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VEHICLE DAMAGE


VEHICLE DAMAGE — Indicate if the accident exceeds the $1,000 threshold for property damage to any one vehicle or property caused by the accident, and describe vehicle damage.


DRIVER OF MOTOR VEHICLE 1

Estimate Cost of Property Damage - Vehicle 1

VEHICLE DAMAGE DIAGRAM — Enter numbers from this diagram which corresponds to damage to your vehicle from the accident

Motor Vehicle 1 Property Damage (Place up to 5 Numbers):


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Vehicle Damage Diagram

1) Driver’s Side
2) Hood
3) Front Passenger’s Side
4) Second Row Left Passenger’s Side
5) Bottom of Vehicle

6) Roof of Vehicle
7) Second Row Right Passenger’s Side
8) Third Row Left Passenger’s Side
9) Vehicle Trunk / Cargo Bed
10) Third Row Right Passenger’s Side

11) Left Rear Corner
12) Left Rear Wheel
13) Left Front Wheel
14) Left Front Corner
15) Front of Vehicle

16) Right Front Corner
17) Right Front Wheel
18) Right Rear Wheel
19) Right Rear Corner
20) Rear of Vehicle


VEHICLE DAMAGE — Indicate if the accident exceeds the $1,000 threshold for property damage to any one vehicle or property caused by the accident, and describe vehicle damage.


DRIVER OF MOTOR VEHICLE 2

Estimate Cost of Property Damage - Vehicle 2

VEHICLE DAMAGE DIAGRAM — Enter numbers from this diagram which corresponds to damage to your vehicle from the accident

Motor Vehicle 2 Property Damage (Place up to 5 Numbers):


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Vehicle Damage Diagram

1) Driver’s Side
2) Hood
3) Front Passenger’s Side
4) Second Row Left Passenger’s Side
5) Bottom of Vehicle

6) Roof of Vehicle
7) Second Row Right Passenger’s Side
8) Third Row Left Passenger’s Side
9) Vehicle Trunk / Cargo Bed
10) Third Row Right Passenger’s Side

11) Left Rear Corner
12) Left Rear Wheel
13) Left Front Wheel
14) Left Front Corner
15) Front of Vehicle

16) Right Front Corner
17) Right Front Wheel
18) Right Rear Wheel
19) Right Rear Corner
20) Rear of Vehicle


ACCIDENT DIAGRAM — Select one of the 9 diagrams (numbered 0-8) below if it describes the accident, or draw your own diagram, take a photo of it and drag and drop the photo into the box indicated below.

Left Turn (0)
Rear End (1)
Sideswipe <br>(same direction) (2)
Left Turn (3)
Right Angle (4)
Right Turn (5)
Right Turn (6)
Head On (7)
Sideswipe <br>(Opposite direction) (8)

Back


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