Claim Forms

UNISONdirect: 0845 355 0845

	London Ambulance Branch

London Ambulance Service Unison Branch

CLAIM FORMS

To return to the stewards resource page Click Here

The Following Claim Forms are available to order from the Branch Secretary or Unison Direct.

FORM CODE	DESCRIPTION
PI (NON WORK)	Legal assistance for non-work related injury, illness or disease for members and their families
PI	Legal assistance for members: injury, illness or disease (including assaults at work)
RTA	Legal assistance for members and members families for road traffic accident claims resulting in personal injury. (Not for vehicle damage only claims)
FLA	Free initial legal advice on a matter outside employment
CW	Application for assistance with conveyancing/wills at fixed charge
CR	Legal assistance for work related criminal/police matters/inquests arising out of members employment or professional indemnity insurance
1133	Accident Benefit claim form (at work or travelling to or from work)

You can fill out the following online request for any of the above forms or if it is urgent please telephone.
Please note: We will only send forms to unison stewards or contacts. If you are a member you should in the first instance speak to your station representative or contact Unison Direct on 0845 355 0845.

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Name:

Station / Workplace:

Forms Requested: (Place a tick in the box and select quantity required)

PI (Non-Work) Qty: PI Qty: RTA Qty:

FLA Qty: CW Qty: CR Qty: 1133 Qty: