| Name | Description | Type | Additional information |
|---|---|---|---|
| insured_party_first_name | string |
None. |
|
| insured_party_last_name | string |
None. |
|
| injured_party_first_name | string |
None. |
|
| injured_party_last_name | string |
None. |
|
| claim_number | string |
None. |
|
| provider_id | integer |
None. |
|
| accident_date | date |
None. |