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Employers Liability

Documentation & Guidance

This page will assist you in progressing your claim and offer general advice and guidance relating to employer’s liability claims.

  1. Please complete the form with as much information as possible – this will speed up the handling of your claim.
  2. Please record only (1) what you yourself actually saw or (2) what you have been told by the injured person or a witness, stating who told you and when. For example “Mr. Jones slipped on oil” may later be interpreted as evidence that you witnessed the slip, whereas ”Mr. Jones states that he slipped on oil” is simply a record of what he says happened and does not imply anything more.

    If possible, try to check the injured person’s account before completing your section of the form. For example, if you found no evidence of a spillage when checking the area after being told of the accident, please state this clearly and state the date and time that you checked.

  3. If required to express an opinion about the cause of the accident or suggest whether any action is required to prevent a recurrence, please choose your words carefully. It is important that you do not overlook the employee’s own duties and responsibilities.

  4. Please state the name of all known witnesses to the accident. It may be useful to give them a witness questionnaire to complete (see below). Where no witnesses are identified, please give the details of anyone else in the vicinity at the time.
  5. In all cases, Employer’s Liability claims require a wages declaration, please click the icon below to download a wages declaration form.
  6. If there were witnesses to the incident, you will need to complete the relevant witness questionnaire, please click the icon below to access this document
  7. If you are in doubt about anything, please contact us.
Employers Liability Claim Form Witness Questionnaires Wages Declaration