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Personal Injury Claim Forms (QLD) – Download

In Queensland, depending on the type of personal injury claim you are making, you are required to commence the matter by using the prescribed claim form (usually called a claim notice). 

Warning: You should never attempt to complete an initial claim notice yourself. We strongly recommend that you engage a solicitor to ensure that the claim notice is completed correctly, and in a way that will help set up your claim to achieve the maximum possible compensation entitlement. Each claim form typically includes some ‘trick questions’ that should be answered very carefully.

  • Motor Vehicle Accident (Resulting in Injury) – Use this MAIC form when you have been injured because of a motor vehicle accident. You could be a passenger, a pedestrian, or a not-at-fault driver. Download Form: Notice of Accident Claim Form (Non-Fatal Injury)
  • Motor Vehicle Accident (Resulting in Death) – Use this MAIC form when you are a relative or dependant claiming compensation for the death of a person which occurred due to a motor vehicle accident that wasn’t their fault. Download Form: Notice of Accident Claim Form (Fatal Injury)
  • Public Liability / General Negligence (Resulting in Injury) – Use this PIPA form when an injured person is claiming for an injury which was not received as a result of a medical incident (for example, injury from a slip and fall in a supermarket). Download Form: Personal Injury Form 1
  • Medical Negligence (Resulting in Injury) – Use this PIPA form when you are an injured person claiming compensation for an injury received as a result of a medical incident (for example, an injury caused by a doctor during a medical procedure). Download Form: Personal Injury Form 2
  • Public Liability / General Negligence / Medical Negligence (Resulting in Death) – Use this PIPA form when you are a relative or dependant claiming compensation for the wrongful death of a person, whether or not medical treatment was the cause of the death. Download Form: Personal Injury Form 3
  • Workers Compensation (Statutory Claim – Workcover) – Use this WCRA form when you have been injured at work and require time off or medical treatment. You can complete and submit an online claim or Download Form: Workcover Claim Form. Please note that your employer may not be insured by Workcover Queensland and in this case you will likely need to obtain the specific insurer’s claim form.
  • Workers Compensation (Common Law Claim for Damages – Injury or Death) – Use this WCRA form when your workers compensation benefits cease and you are alleging that your injury was caused by the negligence of your employer. Download Form: Form 275 Notice of Claim for Damages
  • Total and Permanent Disability – if your injury causes you a total and permanent disability to the extent where you can no longer return to your ordinary workplace, you may be entitled to make a TPD Claim through your super fund. The forms for this depend on which super fund you are with. Contact us if you are unsure if you have TPD insurance within your superannuation policy.

Completing a valid claim notice will commence the pre-court process for your injury claim. Generally speaking, you cannot proceed to court for a trial regarding your injury claim unless and until the pre-court procedures have been followed.

Important time limits apply for each different type of claim and missing a deadline can be fatal. If you need assistance completing a personal injury claim notice, contact Roche Legal urgently to be sure your limitation dates are protected.

The claim forms on this page are current as at 8 April 2021.

This commentary is published by Roche Legal for general information purposes only and should not be relied on as specific advice. The content relates to Queensland law only and is subject to change over time. You should seek legal advice for any question, or for any specific situation or proposal, before making any decision.