Accident statement form

Regardless of the place of the incident, its participants should complete accident statement form, which makes it easier for the insurance company to settle the claim. Therefore, it is advisable to have this form in your vehicle.

A crash can happen to even the most experienced driver. It may be caused by other road users. It is always an unpleasant and stressful situation. So it's good to be prepared for it and ask yourself a few questions before driving:

  • how to describe the course of a possible incident to the insurer?
  • how to communicate with a perpetrator who does not speak Polish?
  • how to report a collision that occurred abroad?
If the accident occurred in Poland and no one was injured, police intervention is not required. Therefore, you should prepare a statement with the perpetrator about the circumstances of the incident.

It is different if the incident occurred on a road in another country. There are countries where a patrol is required for every collision, but in most EU countries this is not necessary.

Regardless of where the incident occurred, the accident statement form provided below is very useful to describe its course. With it, both participants can present the circumstances and confirm them with their own signatures.

The form is universal. It was prepared in Polish, English and Ukrainian (see below). It allows incident participants to present their versions.

A photo of the perpetrator's vehicle with registration plates and insurance documents will also be useful.

Accident statement form

Polish version (PL)

Polish/English version (PL/EN)

Polish/Ukrainian version (PL/UA)

If the accident took place in Poland, let's also check on the Polish Motor Insurers' Bureau (PBUK) website whether the perpetrator's insurer has a Polish representative (correspondent) and which of the Polish insurers performs this function. If the perpetrator's insurance company has a correspondent in our country, the damage should be reported to it. If the perpetrator's insurance company does not have a correspondent in Poland, the damage should be reported to PZU S.A. or TUiR WARTA S.A. However, if it was not possible to determine the perpetrator's insurer, you will need to contact PBUK.

If the accident occurred abroad, the procedure depends on the regulations in force in the country where it occurred. In most EU countries, in the event of an ordinary collision (without victims or injuries), there is no obligation to call the police. It is enough if the participants of the incident prepare a joint damage report. The procedure in such a situation is also described here.