Request for compensation form

To make a compensation claim, please complete all sections of the form below. 

We will be in touch within seven working days of submission. We may request further information including purchase receipts for any damaged items and estimates for repairing or replacing the damaged item(s).

Please retain any damaged items for inspection. 

 

Your details







Details of the incident
Please answer 'as above' if this was at your home address.


Details of loss
E.g. Living room carpet
E.g. 4 years
E.g. £220
E.g. £180
E.g. Burn mark under fire.