your version of the accident.

ALWAYS obtain complete information from those involved. (see section below)

ALWAYS complete this report on the scene - not later on.

ALWAYS obtain the names of witnesses including addresses and phone numbers.

INJURED

Name: Age:

Address:

________________________________________________________________

Telephone:

Person's Role:

Driver Rider-Your Car Position in Car:

Pedestrian Rider-Other Car Position in Car:

Nature and Extent of Injury:

Ambulance Called? Yes No

(Repeat the above section for each injured person)


YOUR VEHICLE

Vehicle Year: Make:

Driven By:

Nature and Extent of Damage:

____________________________________________________________________


WITNESSES

Name:

Address:

____________________________________________________________________

Telephone:

(Repeat for each witness at the scene)


OTHER VEHICLE

Driver: Age:

Address:

____________________________________________________________________

Telephone:

Driver's License Number: State:

Vehicle Year: Make: Model:

Owner of Vehicle:

Address: (if different)

____________________________________________________________________

Telephone: (if different)

Insurance Company:

Policy Number:

Nature and Extent of Damage:

____________________________________________________________________

Number of Passengers:

Statements Made by Other Driver:

____________________________________________________________________

____________________________________________________________________


POLICE REPORT

Officer:

Precinct:

Summons Issued:


DESCRIPTION OF ACCIDENT

Date/Time:

Location: (street, city, state)

_______________________________________________________________________

Estimated Speed of Vehicles:

Description of What Happened:

_______________________________________________________________________

_______________________________________________________________________

Who Received Violation?

Weather Conditions:

_______________________________________________________________________