Notification of an accident: sample filling

Notification of an accident, a sample of which we will consider inarticle, fill in the case of an accident at the place of the accident. It displays the full picture of the accident. The content of the document is very important. After all on its basis in the insurance company the decision on payment to the injured party will be made. Therefore, the driver should know how to fill out an accident notification. If the data is displayed incorrectly or ambiguously, then the insurance payment will be under a large question mark.

When to fill out a notification

If you have an accident, you or another participant in an accidenthurry and do not want to call the traffic police inspector, fill out the road accident notification. A sample of it can be found in our article, as well as on any post of the GAI. But not every traffic accident can be formalized in this way.

notice of an accident

Notification of the insurance about the accident is filled without a traffic police officer in such cases:

  • in the accident involved two or more cars;
  • all participants in the accident have a MTPL policy (not overdue);
  • when an accident was not affected and people were not killed;
  • participants agree among themselves with all the circumstances of the incident (the notice is signed by all participants of the road accident twice).

In addition, it is important that the accident hasan insignificant nature, because the payment for OSAGO has limits. The maximum amount of payment for insurance today is 50,000 rubles, and for Moscow and St. Petersburg - 400,000 rubles.

Therefore, if the accident allegedly causedhigher damage than provided for by OSAGO, DPS employees should be called. Especially it is necessary in the event that as a result of road accident there are victims. Then the case will not be the administrative nature of the offense, as usual, but be regarded as a crime for which the perpetrator must be held criminally liable.

Form - notification of an accident: sample

When concluding an agreement on compulsory motor third party liability insurance, the company issues a notification form. The driver should always carry a few copies with him. You can also print the form yourself.notice of an accident

If in the event of an accident you do not have him with youit turned out that you can take advantage of what another participant has. It does not matter if he is insured in another company. In any case, the insurance must accept it. However, it should be noted that the document must be in proper form. This means that it does not allow any wear and tear. It consists of the front and back sides.

Front side

On the back of the front of the document is a carbon copy. One part is given to one participant in the accident, and the other to another.

On the front side the following information is reflected:

  • time, date and coordinates of the incident;
  • The scene of the incident is described with the names of nearby streets, and the road - with directions of traffic;
  • information about the insurer, insurance policy;
  • place of impact, as well as all damages on one and the other car;
  • Name, address of the car owner and the brand of his car;
  • circumstances and the scheme of an accident.

If the DPS inspector was called, the following additional information is indicated:

  • the number of his breastplate;
  • data on medical examination.

A police officer (senior attorney) must sign the notice and state their data, including name, title and position.

how to fill out an accident notification

After filling out the road accident notification from the front side, the sheets are torn, and each participant of the incident signs on his and other copies.

back side

Thus, the identical information on the front side is obtained. But the reverse is filled by the driver himself. Here are described:

  • information about who was driving during the accident;
  • with the participation of more than two cars, all of them are indicated;
  • Other information or notes may also be included.

If there is not enough space in the description of the incidenton the form, it is possible to continue the notification of an accident. The sample, in this case is not needed, since any clean sheet of paper is taken, and the missing information is described. At the same time, a note is made on the document itself that it is supplemented by the corresponding application.

General recommendations

If employees are called to the scene of the incidentGIBDD, it is best to fill out the document before they arrive. Drafts should not be done unless you have to correct the text. In this case, you have to rewrite everything.

Correct completion of the notice of an accident

In addition, the correct filling of an accident notificationinvolves the use of only a ballpoint pen (the use of a gel or pencil is forbidden - the handle can spread, and the pencil can be erased or not printed on the copier). And one and the other copies are equivalent. Therefore it does not matter who has the original.

Participation of more than two cars

If as a result of an accident severalcars, a notice of an accident is also drawn up, the sample of filling of which remains the same. But there are more of them. For example, if three cars collided in a row, then the driver of the car in the middle should make 2 notices: one is filled with the driver of the car in front, and the other with the participant whose vehicle was behind.

However, on the reverse side, regardless of who made the notice, it is necessary to indicate all the participants in the traffic accident.

Notification of an accident: a sample of filling by items

Let us dwell on several points on the front side of the document.

  • In clause 14 faults are indicated, which are visible. It is important to describe all the scratches, cracks and chips as much as possible.
  • In paragraph 16 describe the circumstances leading toAccident. Here it is necessary to note the necessary graphs, without being confused in terms. So, parking and stopping are not the same as the forced stop at the traffic lights.
  • In paragraph 15, the information of paragraph 16 is supplemented or refined, or other information is introduced.form of an accident report
  • In paragraph 17, draw a diagram of the accident. It should reflect the road and its direction, nearby streets (with the name), fixed objects, traffic signs, traffic lights, if it was, its light and the like.
  • At 18th point drivers sign their names. This is a very important graph. Both drivers must sign and confirm that they agree with all the data specified in the notice. And no notices like "I admit my guilt in part" are not allowed. In this case, the DPS inspector should be called. This will have to be done in the event that another participant in the accident refused to sign the document at all.


Since it is correct to fill out an accident notificationshould be directly at the scene of the accident after the accident, sometimes drivers make mistakes both because of ignorance and because of stress. Let's consider the most typical of them:

  • Be sure to pay attention to the term of the insurance contract of the other participant. Also, specify your fully, even if part of the premium is not yet paid.
  • There should not be any corrections. In addition, after signing the notice, the participants have no right to enter any additional information there.
  • In paragraph 13, do not describe the damage, namely indicate the place of the initial strike.

correctly fill out an accident notification

Frequently Asked Questions

The rules describe how to act in certain situations. But in real conditions, participants of an accident sometimes do not know how to be.

For example, the driver does not understand what he shouldDo if another participant of the accident refuses to fill out the notice. In this case, the document is made up of one driver, where he indicates the data about the other machine that he has. In the item "Remarks" a corresponding note is entered. If it was possible to attract witnesses of an accident, their data should also be recorded. At the same time, it is necessary to call traffic police officers and wait for the registration of an accident with their help.

If one driver does not have a form, you can use the document of another participant in the accident.

A person guilty of an accident sometimes does not know, shouldwhether he send a notice to his insurance company. The answer here is unequivocal: yes, it should. And one and the other driver within 15 days from the moment of the accident send the documents to their insurers.

notification of an accident

Get a payment on insurance actuallyIt is impossible if the accident notification is incorrectly filled. Just in case, you can just print out the sample and carry it along with the document forms. If the accident has resulted in death, then the notice of an accident must not be filled.


The example of the notification of an accident that we presented in the article will tell you how to fill out the document correctly. Nothing complicated in this. Just be as careful and accurate as possible.

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