Please state all medical treatment and/or hospitalization as a result of this accident:
We must know whether you have ever had ANY CLAIM or LAWSUIT (including claims for Worker’s Compensation) in your life, regardless or whether or not you collected any money from your claim or lawsuit.
Insurance companies have access to sophisticated and comprehensive databases regarding past claims and lawsuits asserted by you or on your behalf anywhere in the United States. Prior claims or lawsuits will usually not affect your present case, but a denial of such a prior claim or lawsuit will cause serious damage to your credibility and your current case.
Please list every claim you have made for personal injuries or medical bills arising out of personal injuries.
MORE THAN 3? No Yes -- If more will discuss with attorney.
Failure to mention other problems, diseases or injuries, to the same parts of your body that were hurt in your current case, can undermine or destroy a claim or lawsuit (no matter how trivial the prior injury, problem or disease may seem).
Please list any past injuries or problems with the areas of your body, injured in this case, whether they resulted in a claim for damages or not, stating (to the best of your recollection) the date, place and nature and extent of your injury or problem.
If you have had no prior injuries or problems with the areas of your body injured in this case, state “NONE”.
MORE THAN 4? No Yes -- If more will discuss with attorney.
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