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Calculate the Value of Your Slip and Fall Claim

By: Stewart J. Guss

What Is Your Claim Worth?

1. When was your accident?

2. Did you receive medical care within 24 hours?
YesNo

3. Approximate cost of medical treatment to date, if known:
$
(Enter whole number, omit comma.)

4. Rate the severity of your injuries (5 is most serious)
12345

5. Did the police investigate the accident?
YesNo

6. Could you walk after the accident?
YesNo

7. Approximate cost of medical attention (if known):
$
(Enter whole number, omit comma.)

8. Do you have photos of the scene of the accident or injuries?
YesNo

9. Brief summary of how the accident occurred:

Your Name (required)

Your Email (required)

Phone (required)

 

 

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