Compensation Claim Form

Please tell us about the circumstances around the compensation claim.

Please provide information to support your claim (including details of item/s damaged and evidence of damage - either photographic or physical).

Items supporting claim

Drop files here or

Max. file size: 256 MB.

When did you first become aware of the problem?

If it was more than 28 days since you first became aware of the problem, please give the reason why you have not claimed before now:

Have you already spoken to somebody regarding your claim for compensation? If yes, please give brief details of to whom, when you did so and what happened as a result:

Are you reporting this complaint on your behalf, or are you representing someone on their behalf?

On my behalf
I am representing someone else

If you are filling this out on behalf of someone else, please note that we will be sending an advocate form to be signed by this person before we commence any investigation.

First Name*

Surname*

Address*

Postcode*

Phone Number*

Email Address

Privacy Policy*

You must accept the privacy policy before sending your message.

I agree to the privacy policy.

Compensation Claim Form

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