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CHARTS INSURANCE IRELAND LIMITED Charts House, Version Road, Dublin 4. Tel: +353 1 208 1400 Fax: +353 1 283 7773 Email: postmaster.i.e. chartisinsurance.com PERSONAL ACCIDENT CLAIM FORM Please complete
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How to fill out pers accident claim form

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01
Start by gathering all necessary information: Before filling out the personal accident claim form, make sure you have all the relevant details regarding the accident. This may include your personal information, insurance policy details, date and time of the incident, description of the accident, and any supporting documents such as medical records or police reports.
02
Carefully read the instructions: Thoroughly go through the instructions provided with the accident claim form. This will help you understand the specific requirements and sections that need to be filled out.
03
Complete personal details: Begin by filling out your personal information, such as your full name, address, contact number, and policy number. Ensure that all the details are accurate and up to date.
04
Provide accident details: The next section will require you to provide a detailed account of the accident. Be precise and specific about what happened, where it occurred, and who else was involved. Include any witnesses if applicable.
05
Describe injuries and medical treatment: If you sustained any injuries as a result of the accident, describe them in detail. Include information about the medical treatment you received, any hospital visits, prescriptions, or ongoing therapies. Attach any relevant medical records or bills to support your claim.
06
Attach supporting documents: Depending on the requirements stated in the instructions, include any necessary supporting documents. This might include police reports, photographs of the accident scene or damages, statements from witnesses, or any other evidence that supports your claim.
07
Be honest and accurate: It is crucial to provide honest and accurate information throughout the form. Misrepresenting or providing false information can lead to serious legal consequences and may jeopardize your claim.
08
Review and sign: Carefully review all the information you have provided on the form to ensure its accuracy. Once you are satisfied, sign and date the form as required. Consider making a copy of the completed form for your records.

Who needs the personal accident claim form?

01
Individuals who have been involved in an accident and have suffered injuries
02
Policyholders who are covered by an insurance company offering personal accident coverage
03
Those seeking financial compensation or coverage for medical expenses resulting from the accident
04
Individuals who wish to file a claim with their insurance company to seek reimbursement for accident-related losses or damages.
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The pers accident claim form is a document used to report and file a claim for personal injury or accident-related damages.
Anyone who has experienced a personal injury or accident and wishes to file a claim for compensation is required to file the pers accident claim form.
To fill out the pers accident claim form, you will need to provide detailed information about the accident, your injuries, medical treatment received, and any other relevant details. It is recommended to seek assistance from a legal professional when filling out the form.
The purpose of the pers accident claim form is to formalize and document a claim for compensation for personal injuries or accident-related damages.
The information that must be reported on the pers accident claim form includes details of the accident, injuries sustained, medical treatment received, any witnesses to the incident, and any other relevant information.
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