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STATE OF CALIFORNIA USE ONLY AT NUMBERDEPARTMENT OF MOTOR VEHICLESREPORT OF TRAFFIC COLLISION INVOLVING AN AUTONOMOUS VEHICLE Public Service AgencyNAMEInstructions: Please print within the spaces
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Start by collecting all the necessary information about the incident or claim such as date, time, and location of the event.
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Contact your insurer either through their hotline or visit their nearest branch office.
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Provide your policy number, personal information, and details of the incident or claim.
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Follow the instructions given by the insurer regarding documentation and forms that need to be filled out.
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Fill out the insurer's claim form accurately and truthfully, making sure to provide all required details.
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Submit any supporting documents or evidence that may be requested, such as police reports, medical records, or repair estimates.
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Wait for the insurer's response or further instructions regarding the processing of your claim.
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Once your claim is processed, review the settlement offer or decision made by the insurer and communicate any concerns or disputes if needed.

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Families or individuals who have suffered injuries, losses, or damages covered by their insurance policy can use this information to ensure a smooth and accurate claim submission process.
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Your insurer is the company that provides you with insurance coverage for specific risks or losses.
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The purpose of your insurer is to provide financial protection against potential losses and risks.
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