Automobile Defects

Auto Design Defect: Case Submission

If you or a loved one has been seriously injured in a car accident, you will need a lawyer to help you recover damages for your medical bills and compensation for your pain and suffering. However, in very serious injury cases, many people soon discover that the available insurance is inadequate to provide full compensation. This web site can help you find an attorney if the injuries are so serious that existing insurance is not enough to provide compensation for your medical expenses and life long disability.

Please fill out all of the information requested below and we will refer your case to an attorney in our national network of counsel. Our lawyers have experience bringing lawsuits and claims against auto makers for defective designs that result in serious injuries. Typical Cases involve, seat belt failures, rollover accidents, gas tank explosions and roof crush injuries.

By submitting you have read and agreed to our case legal notices and terms and conditions >>

Title:

First Name:

  M. I.

 

 Last Name:

 Address:

 City:

 State:

 Zip Code:

 Phone Number (day):

 Phone Number (eve):

Email Address

 If this inquiry is not for yourself, please tell us the name of the person?:

 Title:

 

First Name:

   MI

 

Last Name:

What is the Injured's relationship to you?:

Injured's Date of Birth?
(ie . mm/dd/19yy)

Have you or they been been in an auto accident?:

Yes No
Date and time of accident?

 Location of accident?

  Describe Injuries?

What was the
Make, Model and Year of your vehicle?

What was the Make, Model, and Year of the
vehicle that hit you? 

Was the person(s) injured wearing a seat belt? 

 What was the speed of the vehicle when the accident occurred?

What were the weather conditions when the accident occurred? 

Were drugs and/or alcohol involved? 

Describe your injuries and the Defect you believe caused the injury.

 
 I understand that submitting this form does not create an attorney client relationship: Agree


Submit by pressing button below