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STATEMENT OF TRUTH
Your personal information will only be disclosed to third parties, where we are obliged or permitted by law to do so. This includes use for the purpose of claims administration as well as disclosure to third-party managed databases used to help prevent fraud, and to regulatory bodies for the purposes of monitoring and/or enforcing our compliance with any regulatory rules/codes.
Where our services have been recommended to you, do you consent to us liaising with the introducer to progress your claim? This may include sending written communication to them as well as discussing your claim over the phone. This consent can be withdrawn at any time by you.
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By entering your name in the box below, you are effectively providing your signature, indicating that all the information on this claim form are true and accurate, to the best of your knowledge.