Notification of a claim for compensation - welfare 2026

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The document is a notification form from the Social Welfare Services Office regarding the result of a compensation claim. It outlines the necessary steps for reporting the outcome of a claim, including options for settlement, withdrawal, or reduced amounts. The form requires details such as the injured person's name, reference numbers, and payment methods for settling claims, either by electronic transfer or cheque.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the name of the injured person in the designated field. This is crucial for identifying the claim.
Next, input your RBA reference number and your own reference number to ensure proper tracking of your submission.
Indicate the result of the compensation claim by selecting one of the options provided: case settled, withdrawn, or settled at a reduced amount. Fill in any relevant dates and amounts as required.
If applicable, provide details for multi compensators, including names, addresses, and amounts liable for each party involved.
Don’t forget to sign and date the form at the bottom before submitting it.

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