Start your claim - Criminal injury

Please complete the claim form below.

When we receive your information, we will phone you to ask about any further details we may need to support your claim for compensation.

1. The incident

Basic description of the incident and your injury:

Don't worry if you miss something out. When we contact you, we will ask for any further details we need to start examining your claim.

Name:

E-mail address:

Daytime phone number:
Alternative daytime phone number:

When would you prefer to be called?

Call back times are for Mon-Fri only and do not include public holidays

"I was very worried at the beginning because I had not claimed before, but they explained everything to me."