Claim Assessment Form

To find out if you have a claim, please fill in the following form and one of our staff members will get back to you.

*NOTE: WE ARE NOT THE ROAD ACCIDENT FUND. WE ARE A FIRM OF ATTORNEYS WHO WILL CLAIM FROM THE ROAD ACCIDENT FUND ON YOUR BEHALF.

Name (required) *
Email (required) *
Phone *
Alternative Phone
What time of day you prefer to be contacted? *
Please give the date of the accident *
Were you a: DriverPassengerPedestrianOther
Is the injured person a child? YesNo
Are you claiming for someone who has passed away? YesNo
Do you have any of the following injuries? Head injuryBack injuryLeg fractureArm fractureOther
Is the Road Accident Fund currently working on your claim? YesNo
Is another firm of attorneys currently working on your claim? YesNo
Please describe the accident *
What problems are you currently experiencing due to your injuries? *
Have your injuries affected your ability to work? YesNo
How did you hear about us? GoogleInternetFacebookA friendReferralBillboardOther

*By submitting this form you consent to provide Ehlers Attorneys with your personal information. Your information will be kept confidential and will not be used for marketing purposes or shared with any third parties. Please read our Privacy Policy for more information.

Understanding The Claims Process

Click below to read more about the claims process and the criteria needed to claim from the Road Accident Fund

The Claims Process

Important Notice

Please note that Ehlers Attorneys will never ask you to deposit money into our account in order to process your claim. If you have any queries or concerns, please contact our offices.

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