# ACCIDENT AT WORK CLAIM
Date: 14 October 2035
Parties: Amelia Grant and Harbourside Kitchens Ltd
## 1. Purpose and parties
To Harbourside Kitchens Ltd, company number 15220418, of Unit 4, Dock Lane, Portsmouth PO3 5RX. I am Amelia Grant of 9 Cedar Walk, Portsmouth PO4 1JN and was employed by you as a production assistant. This is a completed fictional letter of claim concerning an accident at work.
## 2. Facts, scope and terms
On 22 August 2035 at about 14:20, I slipped on water beside the wash station while carrying a labelled tray. I reported the incident to supervisor Leon Brooks immediately; the entry in the accident book is AB-2035-88. I say the water was not marked or cordoned off, but liability and causation remain matters for investigation.
## 3. Process and responsibilities
I attended Queen Alexandra Hospital that evening and was diagnosed with a fractured left wrist. The plaster was removed on 19 September, and an occupational therapist reviewed my grip on 2 October. The medical evidence presently suggests a further three months of symptoms, subject to recovery; I do not assert a final prognosis without appropriate evidence.
## 4. Evidence, records and safeguards
I was absent from work from 23 August to 15 September and received statutory sick pay of £594.60. My ordinary net earnings for those 17 scheduled working days would have been £1,020.00, calculated as 17 × £60.00, so the claimed net earnings difference is £425.40. I will provide payslips and accept that benefits and payroll records require checking.
## 5. Review, escalation and outcome
I also claim £146.80 for prescribed medication and travel to three appointments, supported by receipts, making presently quantified financial loss £572.20 (£425.40 + £146.80). I do not include unverified care, future treatment or general damages in that subtotal; those heads require medical and legal assessment.
## 6. Reservations and practical protections
Please preserve the risk assessment, cleaning and inspection logs, CCTV, training records, accident-book entry and witness accounts for 22 August. Please provide your employers' liability insurer details and acknowledge this letter within 21 days. I remain willing to consider rehabilitation and an appropriate early exchange of information.
## 7. England and Wales law and completion
This letter is an invitation to investigate and resolve the claim under the applicable pre-action process, not a finding that the company breached a duty. I reserve rights subject to limitation and mandatory employment protections, will obtain independent advice, and will not sign a settlement or release until the injury and losses are properly assessed. It is dated 14 October 2035.