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Home
About Us
Types of Claim
Road Traffic Accidents
Work Accidents
Trip/Slip Claims
Criminal Injury Claims
Industrial Disease Claims
Housing Disrepair Claims
FAQ
Contact
Claim Online
Call: 0333 600 9250 or CLAIM ONLINE
Home
About Us
Types of Claim
Road Traffic Accidents
Work Accidents
Trip/Slip Claims
Criminal Injury Claims
Industrial Disease Claims
Housing Disrepair Claims
FAQ
Contact
Menu
Home
About Us
Types of Claim
Road Traffic Accidents
Work Accidents
Trip/Slip Claims
Criminal Injury Claims
Industrial Disease Claims
Housing Disrepair Claims
FAQ
Contact
Claim Online
Make Your Claim
Fill The Form Below To Make Your Claim
Make Your Claim
Fill The Form Below To Make Your Claim
New Claim Form
Where did you hear about us ?
*
Google
Bing
Social media
Existing or Old Client
Recommended by someone
Please specify recommended person
*
A person or business name if recommended by someone
Please select the closest accident circumstances
Hit in the rear
Hit from a side road
Hit by an oncoming vehicle
Lane changing
At a roundabout
Hit whilst stationary or parked
Hit by a vehicle overtaking yours
Hit by a vehicle pulling out
Hit by a reversing vehicle
Hit by a party opening door
Multiple vehicles involved
Other
Accident Details
Accident Date
*
Accident Location
Third Party Details
Registration Number
Driver Name
Contact Number
Your Vehicle
Vehicle Registration
Vehicle Make
Vehicle Model
Do you need a replacement vehicle?
Yes
No
Your Details
Name
*
Name
Name
Name
Mobile number
*
Email
*
submit
*
By submitting this form, you agree that we can contact you in relation to your claim, and you agree to our privacy policy.
If you have accident pictures, videos, dashcam or CCTV footage, you may email them to
claims@easyclaim.net
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