Please complete the form below to begin your application for criminal injuries compensation. Once you have submitted the form one of our criminal injury experts will review your application and contact you to discuss the next steps before sending you our paperwork to sign via e-sign.

We are RAM Legal Services, an independent legal firm established in 2001. We are one of the UK's largest criminal injury specialists who have represented 1000's of victims of crime in claiming compensation from the Criminal Injuries Compensation Authority. All work is carried out on a No Win No Fee basis. This means that if your claim is not successful you will not pay us anything. If your claim is successful, we will deduct 30% of your award. For example, if you receive £1000, we will deduct £300 for our services and you will receive £700. You are not required to instruct legal representatives to deal with your claim and if you feel able to, you can represent yourself in making a claim to the Criminal Injuries Compensation Authority direct at no cost. Please remember you then become responsible for the entire management of your application for example deciding what evidence is needed to prove your case, injuries, etc and ensuring that it is all obtained and considered. You would also become responsible for reviewing any negative decisions or arguing your case to a Tribunal at a tribunal hearing.

Please note that by submitting this claim form you will NOT be instructing us to act on your behalf until one of our experts has assessed your claim and you have signed our e-sign documents.

Contact information

Prefix

First name *

Middle name

Last name *

Date of birth

Emails

Address *

Type

Upon submission, a copy of this form will be sent to the primary email.

Add email

Addresses

Street address

Country

City

State/Region

Zip/Postal code

Address type

Add address

Phone numbers

Phone number

Type

Add phone number

RAM Legal Services

Are you over the age of 18

How would you prefer to be contacted to discuss your application?

Would you prefer to speak to a male or female file handler ?

Your Contact Information

Contact information

National Insurance Number

Please list any previous names that you have been known by

Incident Details

What best describes the incident

Briefly describe the crime in your own words

Incident Date (for single incidents)

If this was a period of abuse when did the abuse start? (leave blank if not applicable)

When did the abuse end? (leave blank if not applicable)

Where did the incident happen?

Offenders name/s if known

Police Involvement

Was the incident reported to the Police

Who reported the incident to the Police?

When was the incident reported to the Police

If there was a delay in reporting the matter to the Police please explain the reason?

Details or address of investigating Police station/constabulary

Have you co-operated with the Police's enquiries

What is the crime reference number?

Details of your injuries and treatment

Please describe any physical injuries you sustained as a result of the crime

Please describe any psychological injuries that you sustained due to the crime. (please include how long these injuries have lasted as an estimate)

Briefly state how your injuries have affected your daily life

Have you attended your GP as a result of the incident?

Name and address of your GP surgery

Did you attend hospital as a result of the incident?

Have you had any psychological treatment as a result of the incident?

Additional information

Have you ever applied for compensation through the Criminal Injuries Compensation Authority before ?

Any additional information?

Do you have any unspent criminal convictions

Acknowlegement