Auto Injury Referrals
Attorney Referral Intake Checklist
Use this quick checklist to send everything our team needs to open the claim, verify coverage, and get your client scheduled without delays.
What We Need in Your Referral Packet
Complete documentation helps us process auto injury cases quickly and keep your client’s care moving.
1
Client Identity & Contact
- Full legal name
- Phone number
- Email address
Required for claim file creation and identity verification.
2
Declaration Page + Date of Loss
- Complete declaration page
- Date and time of accident
- Police report number (if applicable)
Validates coverage, liability, and claim alignment.
3
Coverage Details
- Insurance carrier name
- Claim number
- Policy limits (PIP, Med Pay, BI)
Allows our team to open, track, and manage care under the correct claim.
4
Adjuster / Claims Contact
- Adjuster’s full name
- Direct phone number
- Email address
Needed to coordinate medical necessity and treatment authorization.
5
Health Insurance Information
- Primary insurance carrier
- Member ID
- Group number
Prevents delays in payment or coordination of benefits disputes.
6
Representation & Litigation Status
- Representation type (full / limited)
- Current litigation status
- Preferred communication method
Helps us follow the correct communication protocols for litigation.
Synergy Health Partners
Mendelson Orthopedics & Spine
📍
36622 5 Mile Road, Ste 101
Livonia, MI 48154
Livonia, MI 48154
📍
35735 Mound Rd.
Sterling Heights, MI 48310
Sterling Heights, MI 48310
📍
600 Fort St #100
Port Huron, MI 48060
Port Huron, MI 48060
📍
29275 Northwestern Hwy #207
Southfield, MI 48034
Southfield, MI 48034