MyInjuryClaim

Did the Accident Take Place in The Last 3 Years?

Did You Report It to Your Employer?

What Area of The Body were You Injured? You can select multiple

What was the severity of the injury?

Did you visit the hospital/doctors?

Are you still affected by the injury?

Describe how briefly.

Your name

Your date of birth

Your address

Manually enter address

Your mobile number

By clicking here you agree to our privacy policy

I/We authorize My Claim Group a trading style of Wisemann Law to pass all information collected about me/us concerning my/our claim for the undisclosed commissions on my payment protection insurance (PPI) policy to The Claims Protection Agency Ltd to process my/our claim(s).

I/We authorize The Claims Protection Agency Ltd to work on behalf of My Claim Group to receive and pass all information about me/us concerning my/our claim for the undisclosed commissions on my/our claim to DCAL Medical Agency Limited so that they can provide an expert witness report.

Your email

Draw your signature

By signing here you are allowing signing all documents relating to your claim, copies of all your documents will be sent to you via email once you have submitted. By singing here you are agreeing to allow us to use your signature for any future documents needed to process your claim.