Claims incident notification

The earlier we know of a potential issue, the better placed we are to offer timely, professional advice.

To notify MIPS of an incident:

  • enter the details in the form below and one of our expert medico-legal advisers will contact you
  • or print out the claims incident notification form and fax or mail it to MIPS.

If you have any questions, please contact our clinico-legal advisers on 1800 021 223, or  claims@mips.com.au

Privacy: MIPS takes your privacy seriously. This site is secure and all information given will be managed in the strictest confidence. Any personal information MIPS collects from you on this form or any other way is held securely and in accordance with the The Privacy Act 1988 (Cwlth). This legislation restricts  how an organisation collects, uses, discloses and stores personal information. View the MIPS Privacy Statement.

PART A:  your details

PART B: Patient details

Gender*required
Is a solicitor acting?
Public or private patient
Is the patient deceased?*required
If deceased, is an inquest likely?

PART C: Incident details

PART D: Incident circumstances

Mandatory field(s) marked with *