{"id":1686,"date":"2026-09-15T21:39:24","date_gmt":"2026-09-15T21:39:24","guid":{"rendered":"https:\/\/www.injurycheck.info\/?page_id=1686"},"modified":"2026-10-12T12:10:14","modified_gmt":"2026-10-12T02:10:14","slug":"claims-enquiry-form","status":"publish","type":"page","link":"https:\/\/www.injurycheck.info\/zh\/claims-enquiry-form\/","title":{"rendered":"\u7406\u8d54\u521d\u6b65\u54a8\u8be2\u8868\u2014\u201424\u5c0f\u65f6\u5185\u83b7\u5f97\u7b54\u590d"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"1686\" class=\"elementor elementor-1686\">\n\t\t\t\t<div class=\"has_eae_slider elementor-element elementor-element-93d8828 e-flex e-con-boxed e-con e-parent\" data-eae-slider=\"42315\" data-id=\"93d8828\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-eb9b704 elementor-widget elementor-widget-elementskit-contact-form7\" data-id=\"eb9b704\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"elementskit-contact-form7.default\">\n\t\t\t\t\t<div class=\"ekit-wid-con\" ><div class=\"ekit-form\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f1687-p1686-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"1687\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/zh\/claims-enquiry-form\/#wpcf7-f1687-p1686-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\" data-no-translation-aria-label=\"\" data-trp-original-action=\"\/ar\/claims-enquiry-form\/#wpcf7-f1687-p1686-o1\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"1687\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.7\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f1687-p1686-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"1686\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<p><strong>\u7406\u8d54\u521d\u6b65\u54a8\u8be2<\/strong>\n<\/p>\n<p>\u6211\u4eec\u4f1a\u572824\u5c0f\u65f6\u5185\u7ed9\u60a8\u7b54\u590d\u3002\n<\/p>\n<p>\u8bf7\u586b\u5199\u60a8\u613f\u610f\u63d0\u4f9b\u7684\u6240\u6709\u4fe1\u606f\u3002\u53ea\u6709\u59d3\u540d\u3001\u7535\u8bdd\u548c\u7535\u5b50\u90ae\u4ef6\u4e3a\u5fc5\u586b\u9879\u3002\u60a8\u63d0\u4f9b\u7684\u4fe1\u606f\u8d8a\u591a\uff0c\u6211\u4eec\u5c31\u80fd\u8d8a\u5feb\u8bc4\u4f30\u60a8\u662f\u5426\u53ef\u4ee5\u63d0\u51fa\u8d54\u507f\u7533\u8bf7\u3002\n<\/p>\n<h3>\u5ba2\u6237\u4fe1\u606f\n<\/h3>\n<p><label><em>\u5168\u540d<\/em> \uff08\u5fc5\u586b\uff09 <span class=\"wpcf7-form-control-wrap\" data-name=\"full-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"full-name\" \/><\/span><\/label><label><em>DOI\uff08\u4e8b\u4ef6\u53d1\u751f\u65e5\u671f\uff09<\/em> <span class=\"wpcf7-form-control-wrap\" data-name=\"date-of-incident\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-of-incident\" \/><\/span><\/label><label><em>\u51fa\u751f\u65e5\u671f<\/em> <span class=\"wpcf7-form-control-wrap\" data-name=\"date-of-birth\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" value=\"\" type=\"date\" name=\"date-of-birth\" \/><\/span><\/label><label><em>\u5730\u5740<\/em> <span class=\"wpcf7-form-control-wrap\" data-name=\"address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"address\" \/><\/span><\/label><label><em>\u7535\u8bdd<\/em> \uff08\u5fc5\u586b\uff09 <span class=\"wpcf7-form-control-wrap\" data-name=\"phone\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"phone\" \/><\/span><\/label><label><em>\u7535\u5b50\u90ae\u4ef6<\/em> \uff08\u5fc5\u586b\uff09 <span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email\" \/><\/span><\/label><label><em>\u4f24\u60c5<\/em> <span class=\"wpcf7-form-control-wrap\" data-name=\"injuries\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"injuries\"><\/textarea><\/span><\/label><label><em>\u4ee5\u5f80\u4f24\u75c5<\/em> <span class=\"wpcf7-form-control-wrap\" data-name=\"previous-injuries\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"previous-injuries\"><\/textarea><\/span><\/label>\n<\/p>\n<h3>\u9002\u7528\u65f6\u9700\u63d0\u4ea4 TPD\n<\/h3>\n<p><label><em>\u517b\u8001\u91d1\u57fa\u91d1<\/em> <span class=\"wpcf7-form-control-wrap\" data-name=\"super-fund\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"super-fund\" \/><\/span><\/label><label><em>TPD\u91d1\u989d<\/em> <span class=\"wpcf7-form-control-wrap\" data-name=\"tpd-amount\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"tpd-amount\" \/><\/span><\/label><label><em>\u4fdd\u5355\u53f7<\/em> <span class=\"wpcf7-form-control-wrap\" data-name=\"policy-number\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"policy-number\" \/><\/span><\/label>\n<\/p>\n<h3>MVA\uff08\u673a\u52a8\u8f66\u4e8b\u6545\uff09\n<\/h3>\n<p><label><em>\u8b66\u5bdf\u62a5\u544a\u7f16\u53f7\uff08\u5982\u5df2\u62a5\u6848\uff09<\/em> <span class=\"wpcf7-form-control-wrap\" data-name=\"police-report-number\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"police-report-number\" \/><\/span><\/label>\n<\/p>\n<p><em>\u78b0\u649e\u7c7b\u578b<\/em>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"mva-type\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"mva-type[]\" value=\"Vehicle vs Vehicle\/Motorcycle\" \/><span class=\"wpcf7-list-item-label\">\u8f66\u8f86\u4e0e\u8f66\u8f86\/\u6469\u6258\u8f66\u78b0\u649e<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"mva-type[]\" value=\"vs Bicycle\" \/><span class=\"wpcf7-list-item-label\">\u4e0e\u81ea\u884c\u8f66\u76f8\u649e<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"mva-type[]\" value=\"vs Pedestrian\" \/><span class=\"wpcf7-list-item-label\">\u4e0e\u884c\u4eba\u76f8\u649e<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<h3>\u8bc1\u636e\n<\/h3>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"doctors-reports\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"doctors-reports\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">\u662f<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"doctors-reports\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">\u5426<\/span><\/label><\/span><\/span><\/span><label><em>\u4e8b\u4ef6\/\u53d7\u4f24\u7167\u7247<\/em> <span class=\"wpcf7-form-control-wrap\" data-name=\"incident-photos\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\".jpg,.jpeg,.png,.pdf\" aria-invalid=\"false\" type=\"file\" name=\"incident-photos\" \/><\/span><\/label>\n<\/p>\n<p>\u5982\u679c\u65e0\u6cd5\u4e0a\u4f20\u6587\u4ef6\uff0c\u8bf7\u5728\u4e0b\u65b9\u6ce8\u660e\u662f\u5426\u6709\u7167\u7247\u3002\n<\/p>\n<p><label><em>\u7167\u7247\u662f\u5426\u63d0\u4f9b\uff08\u662f\/\u5426\uff09\u4ee5\u53ca\u5907\u6ce8<\/em> <span class=\"wpcf7-form-control-wrap\" data-name=\"photos-note\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"photos-note\"><\/textarea><\/span><\/label>\n<\/p>\n<h3>\u5176\u4ed6\u4fe1\u606f\n<\/h3>\n<p><em>\u76ee\u524d\u6709\u5f8b\u5e08\u4ee3\u7406\u5417\uff1f<\/em>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"currently-with-lawyer\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"currently-with-lawyer\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">\u662f<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"currently-with-lawyer\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">\u5426<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<h3>\u8d23\u4efb\n<\/h3>\n<p><label><em>\u53d7\u4f24\u7684\u539f\u56e0<\/em> <span class=\"wpcf7-form-control-wrap\" data-name=\"how-injury-occurred\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"how-injury-occurred\"><\/textarea><\/span><\/label>\n<\/p>\n<p><em>\u8d23\u4efb\u7c7b\u578b<\/em>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"liability-type\"><span class=\"wpcf7-form-control wpcf7-checkbox\"><span class=\"wpcf7-list-item first\"><label><input type=\"checkbox\" name=\"liability-type[]\" value=\"Medical negligence\" \/><span class=\"wpcf7-list-item-label\">\u533b\u7597\u758f\u5ffd<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"liability-type[]\" value=\"At Work\" \/><span class=\"wpcf7-list-item-label\">\u5de5\u4f5c\u573a\u6240<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"liability-type[]\" value=\"Motor Vehicle\" \/><span class=\"wpcf7-list-item-label\">\u673a\u52a8\u8f66\u8f86<\/span><\/label><\/span><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"liability-type[]\" value=\"Public Liability\" \/><span class=\"wpcf7-list-item-label\">\u516c\u4f17\u8d23\u4efb<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"checkbox\" name=\"liability-type[]\" value=\"Rental Property Injury\" \/><span class=\"wpcf7-list-item-label\">\u51fa\u79df\u7269\u4e1a\u5185\u53d7\u4f24<\/span><\/label><\/span><\/span><\/span>\n<\/p>\n<div class=\"ic-consent\" style=\"color:#222;\">\n\t<p class=\"ic-consent-notice\"><strong>\u5728\u4f60\u53d1\u9001\u4e4b\u524d<\/strong>\n\t<\/p>\n\t<p>\u4efb\u4f55\u80fd\u8bc6\u522b\u60a8\u8eab\u4efd\u7684\u4fe1\u606f\u90fd\u4e0d\u4f1a\u53d1\u9001\u7ed9\u4efb\u4f55\u5f8b\u5e08\u4e8b\u52a1\u6240\uff0c\u9664\u975e\u60a8\u9009\u62e9\u4e86\u4e00\u5bb6\u5f8b\u5e08\u4e8b\u52a1\u6240\uff0c\u5e76\u5728\u6211\u4eec\u7684\u4f1a\u9762\u4e2d\u4e0e\u6211\u4eec\u4e00\u8d77\u7b7e\u7f72\u5176\u6388\u6743\u6587\u4ef6\u3002Injury Check \u53ca\u5176\u4efb\u4f55\u5173\u8054\u4eba\u5458\u5747\u4e0d\u4f1a\u56e0\u6b64\u4ece\u4efb\u4f55\u5f8b\u5e08\u4e8b\u52a1\u6240\u6536\u53d6\u4efb\u4f55\u8d39\u7528\u3001\u4f63\u91d1\u6216\u5176\u4ed6\u5229\u76ca\u3002 \u6211\u4eec\u7684\u4e00\u4e9b\u670d\u52a1\u63d0\u4f9b\u5546\u5c06\u6570\u636e\u5b58\u50a8\u5728\u6d77\u5916\uff0c\u5305\u62ec\u7f8e\u56fd\u3002\u60a8\u968f\u65f6\u53ef\u4ee5\u8bbf\u95ee\u3001\u66f4\u6b63\u6216\u5220\u9664\u60a8\u7684\u4fe1\u606f\uff1a <a href=\"mailto:info@injurycheck.info\">info@injurycheck.info<\/a>. <a href=\"https:\/\/www.injurycheck.info\/zh\/privacy-policy\/\" target=\"_blank\" rel=\"noopener\">\u9605\u8bfb\u6211\u4eec\u7684\u9690\u79c1\u653f\u7b56<\/a>\n\t<\/p>\n\t<p><span class=\"wpcf7-form-control-wrap\" data-name=\"consent-health\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"consent-health\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">\u6211\u540c\u610f Injury Check \u6536\u96c6\u6211\u7684\u4f24\u60c5\u4fe1\u606f\u4ee5\u4e86\u89e3\u6211\u7684\u9009\u62e9\u3002\u6211\u660e\u767d\uff0c\u9664\u975e\u6211\u9009\u62e9\u4e00\u5bb6\u5f8b\u5e08\u4e8b\u52a1\u6240\u5e76\u7b7e\u7f72\u6587\u4ef6\uff0c\u5426\u5219\u4efb\u4f55\u80fd\u8bc6\u522b\u6211\u8eab\u4efd\u7684\u4fe1\u606f\u90fd\u4e0d\u4f1a\u63d0\u4f9b\u7ed9\u5f8b\u5e08\u4e8b\u52a1\u6240\u3002<\/span><\/label><\/span><\/span><\/span>\n\t<\/p>\n<\/div>\n<input class=\"wpcf7-form-control wpcf7-hidden\" value=\"\" type=\"hidden\" name=\"referral_code\" \/>\n<p class=\"ic-claims-notice\" style=\"color:#222;font-size:16px;line-height:1.5;font-weight:400;margin:16px 0 12px;\">Only working with legitimate No Win No Fee Law Firms. <a href=\"https:\/\/www.injurycheck.info\/zh\/privacy-policy\/\" target=\"_blank\" rel=\"noopener\">\u9690\u79c1\u653f\u7b56<\/a>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"\u63d0\u4ea4\u54a8\u8be2\" \/>\n<\/p><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>\u0394<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"141\"\/><script>\ndocument.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );\n<\/script>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<input type=\"hidden\" name=\"trp-form-language\" value=\"zh\"\/><\/form>\n<\/div>\n<\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Claims Initial Enquiry We\u2019ll get answers within 24 hours. Fill in all the details you are comfortable with. Only your name, phone and email are required. The more information you provide, the quicker we can assess whether you have a claim for compensation. Client Details Full Name (required) DOI (Date of Incident) DOB Address Phone [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"_acf_changed":false,"content-type":"","footnotes":""},"class_list":["post-1686","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.injurycheck.info\/zh\/wp-json\/wp\/v2\/pages\/1686","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.injurycheck.info\/zh\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.injurycheck.info\/zh\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.injurycheck.info\/zh\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.injurycheck.info\/zh\/wp-json\/wp\/v2\/comments?post=1686"}],"version-history":[{"count":10,"href":"https:\/\/www.injurycheck.info\/zh\/wp-json\/wp\/v2\/pages\/1686\/revisions"}],"predecessor-version":[{"id":1983,"href":"https:\/\/www.injurycheck.info\/zh\/wp-json\/wp\/v2\/pages\/1686\/revisions\/1983"}],"wp:attachment":[{"href":"https:\/\/www.injurycheck.info\/zh\/wp-json\/wp\/v2\/media?parent=1686"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}