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INDIANA UNINSURED AND UNINSURED MOTORISTS COVERAGE REJECTION/SELECTION FORM UNINSURED MOTORISTS COVERAGE (UM) provides protection for persons who are legally entitled to recover damages because of

How to fill out in um-uim form

How to fill out a UM-UIM (Uninsured/Underinsured Motorist) form?

1. Begin by obtaining a UM-UIM form from your insurance company or agent. This form is usually available online or can be requested directly.
2. Fill in your personal information, including your name, address, contact details, and policy number. Make sure to provide accurate information for effective communication.
3. If applicable, include the information of any additional insured individuals on your policy, such as family members or dependents.
4. Indicate the date and time of the accident/incident where you encountered an uninsured or underinsured motorist. Be as specific as possible.
5. Describe in detail what happened during the accident, including the location, circumstances, and any road or weather conditions that may have been a factor. Be concise but provide enough information for clarity.
6. If there were any witnesses present during the incident, include their names, contact information, and a brief statement about what they witnessed. Their statements can strengthen your claim.
7. In the UM-UIM form, specify the damages and injuries sustained as a result of the accident. Mention any medical treatments received or ongoing therapies necessary for recovery.
8. Attach relevant supporting documentation, such as medical bills, receipts for repair costs, police reports, photographs of the accident scene, or any other evidence that can support your claim.
9. Review the completed form carefully to ensure all the required information has been provided. Make sure there are no errors or missing details.
10. Sign and date the UM-UIM form to indicate your agreement with the provided information.

Who needs a UM-UIM form?

1. Individuals who have been involved in a car accident with an uninsured (no insurance coverage) or underinsured (insufficient insurance coverage) motorist.
2. People who have suffered damages, injuries, or medical expenses as a result of an accident caused by an uninsured or underinsured motorist.
3. Policyholders who have a UM-UIM coverage included in their auto insurance policy. This coverage provides financial protection when involved in accidents with drivers who lack sufficient insurance coverage.

Remember, it is crucial to consult with your insurance company or attorney for specific guidance on filling out the UM-UIM form correctly and to understand the rules and regulations regarding uninsured/underinsured motorist coverage in your jurisdiction.

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