Start Your Claim

If you wish to report your personal injury claim to us you can either:

  1. Telephone us free on 0800 587 5787;
  2. Complete your name and contact telephone number on the quick start call back form on the right hand menu with the best time we can telephone you and then submit this to us and we will contact you to discuss the additional information needed;
  3. Fully complete the brief claim form below and we will contact you to discuss matters further

Claim Form

 
 
Full Name: *
 
Address: *
 
Postcode: *
 
Best Time To Contact You: *
 
Email: *
Type of incident: *
 
When did the incedent occur?: *
 
Brief Description of what happened: *
 
What injuries did you sustain: *
 
How long you were off work: *
 
Have you sought medical attention either
at hospital or your General Practitioner?: *
Details of your General Practitioner: *