Contact Us:

670 Lafayette Ave, Brooklyn,
NY 11216

+1 800 966 4564
+1 800 9667 4558

Fatal Injuries (Death)

▪ Duly completed and signed personal accident claim form by the legal personal representative

▪ Payslips for at least three months prior to the injury date.

▪ Witness statement as to the circumstances leading to the accident

▪ Original Death Certificate/ a Certified copy of Death Certificate.

▪ Burial Permit

▪ Post Mortem Report.

▪ Copy of the deceased’s ID – front/back

▪ ID surrender form.

▪ Original medical receipts if any

▪ Police abstract if death is due to assault or a road traffic accident.

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