How to complete this form

Part 1: Security questions

Your answers must be the same as what you told us on your online claim. You will need the following information to hand:

• claim reference number
• National Insurance number

Part 2: Amendment section

Only answer a question if you need to change what you submitted in your online claim.

Leave questions blank that you do not want to change.

Use this section to give us the correct information for your:

• name
• National Insurance number
• date of birth
• email address
• home address
• mobile number

Proof such as a copy of your driving licence, wage slip or passport will be needed to update your name, National Insurance number and date of birth.

Start part 1