Car accident insurance claim form

First notice of loss with empathy: safety check, what happened in their own words, other driver details and a video of the damage.

“Report a car accident”, hosted by Sofia, Claims Specialist · 7 questions

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Is everyone safe?

Yes, everyone is okaySomeone was injured

Question 1 of 7Multiple choice

Every question in this form

Sofia asks each of these 7 questions on camera; people answer by tapping, typing or recording. Some answers send people down a different path, shown under the question.

  1. 01

    Is everyone safe?

    Multiple choice

    Sofia says: “First, the most important question. Is everyone safe?”

    • Yes, everyone is okay→ Tell us what happened
    • Someone was injured→ Did anyone need medical attention?
  2. 02

    Did anyone need medical attention?

    Multiple choice

    Sofia says: “I'm sorry to hear that. Did anyone need medical attention?”

    Yes, emergency services cameMinor, no treatment yet
  3. 03

    Tell us what happened

    Answer by video, voice or text

    Sofia says: “In your own words, walk me through what happened.”

  4. 04

    Was another vehicle involved?

    Multiple choice

    Sofia says: “Was another vehicle involved?”

    • Yes→ Other driver's name and plate number
    • No, only my car→ Show us the damage
  5. 05

    Other driver's name and plate number

    Short text answer

    Sofia says: “Please add the other driver's name and plate number, if you have them.”

  6. 06

    Show us the damage

    Answer by video, voice or text

    Sofia says: “If you can, record a short video of the damage to your car.”

  7. 07

    How can we reach you?

    Contact details

    Sofia says: “Lastly, how can your claims specialist reach you?”

Sample answers, with the AI summary

These answers come from fictional respondents. Every new account gets them as sample data, so you can see transcripts, summaries and comments before your first real response.

Laura Chen2 hours ago
Is everyone safe?
Yes, everyone is okay
Tell us what happened
“I was stopped at a red light, and a van rolled into my rear bumper.”
Was another vehicle involved?
Yes
Other driver's name and plate number

Mark Doyle, plate 7KDF219

Show us the damage
“So this is the back. The bumper is cracked and the trunk won't close.”

AI summaryNegative

Rear-ended by a van while stopped at a red light.

  • rear-end
  • trunk damage
Peter Novak8 hours ago
Is everyone safe?
Yes, everyone is okay
Tell us what happened
“Black ice this morning. I slid into a lamp post at low speed. Nobody else involved.”
Was another vehicle involved?
No, only my car
Show us the damage
“The front left side took it. Headlight's broken, and the wing is dented.”

AI summaryNegative

Slid into a lamp post due to black ice, damaging the front left side.

  • black ice
  • single vehicle
Mateo Rossi30 minutes ago
Is everyone safe?
Someone was injured
Did anyone need medical attention?
Minor, no treatment yet
Tell us what happened
“Um, I was merging onto the highway and didn't see the car in my blind spot. We sideswiped each other.”
Was another vehicle involved?
Yes
Other driver's name and plate number

Sarah Jenkins, plate J92-KLM

Show us the damage
“My passenger side doors are both deeply scratched and dented. The mirror is completely snapped off.”

AI summaryNegative

Sideswipe collision during highway merge with minor injuries reported.

  • sideswipe
  • blind spot
  • minor injury

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