COMMUNITY INSURANCE FUND

Claim Forms

Workers' Compensation
  • The Insurance Commission requires the employer to complete this form when an employee lodges a claim for a work injury. The completion of this form confirms formal lodgement of the claim under the cover provided and gives the employer the opportunity to provide additional information relevant to the claim and whether it is supported by them.

    The Employer's Report Form 1B, Workers' Compensation Form 2B and First Medical Certificate from the treating medical practitioner should be forwarded to the Insurance Commission as soon as the worker's claim is received.

    Please see the Workers' Compensation FAQ's for more information.

Property Claims
  • To be completed by a community organisation when they suffer loss or damage to property owned by or in the care, custody or control of the community organisation. The Property claim form must be fully completed and signed along with the relevant supporting documentation (such as a quote, receipt, invoice, asset or resource listing).

    Please see the Property FAQ's for more information.

Motor Claims
  • To be completed by a community organisation driver when one of the community organisation's registered motor vehicles is involved in an accident. Can be utilised for all types of motor claims, including windscreen claims, single or multiple vehicle accidents, total losses etc. In the event a community organisation is involved with another vehicle or causes property damage where they are at fault, but there is no damage to the community organisation's vehicle, a claim form will still be required as a 'report only' notification to the Insurance Commission so that we may settle the other party's claim.

    Please see the Motor FAQ's for more information.

Liability Claims
  • This form is to be used when a member of the public has injured themselves on your property or your community organisation has caused injury or property damage to another party. The form is to be completed by a person in authority at the community organisation as soon as possible after the event or upon being approached and/or informed by a third party that they have suffered personal injury or property damage/loss. This form is not intended to be completed by the third party.

    Please see the Liability FAQ's for more information.

Get Acrobat Reader To view or print parts of these documents, you will need a copy of the free Adobe Reader which may be downloaded from Adobe's web site.