Below you can select the type of claim form you require.
Please download the required form(s) to your computer/device and complete with all the information relating to your claim.

To complete these forms please use Adobe Acrobat Reader.

*Please note: If you are completing the forms on a mobile device, the Signature field may not be visible.
To sign the forms please open in Adobe Acrobat Reader (a free app) as normal and use the “Fill & Sign” tool to add your signature if required.

Please email your completed Claims Form(s) to: burgess@csal.co.uk

If you prefer to print the forms and complete by hand, you can scan the completed forms and email to the above address or post your completed form to:
If you are sending any Original Documents we recommend sending via Recorded Delivery and keeping copies for your own records.

Burgess Claims
308 – 314 London Road
Hadleigh, Benfleet
Essex
SS7 2DD

Please Note: A Claim Number will be allocated upon receipt of your completed Claim Form.

Baggage & Money

Medical & Other Expenses

Personal Accident & Illness