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Defense

Confidential Intake Form
Defense

Information Regarding Defendants

Defendant(s) - Individual(s)

Defendant(s) - Organization(s)

Information Regarding Defense Representatives

Is coverage contested?

Information Regarding Plaintiff(s) and Representative(s)

Did they agree to participate in InstaResolve?

Information Regarding Accident¹

Was there an incident report

Liability Positions

Is liability contested?
Do you attribute comparative fault to Plaintiff?

Damages Positions

Did you hire a defense medical expert?
Did you share copy of defense medical report with Plaintiff?

Medical Bills Positions

Irrespective of causation, please provide the following information and reasonable value of those services:

1.

2.

3.

4.

5.

6.

7.

8.

Plaintiff’s Settlement Demands

CCP 998?
CCP 998?
CCP 998?
CCP 998?

Defense Settlement Offers

CCP 998?
CCP 998?
CCP 998?
CCP 998?

Other Information

Upload Documents
Upload Images
Upload Videos

Thanks for submitting!

1. If desired, upload Brief with additional information, photo(s)/video(s).

2. If desired, upload the defense medical report.

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