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Please type or print NEW YORK STATE BAR ASSOCIATION LAWYER REFERRAL & INFORMATION SERVICE SUBJECT REQUIREMENTS and APPLICATION AND QUALIFICATION STATEMENT for the MAJOR PERSONAL INJURY PANEL Name:

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How to fill out major personal injury bapplicationb

How to fill out the major personal injury application:

01

Start by gathering all relevant information: Before filling out the application, make sure you have all the necessary information handy. This includes details about the incident, any medical treatment received, insurance information, and any other pertinent documents or evidence.

02

Provide accurate personal information: Begin the application by providing accurate personal details such as your name, address, phone number, and email address. Double-check for any errors or typos to avoid any delays in processing.

03

Describe the incident: Clearly explain the details of the incident that caused your personal injury. Include information such as the date, time, and location of the incident, as well as the parties involved.

04

Explain your injuries and medical treatment: Provide a detailed account of the injuries you sustained as a result of the incident. Include information about any medical treatment you received, such as hospital visits, surgeries, medication, or therapy. Attach any relevant medical records or bills to support your claim.

05

Provide witness statements or contact information: If there were any witnesses to the incident, include their names and contact details. Witness statements can provide crucial support to your case, so try to gather statements from individuals who saw what happened.

06

Describe the impact on your life: Explain how the injury has affected your daily life, including any physical limitations, emotional distress, or financial hardships you may have experienced as a result. Be thorough and specific in describing the impact of the injury on your ability to work, engage in hobbies, or enjoy a normal lifestyle.

07

Include insurance information: If you have insurance coverage that is relevant to your personal injury claim, provide the policy details, including the name of the insurance company and your policy number. Attach any related documents or correspondence.

08

Seek legal advice if necessary: If you are unsure about any section or if you believe your case is complex, it's advisable to consult with a personal injury attorney. They can guide you through the application process and ensure your claim is properly presented.

Who needs a major personal injury application?

A major personal injury application typically needs to be completed by individuals who have suffered significant injuries as a result of someone else's negligence or wrongful act. This may include victims of car accidents, workplace incidents, medical malpractice, or slip and fall accidents, among others. The purpose of the application is to provide essential information and documentation to support a personal injury claim and seek compensation for damages incurred due to the injury. It is crucial to fill out the application accurately and thoroughly to increase the chances of a successful claim.

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