I declare the fatal occupational accident myself

Fill in the declaration form

Print the declaration form (in Dutch/French) and fill it in. This way, we will be able to handle your file more quickly.

If you have difficulties filling in the declaration form, your trade union or our social controllers in our Brussels office can help you. They are available on Monday and Friday.

Add a medical certificate

Add a medical certificate established by the doctor who recorded the death.

If possible, add other elements of proof to your declaration

Some examples of elements of proof:

•    the names of the direct witnesses of the accident. Those are the people who have seen the accident;
•    the police report.

Send the completed declaration form, medical certificate and any other potential element of proof to

the insurance company of your relative's employer


(if you do not know the insurance company of your relative's employer)

Agence fédérale des risques professionnels
Direction Contrôle
Avenue de l'Astronomie 1
1210 Bruxelles

Fedris will send you an acknowledgement of receipt within 7 days.