Victorian Managed Insurance Authority

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Insurance

Incident Notification Form

This form should be completed as soon as possible following an incident. If an incident involves serious injury, significant financial loss or other major consequences, you should consider seeking legal advice before submitting information on-line. Legal counsel can then consider the application of legal privilege. The information will be received by the VMIA claims department. VMIA will be in contact if it is considered that a claim is likely. Also see "Frequently Asked Questions-Dealing with emergency situations".

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