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Civil Matter Claim Form

IMPORTANT NOTES ABOUT THE COMPLETION OF YOUR CLAIM FORM

 

  1. If your claim arises from misconduct allegations and/or criminal investigations DO NOT complete this claim form. There is a separate form available from your Federation Representative for you to complete and return to the Federation office for accelerated processing. This is extremely important, as there are often strict time limits that have to be complied with in responding to any written notifications that have been received from Professional Standards or other investigating authorities e.g. a Regulation 17 Notice, charge sheet or summons.

  2. Any delay could prejudice your position.

  3. For all other matters, please include copies of all correspondence with any parties regarding your claim. This will enable us to consider your claim promptly.

  4. There is no cover for any legal fees incurred until your claim is accepted.

  5. The claim cannot be accepted until this claim form is returned and assessed by Addept.

  6. Only legal fees incurred by Addept’s panel solicitors will be covered under this insurance.


Please complete this form with as much details as possible.

Please note it is not possible to save partially completed claims. We therefore recommend that you do not start the claim submission unless you able to complete this. You will also need to be able to attach relevant documents.

SECTION 1 - Member Details

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