Free Insurance Disclosure Request Form

The One-Page Letter Injury Victims Can Use to Find Out How Much Money May Be Available Without Hiring a Lawyer. 

Call 20to 20report 20claim 20and 20gather 20contact 20info 20  20claim 20number

Here is the exact form that we use everyday to find out how much money is available to pay for our clients' injuries:

How we use the form: 

  • Call the insurance companies listed on the Exchange of Information Form provided by Police at the scene to report the accident and open a claim (obtain adjuster's name, phone number, mailing address, and fax number).
  • Fill in the missing information on the form [below]. 
  • Fax and mail the form to each insurance adjuster. 
  • Call each adjuster the following week to confirm the amount of insurance coverage that may be available.

Note: Downloading and using the free form does not create an attorney-client relationship and you don't owe us any money if you recover compensation for your injuries on your own. The information contained on this page, and in the form, does not constitute legal advice nor is there any guarantee or promise that any insurance company will comply with a self-represented request. There are many instances when the amount of insurance coverage may not apply to a car accident victim. There are also instances when there may be additional insurance coverage from insurance carriers that are not included on the police information exchange report. Anyone who has been in an accident should seek the advice of a Florida licensed attorney before communicating with the insurance companies.


  • I had complete trust in him

    Matthew Waring is an excellent attorney! He is very professional and I highly recommend him. I had complete trust in him and he explained everything thoroughly to me. Thank you! Read On

  • Patient and Very Knowledgeable

    Mr Waring answered my question within 1 hour of my post. I then sent him a more detailed message which he also responded to right away, thanking him. He offered to discuss my issue by phone so I called him. He answered the phone, not an assistant or voice mail. He listened very patiently without ... Read On

  • Quick to Respond

    Matthew helped me after a car accident. He was quick to respond to my concerns. I would recommend him to anyone who has been in an accident. Read On

We are grateful for our prior clients who have offered to provide us with their reviews.

AVVO Reviews AVVO Client's Choice Award 2019

Avvo - Rate your Lawyer. Get Free Legal Advice. 9.0Matthew Scott Waring Best Personal Injury Attorneys in Boca Raton Waring Law, PLLC is a South Florida Personal Injury Law Firm located in Deerfield Beach, FL serving the following locations Boca Raton, Deerfield Beach, West Palm Beach, Lantana, Lake Worth, Wellington, Royal Palm Beach, Greenacres, Boynton Beach, Delray Beach, Pompano Beach, Coconut Creek, Oakland Park, Wilton Manors, Fort Lauderdale, Lauderhill, Tamarac, Coral Springs, Pembroke Pines, Miramar, Hollywood, Hallandale Beach, North Miami, Miami Gardens, Aventura, Opa-Locka, Kendall, Coconut Grove, Coral Gables, Homestead, Florida City, Miami, Brickell, Miami Beach, and the Florida Keys.

1430 South, Federal Hwy
Suite 303

Deerfield Beach, FL 33441
(954) 388-0646
Mon, Tue, Wed, Thu, Fri, Sat, Sun: 08:00am - 09:00pm