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How to complete this form

Part 1: Security questions

Your answers must be the same as what you told us on your online claim.

Part 2: Amendment section

You will need the following information to hand:

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

Start part 1

What is your full name?
Use the same name you wrote in your claim
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