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JOSUE A. QUISTIAN BRAVO

treating
medium
CS-2606-2276·Auto Accident·erika@azandassociates.net
Original Intake Submitted
Staff Updates Applied
Last updated by StaffAug 21, 2026 6:08 PM

Missing Information

Other Party Vehicle

People Involved

Total People2
Injured2
driverJOSUE A. QUISTIAN BRAVOInjured

DOB: 1991-07-18

470-8004625

passengerCARLOS LUCHAInjured

7702946349

Client

NameJOSUE A. QUISTIAN BRAVO
Phone470-8004625
Emailguadalipequistian07@icloud.com
DOB1991-07-18
Address5228 kingswood Cir , ATLANTA, GA 30349

Insurance

Client CarrierSTATE FARM
Claim #1198K977H
Policy #0697872SFP11001
At-Fault CarrierPROGRESIVE
At-Fault Claim #26-758980121
At-Fault Policy #863537191
At-Fault Limits25/50

Adjusters

BI AdjusterUM MARGARET
BI Phone8442928615
PD AdjusterBI VEE L SMITH
PD Phone678-7835498

Vehicle

Year2013
MakeDodge
ModelDURANGO
DrivableYes

Medical

Assigned ClinicDominguez Chiropractic Jonesboro
Treatment Statuspending
ER VisitYes
HospitalATRIUM HEALTH
Currently TreatingYes

Injuries

Client Injuries—

AI Analysis

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Case Summary

Incident Date

Mar 26, 2026

Incident Type

auto accident

Incident Location

FORSYTH

Client Role

driver

Client Insurance

Carrier

STATE FARM

Policy #

0697872SFP11001

Claim #

1198K977H

Adjuster

UM MARGARET

Adjuster Phone

8442928615

At-Fault Insurance

Carrier

PROGRESIVE

Policy #

863537191

Claim #

26-758980121

Policy Limits

25/50

Adjuster

BI VEE L SMITH

Adjuster Phone

678-7835498

At-Fault Driver

MATHEW CHASE PAGETT

Insured Name

MATHEW CHASE PAGETT

Client Vehicle

Year

2013

Make

Dodge

Model

DURANGO

Workstreams

Property Damage

Unassigned

Pending

Treatment / Clinic

Unassigned

Pending

Attorney Documents

Unassigned

Pending

Insurance

Unassigned

Pending

Assigned Clinic

ZIP: 30349ATLANTA, GA

Dominguez Chiropractic Jonesboro

Assigned Attorney

The Law Office of Jonathan Herman

Assigned Carrier

Not assigned

Adjusters

BI

BI VEE L SMITH

BI
Initial Contact

Assigned Clinics

0

No clinics assigned yet.

Intake Completeness

4 fields still missing

85%

Client Info

7/7
  • First Name
  • Last Name
  • Phone
  • Email
  • Address
  • Date of Birth
  • Preferred Contact Method

Incident

4/5
  • Incident Date
  • Incident Location
  • Incident Type
  • Incident DescriptionMissing
  • Client Role in Accident

Police & Injuries

4/5
  • Police Report Filed
  • Police Department Name
  • Police Report Number
  • Injuries DescriptionMissing
  • Hospital Name

Vehicle & Parties

3/5
  • Vehicle Year
  • Vehicle Make
  • Vehicle Model
  • Insurance CompanyMissing
  • Insurance Policy NumberMissing

Docs & Consent

4/4
  • ID Document
  • Consent to Share Info
  • Consent to Accuracy
  • Digital Signature