Cash Benefits for Car Accident Survey YT

1.
By submitting my information, I agree to the privacy policy and terms of use: Privacy Policy Terms of UseWhat type of accident was it?

• Car Accident
• Motorcycle Accident
• Truck Accident
• Pedestrian or Bicycle

2. Were you injured in the accident? *This question is required.

• Yes
• No

3. Are you represented by a lawyer for this incident? *This question is required.

• No
• Yes

4. Were you found at fault for the accident? *This question is required.

• No
• Yes

5. When did it happen? *This question is required.

• In the last 30 days
• 1 – 6 months ago
• 6 – 12 months ago
• 1 – 2 years ago
• Over 2 years ago