🚗 Motor Vehicle Accident Lead
⚠️ All fields are required.
You must confirm every item in the MVA Qualification Checklist below. Incomplete submissions will be rejected.
First Name
Last Name
Email
State
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ZIP Code
Caller ID (Phone)
Will be formatted to E.164 (e.g., +12345678901)
✅ MVA Qualification Checklist
ALL items must be confirmed.
If any cannot be confirmed, do not submit.
Accident occurred within the past 12 months.
Motor vehicle accident only (car, truck, SUV; rideshare allowed if buyer approves).
Claimant was NOT at fault.
Other party has valid auto insurance.
UM/UIM only if buyer explicitly allows (confirm this is not a UM/UIM claim OR buyer allows it).
Real injuries requiring medical attention.
Not just soreness.
Not a minor fender bender.
Submit Lead