Business Interruption insurance claim form Name* First Last Your Company*Your RoleCompany Phone Number*Your Email* Company registration numberFind this Here Registered Company Address* Street Address Address Line 2 City County Post Code Insurance InformationYour Insurance ProviderEcclesiasticalHiscoxLarkQBERSAAvivaOther Have you already emailed your insurance policy to us?*YesNoUpload your Policy*Accepted file types: jpg, pdf, doc. Have you already emailed your schedules to us?*YesNoUpload your schedules*Accepted file types: jpg, pdf, doc. Have you already emailed the terms to us?*YesNoUpload your terms*Accepted file types: jpg, pdf, doc. Have you already emailed the terms & conditions that you entered into?*YesNoUpload the terms and conditions that you entered into.*Accepted file types: jpg, pdf, doc.ConfirmationsHave you received any specific COVID-19 government funding to cover any losses?*Please note: If you have received funding, it does not stop you pursuing a claim.YesNoConsent* I agree to allow JMR Solicitors to contact me by phone or email in response to my enquiry and agree to the Privacy Policy
