Refer a Case: OCL Solicitors – Claimant Solicitor

If the mandatory information is not known, please add ‘n/a’ into the respective field.

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Call on 01698 207 755

Email us at helpis@proclaim-care.co.uk

For enquiries regarding Case Manager CVs and availability, please click here.

Claimant Solicitor
Name*
Reference*
Phone*
Email*
Company*
Address Line 1*
Address Line 2
Town/City*
Postcode*
Injured Party
Name*
Date of Birth*
Phone*
Alternative Phone
Email
Address Line 1*
Address Line 2
Town/City*
Postcode*
Claimant Referral Type
Please select instruction type*
- Single Instruction (interim payment funded)
- Single Instruction (deferred fee funded)
- Joint Instruction
Defendant Insurer
Defendant Insurer section required if Claimant Referral Type is Joint Instruction.
Defendant Name
Company
Claim Handlers Name
Defendant Reference
Phone
Email
Address Line 1
Address Line 2
Town/City
Postcode
Services Required
Service*
Claim Type*
Date of Accident*
Date of Referral
Brief Details of Injury*
Special Instructions
Attachments
Attach Files
Please add any Medical Reports, Medical Records and/or Medical Legal Reports:
Drop files here or

Max. file size: 50 MB.
Comments
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Refer a Case: OCL Solicitors – Claimant Solicitor

For enquiries regarding Case Manager CVs and availability, please click here.

Claimant Solicitor

Injured Party

Claimant Referral Type

Defendant Insurer

Services Required

Attachments

Request CVs & Availability Information