Notification of an accident. Sample filling, diagram, form


What is an accident notification?

The document, which is the basis for the settlement of traffic disputes, is drawn up by all participants in the traffic accident; a sample form can be found on any insurer website in the Russian Federation. The only case when its creation can be neglected is if the incident is not serious (there are no injuries or deaths, and less than 3 participants were injured in the accident) and the parties to the conflict decided not to contact insurance offices.

Notification of an accident

Each form has a special number, being a document of strict accountability.

This applies to holders of MTPL certificates. If motorists have taken out CASCO insurance, problems are resolved in a different manner.

In case of incorrectly filling out the notification of an accident, the driver will face a fine of 1 thousand rubles.

Instructions for filling out the Road Accident Notice

Attention: filling out the Notification of an Road Accident and signing it is not an act recognizing your guilt or the guilt of another participant in the accident.

General recommendations for filling

It is necessary to fill out a notification of an accident (hereinafter referred to as the Notification) in any traffic accident if damage is caused:

vehicle and/or property of other persons;

life or health of other persons, including passengers of your vehicle;

is especially important to note that complete and correct completion of the Road Accident Notice will allow you to exercise your right to settle the insured event in a simplified manner (according to the European protocol), i.e. register an accident without the participation of traffic police officers.

In this case, there must be only two participants in the accident; both must have a compulsory motor liability insurance policy and the damage was caused only to property.

The notice consists of a front (self-copying) part and a back side.

The front part of the Notice contains fields and columns that indicate the place, date, time of the accident, information about the participants in the road accident, insurers, the nature and list of visible damaged parts and elements, the circumstances of the accident and other necessary information.

The reverse side of the Notice contains fields and columns in which additional information about the accident and vehicles necessary, in the opinion of the participants in the accident, is indicated.

Both the front and back sides of the Notice must be completed.

Correctly filling out a notification about an accident is the main thing that needs to be done in this situation. Conscientiously and carefully fill out all positions on the Notification form, take into account all the information about this accident, about its participants and witnesses. A correctly completed Notice speeds up the work of insurers, and you will be able to receive insurance compensation faster.

To exclude subsequent disputes between the participants in the accident regarding the circumstances of the harm, the nature and list of visible damage to the vehicle, you must fill out the front part of the Notice together with the other driver involved in the accident at the scene of the accident .

The notice must be signed (preferably with a ballpoint pen) by both drivers (participants in the accident): make sure that everyone signs not only the sheet that remains with him.

At the earliest time convenient for you, fill out the back of the Notice. If there is not enough space on the back of the Notice to provide all the information, make the necessary additions on a blank sheet of paper, attaching it to the main form.

In this case, on the main form of the Notification, you should make an o, and also do not forget to indicate what this application is for and by whom it was drawn up, put your signature (for legal entities - certify with a seal).

Please note that if one of the drivers (participants in an accident) forgot, for example, to write the name and address of the insurance company, or he did not put a cross where it is necessary, or the number of the insurance contract is not indicated in full, or the second page of the Notice is difficult to read, in this case the insurer is forced to look for missing information. This is wasted time for him and for the owner of the damaged vehicle or other property.

Use only one set of forms for 2 vehicles involved in an accident. It does not matter which party involved in the accident provides a set of forms or selects column A or B. Use a ballpoint pen and write with pressure so that you can read the copy - then both drivers' insurers will receive a readable copy of the same Notice.

Ask, if possible, to certify the Notice with your signature of the traffic police officer (GAI) who arrived at the scene of the accident (indicating the full name, position and rank) for its execution. If the second driver refuses to sign the Notice or fill it out together, fill out the Notice yourself, be sure to indicate the make (model), number, color of the vehicle of the other participant in the accident, try to find witnesses (eyewitnesses) and indicate information about them in the Notice.

What is it for?

A completed form will be required to receive payment under the MTPL policy.

To avoid problems with the correct preparation of the document, it is better to familiarize yourself in advance with the procedure for entering data into it. Insurance companies provide special instructions for this purpose, which are recommended to be kept at hand.

Important! There are many known cases where victims failed to fill out a notification about an accident in accordance with the law. This leads to insurers either completely avoiding compensation payments or delaying resolution of the problem by initiating lengthy legal proceedings.

Where can I get the SOGAZ Insurance Company road accident notification form?

When purchasing an MTPL policy at one of the SOGAZ service offices, the client is given an accident notification form. If a car owner buys car insurance online (e-OSAGO), he needs to download the notice from the website.

To do this, you only need to take 6 steps:

  1. Go to the website sogaz.ru and go to the menu icon.
  2. In the drop-down window, select “Car Insurance”.
  3. On the new page, find the “Insured Event” section and click on it.
  4. After the transition, select “OSAGO”.
  5. Scroll down the instructions to the list of documents and click the highlighted line “Completed accident notification form.”
  6. A file with a browser shortcut will appear on your desktop. If you click on it, a notification form will open that you can download or print.

If you go back one page https://direct.sogaz.ru/products/automobile/osago/#section_desc, the site will open instructions for registering an accident, as well as online reminders and tariffs for civil rights, which can also be downloaded.

Where to get the form

In accordance with paragraph 24 of Chapter IV of the OSAGO Rules, the insurance agent is obliged to provide the car owner with forms free of charge after concluding the contract. It is possible to obtain them by visiting the insurer’s website or on our website: download and be sure to print.

Correctly fill out the notification in case of an accident:

Advice! If the form was not found by the victim, he can ask another driver (of any car) for it. It's completely legal.

The form has a front part (where you need to write the circumstances of the accident), which, when filled out, is self-copied onto a second copy. As a result, each of the participants, the victim and the culprit, receives a separate document.

Compiled by whom and when

Each participant in an accident who is a victim must have a form filled out in his own hand after the incident. The person at fault also has the right to participate in the preparation of the notice. This is especially true for inventorying vehicle damage.

Drawing up a document

When analyzing an accident, traffic police officers will rely specifically on the documents provided by the drivers.

Drawing up a notice in a simplified manner is possible if there are only two participants and the damage was caused only to property. This is called settlement of an insured event according to the European protocol.

What is the Europrotocol

Since 2009, there is no need to call traffic police officers to the scene of an accident. The car owners themselves have the right to record the incident. This form of accident registration is called Europrotocol. This is not a separate notification document, but only a simplified procedure. It involves 2 people: the perpetrator and the victim. This form of road accident registration has successfully proven itself in Europe. The Russian authorities adopted the useful experience of their foreign colleagues, which significantly relieved the traffic police.

Today, almost 1/3 of insurance reimbursements come from European protocols. Car owners are positive about the innovations, since the simplified procedure takes little time, and payments for vehicle damage are received quickly. Drivers should not be afraid that the insurer will refuse compensation for any reason. According to statistics, refusals to pay under the European protocol at IC Sogaz occur less frequently than the average for compulsory motor liability insurance - only 1%.

Instructions and nuances of filling out OSAGO

The fields must be filled out exclusively in blue ink and legible handwriting. If the victim has been injured and is unable to keep records, then one of the witnesses or relatives can draw up the document.

If an accident occurs within the city, you can call an insurance agent (or at least notify him in the case of a minor accident). In this case, he will take care of the registration himself.

Important! The form must not have any tears, stains or corrections.

Document structure:

  1. The front part of the notice - here they enter the time and date of the incident, personal data of the victims and culprits, information about insurance companies, a detailed list of damage caused to vehicles, additional information on items. Also on the main side is a diagram of the event that occurred;
  2. The reverse side - here you should indicate the features of the accident, a list of all the equipment involved in it, enter witness statements of third parties, notes about the video recording devices installed on the vehicle (if they comply with the requirements of the traffic rules), and make other notes.

All items on the main side must be filled out by the owner of the damaged equipment (except for item 18 of the “general information” and item 17 “Road accident diagram” - here the information is recorded by the other driver).

Expert opinion

Artemyev Dmitry

Experience as a forensic expert in the field of automotive technical examination for more than 2 years, more than 3 years of work in the field of insurance disputes, appealing guilt in road accidents.

Ask a Question

The main side of the document must be signed twice by all participants in the event, so all entered data must be agreed upon with each of them. And if at the time of the analysis there are police officers on site, then the senior officer must also apply for a visa; information about the position, rank, personal data (last name, first name and patronymic) and badge number must be available.

Notes about the witnesses present may also be helpful:

  • FULL NAME;
  • Addresses and contact information.

Important! Only damage to vehicles indicated on the form will be compensated by the insurance company.

If one of the cars is insured under the CASCO program, then this is noted in a special column “The car is insured against damage” - a check mark in the “Yes” box, if there is only a compulsory motor liability insurance certificate, then o.

The incident diagram should be drawn up jointly, following the design rules. The correctness of the analysis of the event by police officers depends on this. It is important to indicate which part of the car the first impact occurred (arrow).

Filling out the document

Note the nature of visible damage (dents, cracks), list broken parts and body elements.

It is important to clearly determine the position of the vehicle at the time of the accident relative to local streets, buildings, and nearby trees. Draw road markings and traffic lights in the drawing. If there are tire marks on the road surface (left during braking), then show them too.

Reference! If, during the analysis, traffic police officers identify serious disagreements between drivers, then the information contained in paragraph 16 of the document will be considered priority information.

When assessing the actions of road users, police officers will evaluate all maneuvers that could have helped to avoid an accident or, conversely, led to aggravation of the situation. Therefore, the driver needs to clearly indicate what he was doing at the time of the collision, before and after it.

Expert opinion

Artemyev Dmitry

Experience as a forensic expert in the field of automotive technical examination for more than 2 years, more than 3 years of work in the field of insurance disputes, appealing guilt in road accidents.

Ask a Question

After affixing the signatures, the form is divided into parts: the main one, filled in with a writing pen, and a copied copy. Both fragments have equal meaning. The reverse side is also filled out by each participant.

An example of filling out the first section of the notice of the secondary part:

“The circumstances of the accident - at 22.00 I was moving along Utochkina Street in the direction of Eastern Avenue in the left lane. When changing lanes to the right lane, a collision occurred with a Volvo... under the following circumstances..."

Other graphs:

  • Data on all vehicles that took part in the incident;
  • Is there any damage?
  • Can this vehicle move independently?
  • Was there a video recording of the accident? If yes, then what device (type of model, on which vehicle it is installed).

Important! To avoid misunderstandings, free fields (without text) should be carefully crossed out after filling.

Video recordings can be added to the accident report only in one case: they have GPS or GLONASS sensors.

Filling out the front side

The front part of the Notice contains fields and columns that indicate the place, date, time of the accident, information about the participants in the traffic accident, insurers, the nature and list of visible damaged parts and elements, the circumstances of the accident and other necessary information.

The front side is filled out by each driver independently in relation to his vehicle. Exceptions are paragraphs 1-8 “General Information” and paragraph 17 “Road Accident Scheme”, they are filled out by one of the drivers by mutual agreement.

General information

  • clause 1
    Location of the accident: city, street, house closest to the accident site or street intersection if the accident occurred at an intersection. Outside a populated area - name of the route, kilometer and direction of travel.
  • clause 2
    Date and time of the accident.
  • p.3
    Number of vehicles damaged as a result of an accident.
  • p.4
    Number of injured and killed in the accident.
  • p.5
    Was drivers examined for alcohol or drug intoxication (only when registering an accident involving traffic police officers).
  • clause 6
    Presence of material damage to other vehicles and property.
  • clause 7
    Witnesses to an accident: if there are no witnesses, the entry “no witnesses” is made; if there are, then their last names, first names and patronymics, addresses and telephone numbers are indicated. If these are passengers of your vehicle or another vehicle (involved in an accident), underline the names in order to clarify this.
  • clause 8
    Police officer badge number (only when registering an accident involving traffic police officers).

Information about vehicles and owners

The columns “Vehicle A” and “Vehicle B” are filled in by each driver in relation to his vehicle.

  • clause 9
    Make, model and other information about the vehicle - from the registration certificate or vehicle passport (PTS).
  • clause 10
    Owner of the vehicle.

Driver information

Clause 11 Vehicle driver is the person driving the vehicle at the time of the accident. Provide information about date of birth, residential address, telephone number and driver's license.

If the driver is not the owner of the vehicle, the document on the basis of which he is allowed to drive is additionally indicated, for example, “Notarized power of attorney” or “Waybill”.

Information about insurance companies

clause 12 Insurer - name of the company; number and validity period of the driver’s insurance policy (with “unlimited” insurance - owner) of the vehicle. If the car is insured under CASCO, in the “Vehicle is insured against damage” item, check the “Yes” column.

Damage and accident diagram

  • clause 13 Place of initial impact : the arrow indicates which part of the vehicle the first impact occurred. It is necessary to clearly mark the location of the initial impact, and not the parts that are damaged.
  • clause 14 Nature and list of visible damage .
    It is necessary to describe the nature of damage to parts and elements as accurately and briefly as possible. When characterizing damage to car elements, depending on the degree of damage, select one of: scratch, dent (deformation), rupture (crack). In the absence of a description of visible damage to a particular part (element), the insurance company, when considering the application for payment, has the right to conclude that this part (element) was damaged not as a result of this accident, but under other circumstances, which may lead to refusal to reimburse the cost of repair (replacement) of the part. Invisible (hidden) damage will be identified and described during inspection of the vehicle (property) by experts.
  • p.17 Road accident diagram : carefully draw a road accident diagram.
    Indicate the names of streets, the direction of movement of vehicles, the position of the vehicle at the time of the collision and their final position, the location of traffic lights, road signs and their location, road marking lines (dividing strips, white line, prohibited movement, etc.), and, if possible, - location and configuration of debris, fragments, braking marks, skid marks, etc. Try to avoid contradictions between the information specified in paragraph 16 of the Notice and the road accident diagram. If there are such contradictions, the information specified in clause 16 of the Notice has priority.

Circumstances of the accident

clause 16 Circumstances of the accident . It is necessary to correctly reflect the maneuvers of your vehicle. Please note that:

  • parking is not a stop. If your car stopped, for example, at a red light, do not mark position No. 1 “The vehicle was in a parking lot, parking lot, roadside, etc., stationary.” Position No. 22 “Stopped (stood) at a prohibitory traffic light signal” is noted;
  • if one vehicle overtook another, entering the lane (side of the roadway) intended for oncoming traffic, and then returning to the previously occupied lane (side of the roadway), you must mark position No. 13 “Overtaken”;
  • if the vehicle left the occupied lane or occupied row without entering the lane (side of the roadway) intended for oncoming traffic, while maintaining the original direction of movement, you must mark position No. 12 “Changed lane (changed lanes)”;
  • do not forget to fill in the last position “Indicate the number of marked cells”. This is important to avoid misunderstandings when assessing the circumstances of an accident.

Drivers' comments and signatures

  • clause 15 Remarks - you can additionally provide information that is not specified in clause 16 “Circumstances of the accident”. If the second participant in the accident indicates in the Notification circumstances that seem inaccurate to you, or refuses to sign the Notification on his part, then information about this is also reflected in paragraph 15. The signature of the driver who filled out all the points in relation to his vehicle is also affixed here.
  • clause 18 Signatures of drivers certifying the absence of disagreements. Signatures are affixed only in case of registration of an accident without the participation of traffic police officers.

After filling out the front side, the participants in the accident separate and sign the sheets. It is important to ensure that each driver signs both sheets of the Accident Notice on the front side, and not just the copy that remains with him. Once the forms have been signed and separated, no changes, corrections or additions are permitted.

It doesn’t matter which of the participants in the accident takes the “original” and which one takes the tear-off (self-copying) copy of the completed Road Accident Notice. Completed and disconnected forms are equivalent.

Where to apply and when?

The completed form is sent to the victims to the insurance office, but no later than 5 days after the incident.

In addition to the notice, you should have with you all the papers issued by the traffic police officers. You must arrive at the company that issued the MTPL policy.

If the institution does not work for some objective reason, then the victims must go to the company responsible for the accident and notify its employees.

Reference! In case of refusal to compensate for damage, applicants for payment of compensation have the right to contact RSA (Russian Union of Auto Insurers).

If the deadlines for submitting documentation are violated, the insurance company has the right not to pay the amount of damage.

In what cases can you use the AlfaStrakhovanie Europrotocol?

In accordance with Art. 11.1 of the Federal Law “On Compulsory Motor Liability Insurance”, you can register an accident without calling traffic police officers in the following cases:

  1. Two cars were damaged in the accident, and both drivers had an MTPL insurance policy. There should be no injuries to people in the accident, and no damage to property other than the car.
  2. The participants in the accident have no contradictions regarding the circumstances of the incident, the nature and list of damage to vehicles.
  3. The preliminary amount of damage does not exceed 100,000 rubles. If the injured party believes that these funds are not enough to carry out repairs, registration under a simplified procedure is impossible.

If the circumstances of the accident do not fall under at least one of the above criteria, it is necessary to call the traffic police.

It is important to carefully comply with all requirements, since a violation may limit a party’s right to seek compensation from the insurer.

What to do if you didn’t fill it out at the scene of the incident

A situation may arise that one of the participants in the accident did not fill out the notification:

  • Refused this procedure;
  • Fled from the scene;
  • Killed in an accident;
  • There were no extra forms.

Clause 41 of the OSAGO Rules states that it is allowed to fill out a notice unilaterally if for some reason other participants (or a participant) did not do so.

The statement is written by the victims within 15 days from the moment of the accident.

Be sure to indicate in the form:

  1. The model, type and color of the cars of those drivers who did not submit notices;
  2. It is recommended to find witnesses to the accident and record their information in a document.

Amount of compensation according to the European protocol

As of October 1, 2019, new rules regarding the compensation limit under the European protocol came into force. Drivers can now receive increased damage coverage (unlimited), but under certain conditions. Over the past 8 months, Soglasie Insurance Company has reimbursed:

  • 100,000 rub . In case of damage to the vehicle, no more than the specified amount. For registration, a regulatory form of the European protocol is required. At the same time, drivers may have disagreements. But if the fact of an accident is registered by the ERA-GLONASS system, then it is allowed to register the accident according to a simplified scheme;
  • RUB 400,000 b. Damage to the body is 100,000–400,000 rubles. Mutual agreement was reached between the drivers. In addition to filling out the European protocol, the participants registered the incident in the mobile application “Road accident. Europrotocol” (provided by: AppStore and Google Play).

Attention! It is necessary to transfer data about the accident to the compulsory insurance system through the “Road Accident.Europrotocol” application within 60 minutes. from the moment of the accident.

What to do after filling

After an accident, traffic police officers (when called) will set a day for analyzing the incident. As a result, the perpetrators and victims will be identified.

The injured party, along with a notification form and documents confirming his innocence, arrives at the insurance company’s branch.

Employees are required to accept a citizen’s application requesting compensation for losses.

Reference! The injured party has the right to go to court if it is sure that insurance payments are not enough to pay off the damage.

There are cases when victims of an accident end up in medical institutions, then the relatives or friends of the injured citizen will have to take care of drawing up a notice.

"SOGAZ" - List of documents for receiving payment

To receive monetary compensation or other actions, the client of the organization must download the appropriate application form. It is filled out and submitted to one of the offices of the insurer SOGAZ. However, you will need to collect additional documents. Their list depends on the specific insurance program.

The list of documents required to receive insurance benefits is different for each program. But there are several documents that must be submitted regardless of the type of program:

  • passport;
  • application for insurance payment;
  • application for insurance (filled out during registration of the contract);
  • insurance contract or policy;
  • documents confirming payment of the insurance premium, for example, receipts;
  • application for bank details;
  • consent to the processing of personal data.

Other documents will need to be added to this list in accordance with the insurance contract.

"OSAGO"

In the event of an insured event, employees will need to provide a passport or other document that can be used to identify the client, a policy and a notification form. The following documents will also be required:

  • If damage is caused to a car, you need to prepare documents for the damaged vehicle (TCP, certificate), driver's license and papers that will confirm that the insured event actually occurred (for example, a traffic police report).
  • If damage is caused to a person, in addition to the documents described above, you will have to collect certificates that will contain an indication of the amount of money lost by the citizen due to damage caused to life and health.

It is also mandatory to provide bank account details and a conclusion on an independent examination if the company’s client organized it independently.

If a compulsory motor liability insurance agreement was concluded, then in addition to the above documents you should submit:

  • notification of an accident (needs to be completed);
  • all available documents for the car: title, registration certificate, loan agreement (if the vehicle was purchased with borrowed funds);
  • driver's license;
  • documents confirming that an insured event has occurred. These may be protocols or resolutions on an administrative offense, resolutions on the imposition of a fine, determinations on the initiation of a case on an administrative offense, and others.

An application for payment must be submitted within 5 working days. If the accident occurred in remote places, then the application can be sent within 15 working days.

"CASCO"

The list of documents for receiving payments under the CASCO agreement is not much different from the package of documents under the MTPL. You will definitely need a copy of your driver's license, documents for the car and documents confirming the occurrence of an insured event.

The latter include a certificate from the police department or traffic police, including form No. 154, documents from a medical institution, and the results of a medical examination. To receive compensation, you must attach the following documents to your application:

  • Passport or other paper that will make it possible to identify the applicant.
  • Documentation received at the time the policy was issued.
  • PTS.
  • Vehicle registration certificate,
  • Loan agreement (when buying a car on credit).
  • Purchase and sale agreement (provided if the insured event occurred before vehicle registration).
  • Civil contract (only when the policyholder and the owner of the vehicle are different persons).
  • Details of the account to which the funds will be transferred.
  • Written consent to the processing of personal data.
  • Papers confirming the fact of the occurrence of an insured event (certificate from the police department, traffic police, resolution to initiate a criminal case, etc.).

Under the “Voluntary Civil Liability” program, you also need to submit a protocol (administrative violation), a resolution (initiation of a criminal case), papers from the traffic police confirming what happened, and an inspection report of the damaged property.

In the event of the death of a participant in an accident - a death certificate and documents indicating the expenses associated with his burial.

If the incident did not occur while the car was moving, but, for example, as a result of the fall of an object, then you need to submit documents from the organization that is responsible for such incidents. This could be a fire service, a police department, or a hydrometeorological service.

Common questions that arise when filing a notice

Problems arising at the time of writing:

  1. The document does not establish the guilt of any of the participants. It is intended to give the most objective assessment of the situation that has arisen. The initiator of the accident is determined by police officers as a result of analysis and necessary examinations, after which the participants in the accident are notified;
  2. The notice should always be filled out (if it is necessary to contact insurers); the presence or absence of traffic police inspectors does not matter;
  3. If there are 3 or more participants in the accident, then each of them writes a notice;
  4. In the event of a collision with an obstacle, there is no need to fill out a document, the owner of the MTPL policy will not receive compensation, and the citizen who purchased the CASCO certificate will be able to assess the damage based on the actual damage to the car;
  5. Signatures are not required on the back of the notice.

Expert opinion

Artemyev Dmitry

Experience as a forensic expert in the field of automotive technical examination for more than 2 years, more than 3 years of work in the field of insurance disputes, appealing guilt in road accidents.

Ask a Question

In the event of a collision with animals, structures or pedestrians, insurance companies should write a regular statement asking them to evaluate and pay for the damage.

Reference! It should be taken into account that sometimes the emergency commissioner from the insurance service can meet halfway; with the mutual consent of all participants, notices can be rewritten.

Step-by-step filling out an accident report

Paragraphs 1 to 8 Notifications of road accidents

clause 1 Location of the accident - indicate the exact location of the accident. If it happened in the city: city, street, house. If at an intersection, indicate the intersection of streets. If outside the populated area - Republic, region, region, name of the route, kilometer, directions of movement.

clause 2 Date of accident - write the date and time in numbers.

clause 3 Number of damaged vehicles - if there are 2 participants, then 2, if there are 3 participants, then 3, etc. (i.e. we also indicate our car).

clause 4 If as a result of the accident there are injured (persons who received bodily harm) and (or) dead, then fill out this paragraph. If they are not there, put dashes.

p.5 Whether the participants in the accident were examined for intoxication (alcoholic or nargotic) - put a tick in the appropriate checkbox.

clause 6 Material damage caused to other vehicles or other property , we also tick the appropriate checkboxes.

If there are no witnesses, you need to write “no witnesses” in clause 7 of the Notice . If there are witnesses, then enter their last names, first names and patronymics, addresses and telephone numbers. If these are passengers in your vehicle or another vehicle (involved in an accident), underline the names to clarify this.

Clause 8 The traffic police officer who carried out the registration of the accident indicates only the number of the badge and only on the condition that the accident was registered with the participation of the traffic police. Under the Europrotocol, this item will not be filled in; a dash will be made.

Information about the vehicle and owner

Information about the vehicle and owner

The data in the column “Vehicle - A” and “Vehicle - B” is filled in by each driver for his car

clause 9 Information about the vehicle (make, VIN, etc.) - fill in on the basis of the vehicle registration certificate.

clause 10 Owner of the vehicle - indicate the person to whom the car is registered (it may differ from the driver).

Driver data

Driver data

Clause 11 Vehicle Driver - indicates the person driving the vehicle at the time of the accident. Full name, date of birth, address (registration), phone number, driver's license.

Insurer data

clause 12 Insurer - indicate the name of the insurance company from which the MTPL policy was purchased, the series, insurance number and its validity period. If your car is insured against damage under CASCO, check the box.

Location of impact, damage, accident diagram

Location of impact, damage, accident diagram

In paragraph 13 of the Notice, clearly indicate the location of the initial impact, and not the parts that are damaged.

When filling out clause 14 of the Notice, try to describe as accurately and briefly as possible the nature of the damage to parts and elements. When characterizing damage to car elements, depending on the degree of damage, select one of: scratch, dent (deformation), rupture (crack).

Be careful: in the absence of a description of visible damage to a particular part (element), the insurance company, when considering your application for payment, has the right to conclude that this part (element) was damaged not as a result of this accident, but under other circumstances, which may lead to a refusal to reimburse the cost of repair (replacement) of this part. Invisible (hidden) damage will be identified and described during the inspection of your vehicle (property) by experts.

Carefully draw a diagram of the accident (clause 17 of the Notice) . Indicate the names of the streets, the direction of movement of the vehicles, the position of the vehicles at the time of the collision and their final position, the location of traffic lights, road signs and their location, road marking lines (dividing strips, white line, prohibited movement, etc.), and possibilities - location and configuration of mud scree, fragments, fragments, braking marks, skid marks, etc.

Try to avoid contradictions between the information specified in paragraph 16 of the Notice and the road accident diagram. If there are such contradictions, the information specified in clause 16 of the Notice has priority.

Accident diagram sample filling -

Circumstances of the accident

When specifying the circumstances of the accident (clause 16 of the Notice), it is necessary to correctly reflect the maneuvers of your vehicle. Please note that:

parking is not a stop. If your car stops, for example, at a red light, don't o. Marked pos. 20 “I stopped (stood) at a prohibitory traffic light”;

if one vehicle overtook another, changing lanes from one lane to another, you need o and pos. 11 “Overtook”;

do not forget to fill in the last position “Indicate the number of marked cells”. This is important to avoid misunderstandings when assessing the circumstances of an accident.

Note on the Notice and signatures of drivers

In clause 15 “Remarks” you can additionally provide information that is not specified in clause 16 “Circumstances of the accident”. In addition, if the second participant in the accident indicates in the Notice circumstances that seem inaccurate to you, or refuses to sign the Notice on his part, then you can provide information about this in the same paragraph.

Please note that the front side of the Notice is signed by each driver twice: after each driver has indicated information on their vehicle, and in paragraph 18 to confirm that there is no disagreement between the participants in the accident in assessing the circumstances of the harm caused by the accident, as well as the nature and list visible damage to the vehicle.

After both drivers have signed and signed the forms, making changes to the Notice is PROHIBITED!

Filling out the back side

On the reverse side we indicate in more detail the circumstances of the accident, additional information about the vehicles and the damage caused.

Each driver fills out the reverse side independently.

Circumstances of the accident

Circumstances of the accident

item 1 Vehicle - put a mark depending on which column you filled out on the front side “A” or “B”.

clause 2 Circumstances of the accident - we outline the circumstances of the accident in more detail.

clause 3 We indicate who was driving the vehicle at the time of the accident (the owner or another person).

Vehicle Information

Vehicle Information

clause 4 To be completed if more than 2 vehicles were involved in an accident , you must provide information about these vehicles, namely:

  • brand;
  • vehicle model;
  • state registration plate;
  • name of the insurance company;
  • insurance policy series and number.

clause 5 Damage to property other than a vehicle , indicate the name of the damaged property and who it belongs to.

p. 6 We make a note whether the vehicle can move independently . If not, describe the location where the vehicle is currently located.

additional information

additional information

paragraph 7 Note - if you have information that you consider necessary to reflect in the document, then enter it in this paragraph.

REMEMBER! The completed notification of an accident is submitted to the insurance company within 5 days from the date of the accident. The period begins to run from the next day.

All entered information is double-certified by the driver’s signature.

Common mistakes

  1. If the vehicle was not insured, the culprit will pay for the damage from his own funds. If the victim does not have compulsory motor insurance, he will receive nothing;
  2. The victim forgot to notify the insurance company about the accident and lost the opportunity to receive money as compensation;
  3. Errors in the preparation of notices;
  4. Sometimes all the forms are filled out by the same person (in the same handwriting as the rest of the documents). Insurers may find this suspicious, since there are many cases of fraud in this area;
  5. Corrections to the main text were made with different ink - another reason for refusing to pay compensation;
  6. There is no consistency: the culprit writes one thing, and the victims write something completely different.

Filling example

What to do in case of refusal:

  • Request a written document indicating the reason for the refusal;
  • Conduct an independent examination to assess the damage to the vehicle;
  • Collect all available documents, including receipts indicating additional expenses;
  • Write a statement to the court.

Expert opinion

Artemyev Dmitry

Experience as a forensic expert in the field of automotive technical examination for more than 2 years, more than 3 years of work in the field of insurance disputes, appealing guilt in road accidents.

Ask a Question

You need to understand that a dispute with a structure that has dozens of experienced lawyers on its staff is a long story. Therefore, already at the stage of searching for an insurance company, it is recommended to carefully study the local market for services and choose a large organization with a minimum percentage of refusals.

Advice! Most often, difficulties arise when participants in an accident decide not to call either the police or emergency commissioners. One small mistake results in non-payment of compensation.

Quite often, an accident diagram and a description of the first impact are drawn up with errors (the list of damages is indicated, not the nature of the collision). The police find it difficult to determine the culprit and draw up a report of mutual violation.

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