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Workers Comp Affidavit Template for England and Wales

A Workers Comp Affidavit under English and Welsh law is a sworn legal document that confirms an employer's compliance with statutory requirements regarding workers' compensation and employers' liability insurance. Unlike the US system, the UK relies on mandatory employers' liability insurance, statutory sick pay, and the Industrial Injuries Disablement Benefit scheme. This document typically includes declarations about insurance coverage, compliance with health and safety regulations, and specific incident details when relevant.

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What is a Workers Comp Affidavit?

The Workers Comp Affidavit serves as a formal declaration of an employer's compliance with UK workplace compensation requirements. This document is commonly required in contractual relationships, legal proceedings, or regulatory compliance scenarios. It provides verification of employers' liability insurance coverage, which is mandatory under UK law, and may include details about specific workplace incidents or claims. The affidavit helps demonstrate compliance with the Employers' Liability (Compulsory Insurance) Act 1969 and related regulations in England and Wales.

What sections should be included in a Workers Comp Affidavit?

1. Declaration Statement: Opening statement identifying the affiant and purpose of the affidavit

2. Employer Information: Details of the employer, including business name, address, and registration numbers

3. Insurance Coverage Confirmation: Statement confirming valid employers' liability insurance and policy details

4. Health and Safety Compliance: Declaration of compliance with health and safety regulations

5. Verification Statement: Formal statement verifying the truth of the contents

What sections are optional to include in a Workers Comp Affidavit?

1. Specific Incident Details: Additional section used when affidavit relates to a specific workplace incident or claim

2. Historical Coverage: Additional section for details of previous insurance coverage when historical information is relevant

What schedules should be included in a Workers Comp Affidavit?

1. Insurance Certificate: Copy of current employers' liability insurance certificate

2. RIDDOR Reports: Copies of any relevant accident reports filed under RIDDOR

3. Risk Assessments: Relevant workplace risk assessments when applicable to the case

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents

Jurisdiction

England and Wales

Publisher

Genie AI

Document Type

Insurance Form

Cost

Free to use

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