Accident statement in Poland: form and PDF generator

An at-fault driver's accident statement is a document in which the driver admits causing the collision. The at-fault driver's insurer pays compensation on its basis without the police.

A handwritten accident statement is valid when it contains the details of the driver, car and policy and the signatures of both parties.

Either party can fill in the collision statement. Without the at-fault driver's signature the document does not identify who is at fault.

The statement is needed in two copies, one for each party. A photo of the signed document is enough instead of a second printout.

The statement generator is free. You pay nothing for the PDF and Word and you do not give your e-mail.

You do not need to create an account. A Google account is only useful to save the statement for later.

Data entered without signing in stays in your browser and we send it nowhere. After signing in, the statement is saved in your account, which you can delete with one button.

The joint European accident report itself states that it is not an admission of fault. That is why our form has a separate sentence the at-fault driver signs: “I declare that I am solely responsible for the collision described above.”

If the at-fault driver refuses to sign the statement, call the police. Until they arrive, photograph the cars and plates and note the registration number and witnesses.

At the scene of the collision you sign only the statement. An authorisation to handle the claim or an assignment of claim is signed calmly, not next to the car.

After signing the statement, the at-fault driver does not pay for the other driver's damage, because their liability insurance covers it. They must report the event to their insurer without delay (Art. 16(2) of the Polish Compulsory Insurance Act) and expect a higher premium.

The insurer demands repayment from an at-fault driver who drove under the influence of alcohol, had no licence, caused the damage intentionally or fled the scene (Art. 43 of the Polish Compulsory Insurance Act).

You must call the police when someone is injured, the at-fault driver may be drunk, has no valid insurance, fled or refuses to show documents. The same applies to a dispute over what happened.

mStłuczka in the Polish mObywatel app is as valid as a paper statement. It only works for two cars registered in Poland, when both parties have the app, agree on fault and no one is injured.

You write a statement after a car park collision like any other. Add the car park address, the space number and which car was reversing or pulling out.

If the at-fault driver has foreign plates, note the country of registration and the Green Card number. You report the claim through the Polish Motor Insurers' Bureau (PBUK), which names the insurer's representative.

No, insurers do not require their own statement form. The insurer assesses the details in the statement, not the form they are written on.

You have 3 years to report a claim to the at-fault driver's insurer, from the day you learned of the damage and the person responsible (Art. 442¹ of the Polish Civil Code). Report it straight away, because photos and witnesses lose value over time.

The at-fault driver's insurer pays within 30 days of the claim. In a complex case the undisputed part comes within 30 days, the rest within 90 days (Art. 14 of the Polish Compulsory Insurance Act).

oswiadczeniesprawcy.pl is run by Fleet Team, a company handling motor claims from the at-fault driver's insurance in Poland. The generator is free, and we can handle your claim at no cost to the injured party.