Important information

• Please read the insurance claims against the council page before completing the form
• If the claimant is under 18 years of age (a minor) a parent/guardian will need to complete this form
• The issuing of this form does not constitute any admission of liability on behalf of Warwick District Council or mean you will receive any compensation.
• Please complete all sections of the form relating to general information and the incident. You may then complete the relevant section relating to either personal injury or property damage as appropriate.
• Please provide as much information as possible continuing on a separate sheet of paper if there is insufficient space
• If you have any queries concerning your claim please contact the Insurance and Risk officer on 01926 456823 or email insurances@warwickdc.gov.uk

Privacy statement

All information provided will be treated in confidence and will be used for the purposes of investigating and processing your claim and to assist Warwick District Council in the identification and management of its risks. Where the personal data relates to a child, you verify that you have the legal authority and consent to share the personal data of the child.  Our lawful basis for processing the personal data is that it is necessary for our legitimate interests to investigate and handle the claim.  In doing so, we have balanced the right to privacy against the right to carry out a full and proper investigation. 

We also collect sensitive data known as special category data and our lawful basis for processing is that it is necessary for the establishment, exercise or defence of legal claims.  The information that you provide will be shared with relevant council departments, partner agencies and outside bodies such as insurance companies, claim management companies, solicitors, loss adjusters, the Police, the DVLA and other government bodies or third parties to assist in the processing of claims.

The information provided may also be shared with other departments within the Council for the purpose of preventing fraud, misuse of public funds and for any legal or statutory requirements. It may also be shared with other public bodies and government departments such as the Cabinet Office for similar purposes.

Where we share information with a third party, we shall endeavour to ensure the same level of care and protection is given to the information.

Your personal data will be kept for ten years after the calendar year in which your claim has been fully closed.

You have the right to access your personal data and to complain if you think your data is being used incorrectly. You may also have other rights, such as to have your data corrected or erased. For further information about how your personal information will be used please visit www.warwickdc.gov.uk where you can see a full copy of our privacy notice.