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Accident Reporting
In the event of an accident, please do the following:
Move your vehicle to a safe area out of the path of traffic if possible.
Assess the members of your car for injuries and call for assistance if needed.
Obtain the other vehicle(s) driver(s) information (name, address and phone number). Take a photo of their driver’s license(s) if possible.
Obtain a description of the other vehicle(s) (year, make & model). Take a take a photo of all sides of the vehicle(s) if possible.
Be courteous and cooperative, but do not apologize or admit fault. Do not discuss accident or sign any papers with anyone except for your employer, a police officer or your insurance representative.
Exchange insurance information with the other driver(s). Take a photo of their insurance card if possible.
Make note of the location of where the accident happened (street address or intersection).
If safe, take photos of the accident location.
Report the accident to your insurance carrier as soon as possible
Please feel free to use the form below to submit accident information to DSP:
Date of Accident
Date Format: MM slash DD slash YYYY
Time of Accident
:
HH
MM
AM
PM
Place of Accident
Police Report Number
Describe briefly what happened
Upload images of accident
Drop files here or
Accepted file types: jpg, gif, png, jpeg, heic.
Include photos of all sides of all vehicles, close-ups of damaged areas, skid marks, traffic signals, debris, vehicle interiors (including seat belts and air bags), and all drivers and passengers.
YOUR VEHICLE
Name of the Insured
Year / Make / Model of Your Vehicle
Serial Number of Your Vehicle
Driver's name, address, phone number and email
Damage to your vehicle
OTHER VEHICLE
Owner's name, address, phone number and email
Year / Make / Model of Other Vehicle
Damage to other vehicle
Driver's name, address, phone # and email (if different than owner)
Other driver's insurance company and policy number
PERSONS INJURED
INJURED 1 - Name, address, phone and email of injured
Nature of injuries
Where was the injured person taken and by whom?
Injured 2 - Name, address, phone and email of injured
Nature of injuries
Where was the injured taken and by whom?
WITNESSES
List name, address, phone / email of any witnesses
ADDITIONAL NOTES OR DETAILS
Any additional notes or details?
This field is for validation purposes and should be left unchanged.
About
An Independent Agency
Meet Our Team
Client Testimonials
Business
Benefits
Surety
Safety Consulting
Personal
Contact
Refer a Friend
Review Us
Get Quote
Client Portal
Clickable Coverage
Blog
info@dspins.com
Call 847-934-6100