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New South Wales Government
Personal Injury
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When to use this form

If you have been injured in a motor vehicle accident in NSW, you may be able to claim compensation if:

  • the accident was caused or mainly caused by another vehicle, or
  • you were under 16 years of age and lived in NSW at the time of the accident and the accident was not caused by any fault of the driver of the motor vehicle or
  • you were injured in a blameless accident where the driver or owner of a motor vehicle was not at fault

You should use this Form if:

  • your treatment costs and/or lost earnings will exceed $5000
  • you are unable to lodge an Accident Notification Form within 28 days of the accident
  • you cannot identify the vehicle which caused the accident, or
  • you wish to claim other compensation

How to claim

To make a claim for compensation you will need to:

  • get the registration number of the vehicle that caused the accident
  • report the accident to the police if they did not attend the accident and get the police event number for the accident
  • call the Claims Advisory Service on 1300 656 919 to find out the Green Slip insurer of the vehicle that caused the accident
  • get a Personal Injury Claim Form here or from the insurer
  • if you wish to claim for loss of income, you will also need to get a Certificate of Earnings 
  • complete the Personal Injury Claim Form, and the Certificate of Earnings if required, and have your doctor complete the medical certificate
  • send the claim form to the Green Slip insurer, as soon as possible, but no later than six months from the date of the accident.

If you have already lodged an Accident Notification Form for the same accident it is not necessary to submit a second medical certificate with the personal injury claim form.
You will get a letter from the insurer telling you that your claim has been received. It will include a claim number that you must use when you write to the insurer about the claim and the name and phone number of the officer handling your claim.

The insurer will investigate the accident and injury to find out whether liability for the claim will be accepted. The insurer must advise you within three months of receiving the claim whether they have accepted liability.

For more information, see the Claims Process.

If you cannot identify the vehicle you believe to be at fault in the accident, or if the vehicle at fault is uninsured, you may be able to lodge a claim with the Nominal Defendant.

For more information, call the Claims Advisory Service on 1300 656 919 or email

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