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0116 442 2075
Please complete the detailed accident claim form below.   The more information you can complete about your accident and subsequent injuries, the more help and advice we can give.  If you can, please report the accident and ensure it is written in your employer's accident book or the accident book belonging to the owner of the premises where you were working at the time of your accident. If you provide your phone number, we will only call you to discuss this enquiry.
 
If you would prefer to talk to one of our Personal Injury specialist solicitors and lawyers in confidence, please call free on 0800 3899 096.

Personal Details

From time to time Lawson-West may wish to contact you with special offers or other information that may be of interest to you. Please indicate whether or not you are happy to receive such communication from Lawson-West.
Yes
No

Accident Details

Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
(1) Within 24 hours
(2) Within 1 week
(3) Longer than 1 week
(4) Not at all

Please ensure that you have completed all the required fields (marked with *) and then click submit to send the form.