In Consideration of CLAIMS MANAGEMENT CENTRE LTD (CMC Ltd) agreeing to indemnify me against all of my Legal Costs * and Expenses incurred in relation to my claims arising from my accident , I authorise all payments received to be made payable to CMC Ltd and I understand that no deductions will be made from any Injury damages recovered on my behalf. Any damages will then be paid directly to me in full and final settlement of my claims.

* Legal Costs and Expenses means fees and costs reasonably properly incurred by the nominated solicitor and the party costs of any civil proceedings instituted in relation to my claims which have been incurred by a third party for which I may be liable by order of a court or by agreement with the consent of CMC Ltd.

I authorise CMC Ltd to act as my agent at all times and to:

Nominate a solicitor to act on my behalf if CMC Ltd considers the claim has a better than 50% chance of success.

Settle my claim on terms that the nominated solicitor deems reasonable.

Further I agree that if I decide to terminate this agreement before the claim is won or lost. I will pay the Legal Costs and Expenses of the Nominated Solicitor and an administration fee of £300 plus VAT to CMC Ltd. (Helps protect CMC Ltd from perpetrators of injury claim fraud)

I understand that CMC Ltd may terminate this agreement if I fail to co-operate or provide reasonable instructions to CMC Ltd or the nominated solicitors or if I reject their opinion about making a settlement of my claim, in any of which events I agree to pay the Legal Costs and Expenses of the nominated solicitor up to the date of termination and an administration fee of £300 plus VAT to CMC Ltd. (Helps protect CMC Ltd from perpetrators of injury claim fraud)

I understand that my details may be forwarded to such parties as deemed necessary in relation to the completion of my claims.

I confirm that the information I have provided to CMC Ltd in relation to my claim is correct to the best of my knowledge and belief. I understand that intentionally providing false and misleading information for personal gain could lead to the cessation of my claims and possible prosecution.

Important: By checking the checkbox on the Online Claim Form you agree to be bound by these terms and conditions