Notice of Injury, Loss or Damage

Brisbane City Council (Council) utilises JLT Risk Solutions Pty Ltd (JLT) as an authorised third party liability claims manager to independently and objectively assess Council's liability when liability claims are made by members of the public.

You should use this form if you are seeking compensation for injury, loss or damage arising from an incident or circumstance, which you believe was caused by Council's wrongdoing. On receipt of this liability claim form, JLT will investigate the reasons why you consider Council is liable to pay on your claim and provide you with a detailed response to advise why liability to pay on your claim is accepted or denied.

Steps

  1. Complete this Notice of Injury, Loss or Damage. You can review your Notice before submitting.
  2. After submitting your claim, you will receive a confirmation email within 10 minutes that contains all of the information that you submitted.
  3. JLT will send you an acknowledgement letter and reference number within two (2) business days of submitting your Notice.
  4. JLT will investigate your claim in a timely manner and provide you with a detailed response to advise why liability to pay on your claim was accepted or denied.

If your claim is for personal injury, this Notice of Injury, Loss or Damage is not a substitute for compliance with the Personal Injuries Proceedings Act 2002 (PIPA) and associated strict timeframes.

You may obtain your own independent advice at any time.

If you are unsure how to complete this form, or if you require further information, please contact JLT between the hours of 8:30am – 5:00pm on (07) 3000 5555 or via bccpl@jlta.com.au

Data collected in this form will be provided to JLT as an authorised third party provider to Council. Information collected in this form will be handled in accordance with Council's Privacy Policy and the JLT data collection statement.

 
1 Safety check 2 Contact details 3 Incident details 4 Claim details 5 Amount of loss details 6 Declare & sign 7 Review and submit

Pre-claim safety check

The purpose of this Safety Check is to ensure any hazard associated with your claim is bought to the attention of Council for early attendance.

Is your claim a result of a Council-related maintenance or public safety issue? *
Have you reported this to Council? *

Stop. Report Maintenance / Public safety issue

Before proceeding with your notice of injury, loss or damage claim, you should report the maintenance or public safety issue to Council.

Please call Council's 24-hour Contact Centre on 07 3403 8888 to report the maintenance / public safety issue. Council’s Contact Centre will provide you with a Council Reference Number. Please take note of the Council Reference Number as it will be of assistance in the investigation of your liability claim.

 

21 March 2022