Claim Online Form

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Please fill out the form below and one of our specialist advisors will telephone you shortly (without obligation) to discuss your claim further.

Fields marked with * are compulsory

A. Tell us about your accident:

Please describe the type of accident: *
When were you injured? *
Please provide a brief description of how you received your injuries
(up to 500 characters): *

B. Enter your contact details:

Full name: *
Telephone number: *
Alternative telephone number:
Email Address: *
When would you prefer to be called? *

C. Click on the start your claim button to make your claim:

Anti Spam Code: *

Please enter the text exactly as it appears.

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Simple Justice is Regulated by the Claims Management Regulator in respect of regulated claims management activities. Registration can be found on www.claimsregulation.gov.uk