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Reporting personal injury
I want to report my case to you. Fill in the contact form and we will contact you:
Reporting personal injury
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What happened?
Traffic accident
Industrial accident
Medical error
Homicide
Attacked by animal
Street fall
Abuse
Assault
Defective product
Other
What is your damage?
Bodily injury
Mental injury
Material damage
Is hospital admission required?
Is there any question of coma?
Is there any question of death?
Has the perpetrator already been held liable?
Yes
No
Has the other party's insurer contacted you?
Yes
No
Have you received notification from the public prosecutor's office?
Yes
No
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Residence
Telephone number
Email address
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