Slip and Trip - Online Claims

1. Your Details

*Name

Address

*Email Address

*Telephone Number

2. Information regarding the accident

Please provide the time, date and location of the accident.

Describe in detail how the accident happened and what you were doing at the time. If applicable provide the dimensions of the area on which you tripped or the surface area of the substance on which you slipped. Also, if applicable, please state what substance you slipped on.

Please describe the injuries you sustained and the treatment provided so far.

Who do you believe is responsible for the accident?

3. Click below and submit your claim to us