Reclamo — Digital Accident Report Demo v19

Accident time and location

Date and time1 of 2

Confirm when it happened

We prefilled the current date and time. Edit them if the accident happened earlier.

Automatically detectedEditable

8 August 2026 at 17:18, using the time on this device.

Date

Time

Enter a valid date and time that are not in the future.

Confirm where it happened

We prefilled a GPS-based location. You can correct the address or add useful context.

GPS location detectedApprox. 12 m

45.5231, -122.6765 · Portland, Oregon

Street, highway or location

City

State

County

ZIP code

Latitude

Longitude

Location notes (optional)

Shared accident detailDriver A sets the date, time and location. Driver B can confirm them or request a correction, but cannot overwrite them directly.

Waiting for Driver B to join

Enter the street or location, city and state.

Safety, severity and police

People1 of 4

Was anyone hurt?

These facts determine emergency, police, state-report and commercial-vehicle obligations.

Any injury or complaint of pain?

Any fatality?

People in Vehicle A

People in Vehicle B

Damage thresholds and mobility

You do not need to know the repair cost. DAR asks only whether the visible damage is likely above the legal threshold that matters in this state.

Vehicle A disabled / towed?

Vehicle B disabled / towed?

No repair quote needed DAR shows only the dollar threshold that matters for the selected state. Answer Yes, No or Not sure. If an official filing requires an actual dollar estimate, DAR will ask for it only inside the relevant damage task.

Law-enforcement response

DAR cannot replace a required police notification or officer-generated crash report.

Checking the state requirement

DAR uses the accident state together with injury, tow, damage and other trigger facts to determine whether law-enforcement notification is required.

Police / law enforcement contacted?

Officer attended / investigated?

Final trigger checks

These answers activate uninsured, hit-and-run, CDL or other special reporting branches.

Did any involved driver leave without exchanging information?

Other driver insurance status

Moving-traffic citation issued to Driver A?

Reports and actions for this accident

DAR will determine and generate the applicable reports automatically, and separately show any action the driver or employer must take.

Your details

Driver identity1 of 3

Who was driving?

Enter the driver's identity exactly as shown on official documents.

First name

Last name

Date of birth

Country

Address and contact

Add the driver's current address and a reliable contact method.

Address

ZIP code

City

Phone

Email

Licence and vehicle owner

Confirm the driving licence and whether the driver is also the policyholder.

Licence class

Driving licence number

Licence state / jurisdiction

CDL endorsements (if any)

Your vehicle

Registration1 of 3

Confirm Vehicle A

These fields are normally preloaded from the vehicle QR. Confirm that they match the vehicle involved.

Prefilled from vehicle QRStable fleet, vehicle, owner and insurer data should be loaded before the driver starts the accident report.

Registration / plate

Plate state

VIN

Describe the vehicle

Confirm the model year, body type and trailer status.

Make

Model

Model year

Vehicle type

How was this vehicle being used?

This activates employer, carrier and commercial reporting only when relevant.

Vehicle use

Fleet unit / asset ID

Registered owner / company

Insurance

Insurer1 of 3

Who insures the vehicle?

Use your insurance certificate or insurer app.

Insurance company

Agency / broker (optional)

Add the policy reference

Enter the policy number and coverage dates.

Policy number

Valid from

Valid to

Confirm coverage details

Confirm the insurer identifier and claim/FNOL route used by the fleet.

NAIC / insurer code (optional)

FNOL phone / route (optional)

Photos and damage

Capture the scene before vehicles move

Take wide photos first, then photograph visible damage.

Visible damage to Vehicle A

Points of impact

Where was your vehicle hit?

Select a vehicle, then tap each impact point. Tap a red dot again to remove it.

FRONT ↑REAR

Car · 0 pointsMaximum 10

Witnesses and third parties

Witnesses1 of 2

Were there any witnesses?

Select an answer even when there were no witnesses. A negative answer completes this part.

Select Yes or No to continue.

Add witness details

Add only the information available. Use one pair of boxes per witness.

Witness information

Witness statement

Was anyone else or other property involved?

This includes another vehicle, a pedestrian, cyclist, road sign, barrier, building or other property.

Select Yes or No to continue.

Add third-party details

Describe the person, vehicle or property and include contact or registration details when available.

Details

Commercial vehicle & carrier

Carrier1 of 3

Confirm the QR-prefilled carrier

Stable carrier and vehicle identifiers should already be loaded from the QR.

QR profileDriver confirms the profile rather than entering carrier data from scratch.

Legal carrier / employer name

USDOT number

Motor carrier / state ID

Fleet unit

Carrier contact

CMV and CDL facts

DAR uses these facts to decide FMCSA accident-register and later CDL compliance obligations.

GVWR (lb)

GCWR (lb)

Operation

CDL required for this vehicle?

CDL class

Endorsements

CMV status

Enter GVWR/GCWR or hazmat status to evaluate.

Cargo and hazardous materials

Passenger-bus rules are excluded. This branch covers freight-carrying commercial vehicles.

Cargo carried?

Regulated hazardous material / placards?

Shipping paper / load reference

CDL post-accident evaluation

No testing trigger identified yet.

Hazardous materials

Material1 of 3

Identify the material

Prefer data imported from the shipping paper. Driver confirms what was actually being transported.

UN / NA number

Hazard class / division

Proper shipping name

Packing group

Package / containment type

What happened to the hazardous material?

These facts determine NRC immediate notification and PHMSA written-report obligations.

Release / spill?

Estimated quantity released

Fire / explosion / continuing danger?

Evacuation ordered?

Evacuation duration (minutes)

Major road closed (minutes)

NRC / PHMSA reporting

DAR can prepare the report, but an immediate NRC notification must be made through the accepted federal channel.

NRC notified?

NRC report / confirmation number

Response agencies / cleanup contractor

Hazmat outputs

Complete the consequence facts to evaluate NRC and DOT F 5800.1.

Accident drawing

Show what happened

Choose a background, then add and move the elements.

Background Changing it keeps your elements

1 elementBlank background

Elements Tap an item, then the diagram

Vehicle A is ready. Drag it into position or add another element.

Review and sign

Confirm your side of the report

Signing confirms your details and description. It does not mean you admit liability.

Your remarks

Signature

Sign here with your finger or mouse

Signature required

Invite the other driver

Ask Driver B to scan

They can complete their side on their own phone and in their own language.

Session RCL-8YAG-XZY8

One-phone mode

Complete both sides on this phone

Finish Vehicle A first, then hand the phone to Driver B. Their interface can switch to their language.

The app keeps each driver's details and signature separate. Driver B cannot change Vehicle A after it has been signed.

Not a standard collision?

File a legal claim with Reclamo Legal

Use the connected Legal service when the fleet incident may require a police complaint, formal claim or structured evidence report.

Vehicle theft Break-in or theft from a vehicle Hit-and-run or parked-vehicle damage Vandalism or intentional damage Rental or shared vehicle not returned Cargo, tool or equipment theft Rental or identity fraud Number-plate theft or cloning Driver assault, robbery or threats Defective public infrastructure damage

File a legal claim Reclamo Legal opens in a new tab and this Fleet report remains unchanged.

Vehicle A — signed

Vehicle A is signed

Driver B cannot change Vehicle A. Driver A may unlock their own information before final submission, but must review and sign again.

Driver AJohn Smith
+1 503 555 0123

Vehicle AFord Transit Connect · OR 483KLM

InsuranceTravelers Insurance · TRV-2026-447182

Shared accident facts8 August 2026 · 17:18
1000 SW Broadway, Portland, Oregon

Signature Vehicle A signed

Your details

Driver identity1 of 3

Who was driving?

Enter Driver B's identity exactly as shown on official documents.

First name

Last name

Date of birth

Country

Address and contact

Add Driver B's current address and a reliable contact method.

Address

ZIP code

City

Phone

Email

Licence and vehicle owner

Confirm the driving licence and whether Driver B is also the vehicle owner.

Licence class

Driving licence number

Licence state / jurisdiction

CDL endorsements (if any)

Your vehicle

Registration1 of 3

Identify Vehicle B

Use the plate, registration card or insurance details when available.

Registration / plate

Plate state

VIN (if available)

Describe the vehicle

Add the year, make, model, body type and trailer status.

Make

Model

Model year

Vehicle type

Vehicle use

Commercial identifiers are requested only when the other vehicle is a freight vehicle or carrier.

Vehicle use

Insurance

Insurer1 of 3

Who insures the vehicle?

Use the insurance certificate or insurer app.

Insurance company

Agency / broker (optional)

Add the policy reference

Enter the policy number and coverage dates.

Policy number

Valid from

Valid to

Confirm coverage details

Add any insurer identifier and confirm vehicle damage coverage.

NAIC / insurer code (optional)

Claims contact (optional)

Photos and damage

Capture the scene before vehicles move

Take wide photos first, then photograph visible damage.

Shared photos are locked on this phoneDriver B can view scene photos added by Driver A and add Vehicle B damage.

Visible damage to Vehicle B

Points of impact

Where was your vehicle hit?

Select a vehicle, then tap each impact point. Tap a red dot again to remove it.

FRONT ↑REAR

Car selected0 points

Review and sign

Confirm your side of the report

Signing confirms Driver B's details and description. It does not mean Driver B admits liability.

Maria Garcia · Toyota Corolla · WA BXY2214
State Farm · SF-8829146

Your remarks

Signature

Sign here with your finger or mouse

Signature required

Report

Check everything before submission

Use the collapsed summaries for quick review. Open a section only when something needs editing.

Accident details⌃

8 August 2026 · 17:18
1000 SW Broadway, Portland, Oregon

Vehicle A⌄

Ford Transit Connect · OR 483KLM
John Smith
Travelers Insurance · TRV-2026-447182

Vehicle B⌄

Will be completed on this phone after Vehicle A signs.

Witnesses and third parties⌄

Not answered.

Accident description⌄

Circumstances, point of impact, drawing, remarks and attached photos.

Reports and actions⌃

Complete Safety, severity and policeDAR will then determine the required reports and actions.

Prepare completed reports

Review and prepare all reports

DAR generates every applicable report from the same signed accident record. Review each preview before preparing the one-time local download package.

Vehicle AJohn SmithSigned

Vehicle BMaria GarciaSigned

Preparing report previews…

I reviewed the generated reports and authorize DAR to prepare the signed report package on this device.

This static demonstration does not transmit or store the report. Printable reports and filing instructions will be downloaded for the driver. Use the browser’s Print → Save as PDF option when a PDF is required.

Complete both sides on this phone

Your tasks

Your tasks