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Legal Documents

At Lozner & Mastropietro, our personal injury attorneys are dedicated to helping victims of car accidents, construction accidents, medical malpractice and other acts of negligence or recklessness recover much-needed compensation. Since 1996, we have served as aggressive advocates for injured clients throughout the New York City area. Contact our firm to put our experience and dedication to work for you.

To speak with a NYC personal injury lawyer about your potential claim, or if you simply need more information, please call our Brooklyn office at 1-917-920-9431.

Below are legal documents that you may need to complete in order to recover compensation for your serious injuries :

Affidavit of No Insurance : If you are injured in a car accident but do not own a car and do not carry insurance on one, you must complete the Affidavit of No Insurance in order to make a claim against New York State’s Motor Vehicle Accident Indemnification Corporation or the insurance company for the car you occupied.

Authorization for Release of Health Information Pursuant to HIPAA : By completing the Authorization for Release of Health Information Pursuant to HIPAA, you authorize your doctors and hospitals to release your medical records to a specified attorney or government agency for the purposes of an investigation and/or lawsuit.

New York Motor Vehicle No-Fault Insurance Law Employer’s Wage Verification Report (NF-6) : If you lose time from work as a result of a car accident in New York State, you have the right to be paid for your lost wages. The New York Motor Vehicle No-Fault Insurance Law Employer’s Wage Verification Report (NF-6) must be completed by your employer and verifies the lost wages from work if you are injured or disabled.

Notice and Proof of Claim for Disability Benefits (DB-450) : If you become sick or disabled as a result of someone’s negligence while employed, you must complete the Notice and Proof of Claim for Disability Benefits (DB-450) in order to prove and apply for disability benefits. The document must be mailed to your employer within 30 days of your disability.

Notice of Intention to Make Uninsured Claim : If you are the victim of a hit and run car accident, or if the car that injured you has little or no insurance, or if the insurance company for the at fault vehicle denies coverage for the accident; you must complete the Notice of Intention to Make Uninsured Claim in order to make a claim for uninsured benefits.

New York Motor Vehicle No-Fault Insurance Application (NF-2) : The New York State No-Fault Law reimburses victims of car accidents for financial losses due to hospital and medical expenses, lost wages, home care, travel, medications and other expenses. You must complete the New York Motor Vehicle No-Fault Insurance Application (NF-2) within 30 days of the accident in order to receive benefits under New York’s No-Fault Insurance Law.

New York State Department of Motor Vehicles Report of Motor Vehicle Accident (MV-104) : The driver of a car involved in an accident that resulted in personal injury or death must submit the New York State Department of Motor Vehicles Report of Motor Vehicle Accident (MV-104) to the Department of Motor Vehicles within 10 days of the accident.

New York Motor Vehicle No-Fault Insurance Law Verification of Self-Employment Income (NF-7) : The New York State No-Fault Law reimburses victims of car accidents for financial losses due to lost wages. You must complete the New York Motor Vehicle No-Fault Insurance Law Verification of Self-Employment Income (NF-7) to apply for and receive benefits for lost wages if you are self-employed.

New York State Workers’ Compensation Board Employee’s Claim for Compensation (C-3) : Every employer in New York State must provide its employees with Workers’ Compensation insurance which provides benefits to employees for hospital and medical expenses, lost wages, home care, travel, medications and other expenses. You must complete the New York State Workers’ Compensation Board Employee’s Claim for Compensation (C-3) in order to apply for and receive benefits under New York’s Workers’ Compensation Law.

New York State Workers’ Compensation Board Claimant’s Record of Medical and Travel Expenses (C-257) : If you wish to apply for Workers’ Compensation benefits for reimbursement of medical and travel expenses related to your accident/work-injury, the New York State Workers’ Compensation Board Claimant’s Record of Medical and Travel Expenses (C-257) helps you keep track of your expenses.