Passenger Injury Insurer-Contact Worksheet
From our guide Uber Passenger Accident Insurance: Prove Your Trip and Check Coverage
| Field to complete | Your entry | Verification step |
|---|---|---|
| Platform report reference | __________ | Confirm this is a support reference, not necessarily an insurance claim number |
| Insurance company and administrator | __________ | Ask which organization issued the policy and which handles the claim |
| Passenger bodily injury claim number | __________ | Confirm it includes your injury claim, not only vehicle damage |
| Adjuster name and verified contact | __________ | Confirm contact details through an official channel |
| Accident date, location, and trip ID | __________ | Compare with the receipt and your crash records |
| Trip phase assigned by insurer | __________ | Ask for the records supporting that classification |
| Applicable policy and coverage under review | __________ | Request relevant certificate, policy information, and state endorsements |
| Documents requested and delivery method | __________ | Keep copies and submission confirmations |
| Next action, responsible person, and follow-up date | __________ | Update after each substantive exchange |
| Written coverage decision received | __________ | Save the complete decision and any cited provisions |
More From This Guide
General information only, not legal advice. Laws vary by state. Speak with a licensed attorney about your situation.
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