Get the free Workman Compensation claim form - InsuranceMarket.ae

Name: Fillable Online Workman Compensation claim form - InsuranceMarket.ae Fax Email Print - pdfFiller
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AXA Insurance Gulf B.S.C. Building 7, Dubai Outsource Zone, Manama Street P.O. BOX 32505, Dubai United Arab Emirates 800 4845 (Clients) / 800 292247 (Brokers) +971 (0)4 4291380 work comp. Claims axagulf.com

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How to fill out workman compensation claim form

01

Start by obtaining the workman compensation claim form from your employer or the relevant authority.

02

Carefully read the instructions provided with the form.

03

Fill out your personal details such as name, address, contact number, and social security number in the designated sections.

04

Provide detailed information about your employment, including the name of your employer, job title, and date of hire.

05

Describe the nature of your work-related injury or illness in a clear and concise manner.

06

Include the date, time, and location of the incident that led to the injury or illness.

07

If applicable, mention any witnesses or colleagues who can provide additional information about the incident.

08

Provide details about the medical treatment you have received or plan to receive for your injury or illness.

09

Attach any supporting documents such as medical records, bills, or witness statements.

10

Sign and date the form to certify the accuracy of the information provided.

11

Submit the completed form to the appropriate authority or your employer as per the instructions.

Who needs workman compensation claim form?

01

Anyone who has suffered a work-related injury or illness and wishes to file for workman compensation benefits needs to fill out the workman compensation claim form.

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