Injury Forms

Official California forms people use after an injury, grouped by stage, with what each one is for. Every link goes to the agency, court, or company that publishes it. Always download the current version from the official site.

After the Crash

Which forms do I need right after a car crash in California?

Most drivers need the DMV SR-1 if anyone was hurt or damage was over $1,000, filed within 10 days. To get the police report, use the CHP 190 for CHP crashes or your city police department’s request form. Keep copies of everything you send.

  • SR-1Report of Traffic Accident Occurring in California (DMV)Each driver files it within 10 days if anyone was hurt, even slightly, or property damage was over $1,000. File online or on paper.Open
  • CHP 190Application for Release of Information (CHP)Ask for a copy of a CHP crash report in person or by mail. CHP reports can also be requested online.Open
  • City policeCity police and sheriff report requestsEach city handles its own reports. See the Los Angeles guide for LAPD and Sheriff steps.Open Guide

Sources: DMV: SR-1; CHP: Request a Crash Report. Report wrong? Read what to do if a collision report blames you.

Claims Against the Government

How do I file a claim against a government agency in California?

Before suing a public agency, you usually must file a written claim within six months of an injury. Claims against State agencies go to the DGS Government Claims Program with a $25 fee or a fee waiver request. Each city, county, and transit agency uses its own claim form and office.

  • DGSGovernment Claim Form (State of California)For claims against State agencies. File online or mail the paper form with the $25 fee.Open
  • DGSFee Waiver Request (State claims)Ask the State to waive the $25 claim filing fee if you can’t afford it.Open
  • City, countyCity and county claim formsCities and counties use their own forms and offices. See the city guides for the exact form and address.Open Guides

Sources: DGS: File a Government Claim; Gov. Code §911.2. Hurt on a public sidewalk? Read suing a California city or county over a broken sidewalk.

Report a Claim to Your Insurance Company

How do I report an accident to my insurance company?

Call your insurer’s claims line or use its online claim page as soon as you can, even if the other driver caused the crash. Have your policy number, the date and place of the crash, what happened, and the other driver’s details. Many policies require prompt notice to keep your coverage.

InsurerReport a claim onlineClaims phone
State FarmState Farm claims page800-732-5246
GEICOGEICO claims page800-841-3000
ProgressiveProgressive claims page800-776-4737
AllstateAllstate claims page800-255-7828
FarmersFarmers claims page800-435-7764
MercuryMercury claims page800-503-3724
AAA: Automobile Club of Southern CaliforniaAAA: Automobile Club of Southern California claims page800-672-5246
AAA: CSAA Insurance Group (Northern California)
CSAA lists other numbers for policies outside Northern California.
AAA: CSAA Insurance Group (Northern California) claims page800-922-8228
USAAUSAA claims page800-531-8722
Wawanesa
Claims other than glass are reported by phone.
Wawanesa claims page888-929-2252
CSE
CSE says it has no active policies; this number is for existing or new claims.
CSE claims page800-282-6848
Kemper
New auto claims by phone: Mon to Fri 8 a.m. to 7 p.m., Sat 11 a.m. to 6 p.m. Central Time.
Kemper claims page800-353-6737
Liberty MutualLiberty Mutual claims page800-225-2467
TravelersTravelers claims page800-252-4633
NationwideNationwide claims page800-421-3535
Infinity
Infinity is now an agency; your claim goes to the carrier named on your ID card (for example, Kemper Auto at 800-353-6737).
Infinity claims page855-478-3705

Report the crash promptly to your own insurer. Be careful about giving a recorded statement to the other driver’s insurer because what you say can be used to limit your claim. Read dealing with insurance adjusters after a California accident.

Listing an insurer here is not a recommendation. Links and numbers were taken from each insurer’s own website on October 27, 2026; check your ID card or policy for the number that applies to you. Hit by an uninsured or fleeing driver? Read what happens after an uninsured or hit-and-run crash. Your own MedPay coverage may help with bills: what MedPay covers in California.

Get Your Medical Records

How do I get my medical records and bills in California?

Ask each hospital, clinic, and doctor in writing, through their patient portal or records request form. California law lets you inspect records within five working days and get copies within 15 days, for a limited fee. Federal HIPAA rules also give you a right to your medical and billing records.

RuleWhat it saysSource
Inspect recordsWithin 5 working days after the provider gets your requestHealth and Safety Code §123110(a)
Get copiesSent within 15 days after the provider gets your request§123110(b)
Copy feesReasonable, cost-based fee; no more than 25 cents a page for paper (50 cents from microfilm)§123110(j)
Unpaid billsA provider can’t withhold your records because you owe money§123110(i); HHS: Your Medical Records
Free copy for benefitsOne free copy of the relevant records if needed for a public benefits claim or appeal (not when a private attorney is paying claim costs)§123110(d)
Federal HIPAACovers medical and billing records; the provider must act within 30 days, with one 30-day extension if it explains the delay in writing; no fee for searching or retrievingHHS: Your Medical Records; HHS: response timing

California’s patient access law is Health and Safety Code sections 123100 to 123149.5.

Records request pages for major California health systems

  • RecordsKaiser PermanenteOfficial medical records request page.Open
  • RecordsCedars-SinaiOfficial medical records request page.Open
  • RecordsUCLA HealthOfficial medical records request page.Open
  • RecordsUCSF HealthOfficial medical records request page.Open
  • RecordsUC San Diego HealthOfficial medical records request page.Open
  • RecordsStanford Health CareOfficial medical records request page.Open
  • RecordsSutter HealthOfficial medical records request page.Open
  • RecordsSharp HealthCareOfficial medical records request page.Open
  • RecordsScripps HealthOfficial medical records request page.Open
  • RecordsDignity Health Southern California (CommonSpirit)Official medical records request page.Open
  • RecordsLos Angeles County Health Services (DHS)Official medical records request page.Open
  • RecordsAdventist HealthOfficial medical records request page.Open

Bills and ambulance records: also ask each provider’s billing office for an itemized bill and a payment ledger showing what insurance paid. For the ambulance ride, ask the ambulance company or fire agency named on the bill for its patient care report and itemized bill. Why it matters: what insurance companies look for in your medical records.

Check for Medical Liens

Who can claim repayment from my injury settlement?

Anyone who paid for your injury care may have a right to be repaid from a settlement. That can include Medi-Cal, Medicare, the hospital, your health plan or employer plan, the VA, or TRICARE. Ask each one for its claim amount before you settle, so the money can be divided correctly.

WhoHow it worksHow to find out
Medi-CalThe injured person or their lawyer must give DHCS written notice within 30 days of filing a claim or lawsuit. DHCS confirms receipt and later sends its lien after treatment ends or the case settles.DHCS: Report a New Case (online forms); DHCS Personal Injury Program; Welf. and Inst. Code §14124.73
MedicareMedicare makes “conditional payments” that must be repaid from a settlement. Report the case to the Benefits Coordination and Recovery Center (BCRC), which sends a Conditional Payment Letter, then a final demand after settlement.CMS: Medicare’s Recovery Process; Medicare Secondary Payer Recovery Portal (MSPRP); BCRC 1-855-798-2627
HospitalsA hospital that treated you after an accident can claim a lien for its reasonable and necessary charges. After notice, a payer generally must honor it only up to 50 percent of the recovery left after paying any prior liens.Civil Code §3045.1; §3045.4
Health plans and insurersMany California health plan liens are capped at what the plan actually paid, and no more than one-third of the recovery if you have a lawyer (one-half if not), with reductions for fault and legal fees.Civil Code §3040
Employer (ERISA) plansSome employer plans, especially self-funded ones, are governed by federal law. They may demand repayment under the plan’s own terms, and the state caps above may not apply. Ask the plan for its documents and its claimed amount in writing.Civil Code §3040(h)
VAVA can recover the cost of care for injuries caused by someone else. Veterans must tell VA about the case and any settlement or offer, starting with the Request for VA Billing form.VA: Subrogation and Medical Bills
TRICARETRICARE can be repaid when someone else caused your injury. If your contractor sends DD Form 2527, complete and sign it within 35 calendar days.TRICARE: Third-Party Liability

Learn more: what subrogation means in a personal injury case and who pays your medical bills while your California case is pending.

Court Forms

Which court forms start a personal injury lawsuit in California?

A typical injury lawsuit starts with the Judicial Council complaint PLD-PI-001 plus the cause of action pages that fit, a summons on SUM-100, and a civil case cover sheet on CM-010. After filing, the defendant must be served, and the server fills out a proof of service on POS-010.

  • PLD-PI-001Complaint: Personal Injury, Property Damage, Wrongful DeathThe main form complaint for injury cases. Attach the cause of action pages below that fit.Open
  • PLD-PI-001(1)Cause of Action: Motor VehicleAttach for car, truck, and other vehicle crash claims.Open
  • PLD-PI-001(2)Cause of Action: General NegligenceAttach when someone was careless outside of driving.Open
  • PLD-PI-001(4)Cause of Action: Premises LiabilityAttach for injuries from unsafe property, like a fall.Open
  • SUM-100SummonsTells the defendant a case was filed and that they have 30 days to respond.Open
  • CM-010Civil Case Cover SheetFiled with the complaint so the court can classify the case.Open
  • POS-010Proof of Service of SummonsThe person who served the papers fills it out to show the defendant was served.Open

Check the deadline first: how long you have to file a personal injury claim in California. Where to file in Los Angeles: Los Angeles Accident Guide.

Which forms come up later in an injury case?

Common later forms include FW-001 to ask the court to waive filing fees, DISC-001 form interrogatories to ask the other side written questions, and, if the defendant never responds, CIV-050 to state the damages claimed and CIV-100 to ask the court to enter a default and judgment.

  • FW-001Request to Waive Court FeesAsk the court to waive filing and other fees if you can’t afford them.Open
  • DISC-001Form Interrogatories: GeneralStandard written questions each side can send the other during the case.Open
  • CIV-050Statement of Damages (Personal Injury or Wrongful Death)Tells a defendant the amounts you claim; needed before a default in an injury case.Open
  • CIV-100Request for Entry of Default and Court JudgmentUsed when a served defendant does not respond on time.Open

How long cases take: how long a California personal injury case takes.

Can I use small claims court for an injury in California?

Yes, for smaller claims. An individual can generally ask for up to $12,500 in small claims court, and lawyers do not appear with you at the hearing. You start the case with form SC-100, the Plaintiff’s Claim and Order to Go to Small Claims Court, filed in the right county.

  • SC-100Plaintiff’s Claim and Order to Go to Small Claims CourtStarts a small claims case. Read the instructions first.Open
  • SC-100-INFOInformation for the PlaintiffPlain instructions for filing and serving a small claims case.Open

Source: California Courts: Small Claims.

Which forms are needed when a child is injured?

A child can’t sue alone, so a parent or guardian usually asks to be appointed guardian ad litem on CIV-010. Any settlement for a minor needs court approval, usually with petition MC-350 or the expedited MC-350EX, then an order such as MC-351 and, often, MC-355 for a blocked account.

  • CIV-010Application and Order for Appointment of Guardian ad LitemAsks the court to name an adult to bring the case for a child.Open
  • MC-350Petition for Approval of Compromise of Claim (minor or adult with a disability)Asks the court to approve a settlement for a child.Open
  • MC-350EXPetition for Expedited Approval of Compromise of ClaimA shorter petition for simpler settlements that qualify.Open
  • MC-351Order Approving Compromise of Claim or ActionThe judge’s order approving the child’s settlement.Open
  • MC-355Order to Deposit Funds in Blocked AccountOrders the child’s money held in a blocked account until released by the court.Open

Learn more: why a California child’s injury settlement needs court approval.

Need help with these forms?

Deadlines and next steps depend on facts this page can’t see. You can talk with Geller Legal about your options. Call 213-770-4870. No fee unless we recover.*

Contact Geller LegalCall 213-770-4870

*Under our written contingency fee agreement, if there is no recovery you owe no attorney fees and do not have to repay the case costs we advanced. Medical bills and other non-litigation expenses remain your responsibility. Offices in Los Angeles and Oakland.

This page is general information about California law and California procedures, not legal advice, and reading it does not create an attorney-client relationship. Fees, forms, and agency procedures change; confirm with the linked official source. Prior results do not guarantee a similar outcome. Attorney advertising. Geller Legal, a dba of The Geller Firm, Inc.