For this reason, it is best to hire the services of an experienced lawyer who can guide you through the process and advise you on whether or not an offer is relevant. Think more about why you need a lawyer and read our guide to the best lawyers for traffic accident claims for more tips. 4 Please indicate if you (or the injured) were wearing a helmet at the time of the accident? YesNoYesNo9 Contact information of the deceased (if any):10 Security measures:aa/mm/ddorThe right of opposition of third parties formraf 1 page 4 The Workers` Compensation and Sickness Compensation Act gives employees the right to claim compensation if they are injured during the motor vehicle The accident gives rise to one or more claims under the Workers` Compensation and Occupational Diseases ActJaNunNeinFün you have answered YES, Did you make a claim for compensation when there are witnesses to the accident? YesIf you answered YES, please provide the following information about these cookies:First and last nameAddressPhone number No. Cell NoWhat was the employment status of the injured/deceased at the time of the accident? Independent EmployeesName and Last NameAddressPhone Number (If this claim form does not leave enough space to list all witnesses, please indicate the remaining witnesses and their contact information on a separate page that will be attached to this claim form)If YES, indicate the reference number of the compensation fund received so far Indicate whether the compensation received will be included in the final arbitration11 details of the compensation Compensation for the Worker:12 Cookies:13 Employment status. The legislation on claims against the Accident Insurance Fund was amended with effect from 1 August 2008. The new law sets stricter limits on what you can claim. For more information, see our simple explanation of the changes to the claims rules in 2008. Learn more about this form and what it confirms in our article on injuries considered « serious ». This lawyer can assess your claim, ensure it is filed with appropriate evidence, advise you on whether or not to accept an RAF settlement offer and, if necessary, guide you through the appeal process. Often, the traffic accident insurance company submits an offer to the applicant in the hope of a quick agreement. While accepting an amount offered may seem preferable to a longer wait for compensation, billing can only be a small percentage of what you could get as coverage if you pursue your claim. 3 6 Passengers, pedestrians and cyclists: third party claim formfl 1Page 3 What is the registration number of the motor vehicle/motorcycle you are driving (or of the injured/deceased)? Mobile Phone Number: Physical Address: If you (or the injured/deceased) are not the owner of the motor vehicle/motorcycle, please provide the following information in relation to the owner – first and last namePhone number: Please provide details about other vehicles involved in this accident. (Pedestrians and cyclists must also answer this question by providing details about the vehicles involved.) License Plate:Driver Contact Number:License Plate:Driver Phone Number:Was it a Driver Leaked Accident? Yes No.
7 Drivers/Motorcyclists:8 Details of other vehicles in the accident:Name Date of deathNameNameWhat is your connection to the deceased? Identification number Please attach a copy of the death certificate, examination report or indictment sheet to the date of birth Please indicate whether you (or the injured person) were attached at the time of the accident? It is the responsibility of the applicant to submit sufficient supporting documentation. The Traffic Accident Fund requires you to submit an application within three years of the traffic accident if you know who was responsible. Third Party Claim Formraf 1Page 1 TitleName Postal AddressName Date of Birth Home Telephone NumberIdentification Number / Passport NumberProfessional Telephone NumberNote: This application form must be accompanied by a certified legible copy of your identity cardFlow numberLife addressE-mailHow would you like us to contact you? Sms e-mail PostTel (H) Tel (W) CellAre you claiming compensation on behalf of another person? Your first and last name: AddressYESNOYour ID/passport number:If you answered YES, please provide the following informationIn what capacity you actIf your application is accepted, the RAF will pay you directly. Please provide bank details for the payment of compensation on the basis of (name)Account number:Branch numberName of account holder1 Personal data of the applicant:2 Contact details of the person entitled to claim as a representative:3 Bank details of the applicant:yy/mm/ddThe third party complaint formraf 1Page 2When the fee becomes due, please provide the account details to which the fee must be attached to one of the following documents on the RAF Application Form to verify bank details: a void cheque or a certified legible copy/original extract clearly indicating the name, account and branch number of the account holder, or an original letter from the bank (on an official letterhead) confirming the name, the account and disbursements from the Traffic Accident Fund of the account holder depend on several factors. the severity of your injuries, the impact of the accident on your life, and the cost of future treatment of your injuries. For more information, check out our detailed guide on what you can apply for and how much you can apply to the Traffic Accident Fund. Also read our article on the documentation you need to make a claim. .
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