Request a No-Fault Benefits Application Form if you are injured in a car accident
Ask your insurance adjuster to send you a no-fault benefits application form consisting of an Accident Report form, a Physician's Report form and a Wage and Salary Verification form. These documents must be completed and returned to the insurer before any no-fault benefits can be paid. Medical benefits are paid directly to your health care provider(s) and lost wage benefits are paid to you.
Request the assistance of your physician and your employer
When you receive the forms, you will fill out the Accident Report form yourself and return it to the no-fault insurance adjuster. You will take the Physician's Report form to your main treating physician who will fill out the form and forward it to your insurer. Your will take the Wage and Salary Verification form to your employer (if your injuries resulted in lost wages). Your employer will fill out the form and return it to your insurer.
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