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  • MOTOR VEHICLE CLAIM

  • YOUR VEHICLE DETAILS

  • DRIVER DETAILS

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  • VEHICLE OWNER DETAILS

  • *Do you own the car that was involved in the accident? If yes skip this page.*

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  • OFFENDING VEHICLE DETAILS

    Details of the vehicle you believe is at fault in the accident.
  • OFFENDING DRIVER DETAILS

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  • OFFENDING VEHICLE OWNER DETAILS

    *If the owner of the vehicle is the same as the driver then you may skip this page*
  • WITNESS DETAILS

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  • ACCIDENT DETAILS

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  • AUSTRALIAN CLAIM SERVICES AUTHORITY TO ACT

  • YOU SHOULD READ THIS AGREEMENT BEFORE SIGNING IT. IF YOU REQUIRE SPECIFIC ADVICE ABOUT THIS AGREEMENT, PLEASE CONTACT ACS (AUSTRALIAN CLAIMS SERVICES) 03 8567 1930.

  • 1. I authorise ACS to do the following, as per my instructions and Authority to Act:

    a. I authorise the repairer to prepare an estimate of repairs necessary to restore my vehicle to its pre-accident condition (the repairs);

    b. Engage a qualified motor vehicle loss assessor to inspect the vehicle and assess the reasonable cost of repairs,

    c. Perform the repairs in accordance with the assessment including subletting any part of the repairs to qualified repairers as necessary; and

    d. Tow, drive and store my vehicle as necessary for the purposes of the estimation, assessment and performance of the repairs.


    2. I authorise ACS to pursue recovery of the cost of the repairs (including the assessment fee) together with any other losses I may suffer
    as a result of the collision (my claim) from the person responsible for the happening of the collision (the third party) and for the purpose to instruct ACS to:

    a. Deal directly with the third party and any insurer or other representative of the third-party regarding recovery of my claim:

    b. Commence and conduct legal proceedings in my name, if the file is not settled satisfactorily through ACS, and after receiving my instructions to do so. Furthermore, I Instruct ACS, to pass on my recovery claim to FLD Legal or another Law Firm associated with ACS.

    c. Take such other steps as is reasonably required in order to recover my claim in full.


    3. I authorise and direct ACS to receive from the third party and or their insurer, or other representative of the third party required to pay any
    monies in respect of my claim, any and all monies in respect of my claim, and the receipt of such monies by ACS shall be a good discharge of the monies required to be paid. a. If I receive payment for my losses directly from the Third Party or their Insurer, then I agree to immediately pay the amount or return payment that I have received in full to ACS


    4. I authorise ACS to apply any amounts recovered from the third party and or their Insurer of any costs including Total Loss, Repairs,
    Assessing, Hire, and after deducting their Recovery fee, and any other associated costs.


    5. I agree to cooperate with ACS including by signing necessary documents as requested.

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  • We have been referred your matter from {whereIs} , and enclose a copy of the claim form provided to us to assist you in recovery of your costs arising from the accident referred to in the form.

    Our first step will be is to contact the at-fault party (or their insurer) seeking admission of liability. This step is free to you irrespective of whether the insurer/at-fault party admit fault or not.

    Once the insurer for the at-fault party admits fault on behalf of their insured, your repairer will be notified so they can commence repairs to your vehicle (if they have not done so already) at no cost to you. *

    In most cases the at-fault driver will have insurance, and we will claim on that rather than making a claim on your insurer. We only recommend you claim on your insurer if you are at-fault, or the at-fault driver is uninsured. We will negotiate a settlement of your claim with the at fault-party, their insurer or their lawyers.

    ACS will not require you to make any out-of-pocket payments for using our services. After we collect your settlement monies, we pay your service providers such as your repairer, assessor and rental company and they will pay us for our services. You are not liable to pay for our services.

    If the offer of settlement by the at-fault parties’ insurer is unsatisfactory and the insurer admits fault in writing on behalf of the at-fault party and you instruct FLD Legal to take legal action in your name, then this fee is waived.

    * Exceptions apply, see Terms of Engagement

     

    If FLD Legal are required to issue proceedings on your behalf against the at-fault driver, and the at-fault party’s insurer has admitted fault, you will be completely indemnified (covered) by FLD Legal office for the following: 

    1. Legal costs incurred by FLD.
    2. Legal costs incurred by the other side.
    3. Cost of the hire vehicle.
    4. Cost of repairs; and
    5. Any other cost arising from actions taken by FLD to collect the debt on your behalf.

    Please note FLD Legal will not commence legal action before communicating with you.

    For further details about/this process, the authority you give us to act on your behalf and for settlement instructions, please see our Terms of Engagement.

    We ask that you carefully read both our Authority to Act and the Form 4A and if you are satisfied sign and return them to us. By signing these documents, you acknowledge you have understood the nature of these documents.

    If you need a further explanation before signing anything, please call our office to discuss.


    Yours sincerely,


    Upeka Hewagama

  •  

    Dear Sir/Madam

    We refer to the accompanying information from Australian Claims Services (ACS) and confirm that like ACS we are a member of the Trident Group of Companies. If ACS is unable to recover your losses without litigation under their authority from you, they will hand over the matter to us for legal action. We will not start legal action without first advising you.

    If it becomes necessary to issue proceedings on your behalf it is important that you know and understand the "Overarching Obligations" set out in sections 16 to 26 of the Civil Procedure Act 2010 (Vic) a copy of which are enclosed. These are basically the key rules by which parties must conduct themselves in litigation in Victorian Courts. To confirm that you have read understand these obligations please sign and return the enclosed Form 4A Overarching Obligations Certificate at your earliest convenience.

    If you have any queries, please call us on (03) 8567 1940

     

    Kind regards,

    NICHOLAS LAMBROS

    LEGAL PRINCIPAL

  • TERMS OF ENGAGEMENT

    1. You authorise and direct Motor Vehicle Accident Advisors (ACS) to act on your behalf in their capacity as a law firm to recover the following provider arising from your motor vehicle collision with the at-fault party:
      1. The repair costs of your vehicle (“Repairs”);
      2. The total loss/write-off of your vehicle (“Total Loss”);
      3. The hire replacement vehicle costs (“Hire”);
      4. Storage costs for your vehicle (“Storage”);
      5. Towing costs for your vehicle (“Towing”);
      6. The assessment costs of your vehicle; (“Assessing Costs”);
      7. Your loss of earnings (“Loss of Use”);
      8. Damaged property (“Damaged property”);
      9. Any other costs as may arise from the collision
    2. If that your vehicle has been or is subsequently repaired, you authorise ACS to receive settlement instructions for the Repairs, directly from the repairer of your vehicle.

    3. If that your vehicle has not been repaired and has been assessed as a total loss by a qualified vehicle assessor engaged on your behalf, you authorise ACS to negotiate directly with the at-fault party, their insurer or legal representative, a settlement for your Total Loss.

      1. You acknowledge that ACS will seek instructions directly from you or as otherwise agreed, with regards to making offers for your Total Loss in their settlement negotiations on your behalf.

    4. You authorise ACS to received settlement instructions for Hire Car Costs Directly from the company/party you hired your replacement vehicle from whilst your vehicle was being repaired, as a result of your collision with the at-fault party.

    5. You authorise ACS to received settlement for Assessing Costs, directly from the Assessor of your vehicle.

    6. You authorise ACS to received settlement for Storage, directly from the party that stored your vehicle.

    7. You authorise ACS to received settlement for Towing, directly from the party that provided towing services for your vehicle.
    8. You authorise FLD Legal to use monies held in trust on your
    behalf of pay FLD Legal legal costs.

    9. You acknowledge that you may receive correspondence
    from FLD Legal regarding the commencement of legal
    proceedings in your name if they are unable to reach a pre
    litigation settlement with the at-fault party and/or their
    insurer.

    10. You authorise FLD Legal to commence legal proceedings in
    your name as the Plaintiff, Claimant or Applicant.

    11. You acknowledge that in exchange for the services
    provided to you by FLD Legal you will cooperate with any
    reasonable request made by FLD Legal and undertake that
    you will provide truthful and honest instructions.

    12. If FLD Legal commence proceedings in your name, you
    authorise FLD Legal to:

    a. Negotiate a settlement with the at-fault party,
    their insurance provider or their legal
    representative.
    b. Brief Counsel (a barrister) to obtain advice on
    your behalf.
    c. Brief Counsel or other Advocate to appear on
    your behalf at a Hearing, Arbitration, Pre-Hearing
    Conference or Mediation; and
    d. Enforce any judgement made in your favour
    against the at-fault party.

    13. You acknowledge FLD Legal will fully indemnify you of the
    following costs:

    a. Repairs.
    b. Hire.
    c. Assessing.
    d. Storage.
    e. Towing.
    f. FLD Legal fees including disbursements such as
    court filing fees and process server fee.
    g. Counsel’s and/or advocates fees.
    h. The legal costs of the at-fault party.

    14. You authorise and direct FLD Legal to pay the cost of your
    Repairs, Hire, Assessing, Storage and Towing charges, once
    FLD Legal receives payment for same, from the at-fault
    party and/or their insurance provider.

    15. If you receive payment for Repairs, Hire, Assessing,
    Storage, Towing and/or legal fees directly from the at-fault
    party or their insurance provider, you undertake to
    immediately pay those funds into FLD Legal trust account
    so that FLD Legal can then pay for the Repairs, Hire,
    Assessing, Storage, Towing and/or legal fees.

    16. You acknowledge you may be liable to pay for the cost of
    Repairs, Hire, Assessing, Storage, Towing and/or legal fees
    only in the event that you:
     

    a. Expressly terminate your retainer with FLD
    Legal or direct them to cease acting prior to FLD
    Legal reaching a full and final settlement; and/or

    b. Do not attend Court on the day of your Hearing,
    Arbitration, Pre-Hearing Conference or
    Mediation without providing prior, reasonable
    and adequate notice of your unavailability to
    attend; and/or

    c. Fail to participate with FLD Legal reasonable
    requests such as making your vehicle available
    for inspection if requested by the at-fault party
    or their insurance provider/legal practitioner.

    d. Receive payment directly from the at-fault party
    and/or their insurance provider and refuse to
    transfer these funds into FLD Legal trust
    account after being requested to do so; and/or

    e. Are found to have provided inaccurate,
    misleading, false and/or fraudulent instructions,
    contrary to the facts of the collision.

    17. FLD Legal will endeavour to recover the costs associated
    with Loss of Use or Damaged property claims. However,
    you acknowledge that they do not indemnify you for these
    costs if they are unable to recover these items.

    18. You acknowledge that FLD Legal does not indemnify you
    of the costs arising from any Personal Injury claims
    associated with your motor vehicle collision.

    19. Wherever you have authorised FLD Legal to receive
    instructions from someone other than yourself, you further
    authorise, agree and acknowledge that FLD Legal has your
    full authority to settle the matter on the instructions of
    such other person without reverting to you so long as you
    are not required to make any payment or contribution in
    respect of such aspect of your loss.

    20. FLD Legal may close your file and cease to act on your
    behalf when:

    a. There is insufficient information to
    identify, locate and/or sure the at-fault
    party.

    b. The at-fault party’s insurance provider
    revokes concession of liability or
    indemnity of the at-fault party.

    c. It becomes apparent that your
    instructions are materially inaccurate or
    incomplete.
          You do not follow our advice.

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  • AUTHORITY TO ACT AND AUTHORITY TO APPOINT A LEGAL PRACTITIONER

  • I {fullName}, nominate and authorise FLD Legal to act on my behalf in the matter above. 

    • I acknowledge I have read and understood FLD Legal’s Terms of Engagement.
    • I have been given the opportunity to seek my own legal advice and/or to speak with a Legal Practitioner at FLD Legal 03 8567 1940 to discuss this authority prior to signing the same.
    • I have been given access to and read the Overarching Obligation on me in accordance with s41 the Civil Procedure Act 2010 as set out in s16 to s26 of that Act and understand them.
    • I have made the decision not to lodge a claim through my insurer, I understand my right to do so and may lodge a claim should I think it is appropriate to do so.

    I authorise FLD Legal to:

    • Recover my claim for repair costs, hire car costs, loss of income and associate losses arising from my recent motor vehicle accident, and I appoint your firm as my legal practitioner.
    • Receive and make available information regarding my motor vehicle accident claim.
    • Pay its legal fees using funds held in trust on my behalf
    • Communicate and negotiate on my behalf to achieve a settlement.
    • Initiate and conduct legal proceedings in my name as Plaintiff, Claimant or Applicant.
    • Receive and handle settlement funds on my behalf.
    • Complain to Australian Financial Complaints Authority (AFCA) about the at-fault driver’s insurer on my behalf
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  •  

    FORM 4A

    Rule 4.09

    IN THE MAGISTRATE COURT OF VICTORIA
    AT
                                                         No. Cl-

    B E T W E E N

    {fullName}
                                                                                           Plantiff
    and


    {mrmrsms37}
                                                                                     Defendants

    OVERARCHING OBLIGATIONS CERTIFICATION

    Date of Document: {date99} Solicitor's Code: CR120847
    Filed on behalf of: The Plaintiff DX:
    Prepared by: FLD Legal Pty Ltd Telephone: 03 8567 1940
    Level 1, 13 Moller Street, Ref:
    Oakleigh, VIC,3166 Email: info@fldlegal.com.au

    In accordance with section 41 of the Civil Procedure Act 2010, I {fullName}, certify to the Court that I have read and understood the overarching obligations set out in sections 16 to 26 of that Act and the paramount duty set out in section 16 of the Act.

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