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Get Instant Online Pre-Approval!

If your case is a traffic accident, CapTran’s proprietary case evaluation model can pre-approve your case before you even apply. Simply tell us about your case using the application below and we will notify you as fast as cyberspace will allow.

If your case is pre-approved, a screen will be provided for you to enter your personal information and your attorney’s contact information. Once we have verified what you have told us with your attorney and evaluated your damages, we will present you with an offer containing the amount we will invest in your case and the fees we will charge.

If you don’t like our offer – you have no obligation whatsoever.

If you accept our offer, we will FedEx our contracts and a check to your attorney’s office that day!

(CapTran does not invest in cases whose basis of venue and/or residence of claimant is Alabama, Alaska, District of Columbia, Georgia, Indiana, Iowa,Kentucky, Louisiana, Michigan, Missouri, Montana, Nevada, Ohio, Rhode Island, South Dakota, Utah, Vermont, Wyoming.)
Broker Code (if applicable):

Client Personal Injury Application ©
Name : Email Address:
I Have A Personal Injury LawSuit/Claim/Action: I have retained an attorney:
Have you ever been arrested? : Yes No Amount requested: $

Step 1. Event Description
Date of Accident (mm/dd/yyyy): Position In Vehicle:
Type Of Vehicle: Type of Accident:
Impact: My Vehicle was: Moving Stopped

Step 2. Injuries/Damages
Property Damage
Vehicle Damage: Less Than $4000 Greater Than $4000 Don't Know
Personal Injuries
Emergency Room:
I was admitted to the hospital: Stayed Overnight   # of Days In Hospital
Most Serious Injury:
Describe:
 
 
Treatment
Health Care Providers that treated me:
(Hold Down Control Button to Select Multiple)
Procedures - Diagnostic:
(Hold Down Control Button to Select Multiple)
Procedures-Other:
(Hold Down Control Button to Select Multiple)
Phone Number and Address  
 
I am still being treated: Yes No
Lost Wages
I have a lost wages claim:
Yes No 		Wages Per Day:
Disability
If you have a disability as a result of this accident please explain:

Step 3. Liability/Insurance
The Police Arrived At The Scene There Were Witnesses
The Defendant Received A Ticket  I Received A Ticket
Defendant Was Insured  Defendant Was Not Insured
Defendant’s Insurance Company Paid
For The Property Damage To My Car		  Check if you live in a no-fault state
Defendant's Insurance Company:
My Insurance Company:
I Have Un-Insured Motorist Coverage   Amount:
I Have UnderInsured Motorist Coverage   Amount:
By clicking here you indicate that you have read and agree to the Records Release Authorization. You must check this box to have your application processed. This gives us permission to contact your attorney and review your file. All information is held strictly confidential.



Traffic Cases - Instant Online Pre-Approval

 

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Disclaimer: The material published at this site is for informational purposes only and is not intended to be legal advice. Transmission of the information is not intended to create, and receipt does not constitute, an attorney-client relationship between any parties whatsoever. Readers, whether or not attorneys, should not act upon this information without seeking professional advice or doing independent legal research. CapTran disclaims any liability whatsoever for any consequences that may flow from any material published here.

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