Online Corona Form

Please fill in this form to tell the Mutual about a claim. The form needs to be completed and signed by the Member named in the Schedule or, if the Member is a company or a partnership, by one of the directors or partners.

Please fill in all relevant sections as fully as possible and attach additional pages if necessary together with copies of all documents, quotes, tax invoices and receipts to support your claim.

Please contact us if you have any questions about your claim or filling in this form.

Using Personal Information
We may collect, use and share personal information from you, other people, businesses and organisations as part of our claims process. We will only keep personal information for as long as we need to use it. You can see how we use personal information, and the legal rights of people whose personal information we hold, in the privacy notice on our website If you would like us to send you a copy of our privacy notice please ask us.

Permitted files JPG, PDF, PNG can not be larger then 10MBs per file

A) Details of Membership

B) Details of Event

C) Claims for Business Interuption

Business Interruption Loss

Please fill in details of all items included in your claim and attach extra pages if necessary

Date business closed Date Business re-opened Rate of Gross profit

Please include your takings for the dates the business was closed and the same period in the last 12-24 months, along with confirmation of your rate of gross profit . Your accountant will be able to provide this information.

D) Declaration

Being a Member / on behalf of the Member confirm that the information I have given in this form is true and I understand that The Retail Mutual may exercise its discretion to provide cover

Permitted files JPG, PDF, PNG can not be larger then 10MBs per file