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Settlement Funding
Estimator / Calculator

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Attorney Questionnaire

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Client Information

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Initial
Last Name
Date of Birth
Address
Telephone
Clients Social Security

Attorney Information

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Phone Number *
Fax Number
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Case Information

Type of Case
Date of Accident
Property Damage $
Wage Lost $
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Arbitration Date
Mediation Date
Trial Date
Award
Case Number
County of Court
Offer Amount
Demand Amount
Case Value
Settlement Prospects: Good Fair Poor

Injury Information

Injuries
Surgery?: Yes No
Prior Injuries
Total Medical Bills
First and Last Date of Treatment
Defendants Insurance Company
Claim Number
Policy Limits
Attorney Fee
Litigation Costs
Medical Liens
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We do not fund cases filed in Colorado, Illinois, Kansas or Maryland.

We can only fund $25,000 or more in North Carolina.