Forms
Motor Injury Insurance Forms
Motor injury insurance claimants may need to complete one or more of the following forms based on the advice of claims staff.
Medical Information Disclosure Authority
Completed by claimants to authorise the release of their medical information to the Insurance Commission.
Electronic Funds Transfer Application for Claimants
Completed by claimants to request a reimbursement for out-of-pocket expenses.
Employers Confirmation of Loss of Salary
Completed by claimant’s employer to confirm employment details and weekly wages.
Completed by claimant for advance payment of weekly wages.
Completed by claimants who are self employed to prove loss of income.
Completed by parties involved in the crash to provide further information about the crash.
Completed by claimants to report economic loss from employment.
Notice of Intention To Make Claim
Most claims are lodged by filling out the Online Crash Report Form. This form (Notice of Intention to Claim) is only required in limited circumstances. If you need this form, please contact the Insurance Commission to have it emailed to you.
Crash Report
Owners/drivers are required by law to report vehicle crashes. Lodge online: Crash Report
Other parties (passengers, cyclists, pedestrians and witnesses) can be asked to report a crash. In the rare circumstance a paper crash report is required, please contact the Insurance Commission.