Insurance

Forms and Downloads

Employer Forms

Resources for policyholders: employers at mine sites, contractors and/or other businesses.

Policy Forms

CMI workers compensation insurance proposal
Insurance
PDF (634 KB)
2024-25 Annual wages declaration
Insurance
PDF (291 KB)
CMI policy cancellation form
Insurance
PDF (213 KB)

Claim Forms

Employer’s Incident Notification Form
Insurance
PDF (1 MB)
Employer Authority Claims History Checks
Insurance
PDF (556 KB)
Contractor Mine Operator Claims History Checks Form
Insurance
PDF (594 KB)
Request for Payment Form (Wages Reimbursement)
Insurance
PDF (729 KB)
Request for Payment Form (Wages Reimbursement) Instructions
Insurance
PDF (629 KB)

Resources

Employer guide: what to do when someone is injured
Insurance
PDF (3 MB)
Similar Exposure Groups
Insurance
PDF (249 KB)
Employer obligations checklist
Insurance
DOCX (173 KB)
Post-injury review checklist
Insurance
DOCX (173 KB)

Worker Forms

Resources for workers (individuals) who are employed by mine sites, contractors and/or other businesses.

Claim Forms

Worker’s Injury Claim Form
Insurance
PDF (2 MB)
Industrial Deafness Claim Form
Insurance
PDF (2 MB)

Resources

How to make a claim
Insurance
PDF (692 KB)
Your rights and responsibilities
Insurance
PDF (722 KB)
What to do if you’re injured at work (poster)
Insurance
PDF (3 MB)
What to do if you’re injured at work (pocket guide)
Insurance
PDF (454 KB)

General Information and Downloads

 

About Industrial Deafness Claims
Insurance
PDF (1 MB)
Injury Management Program for the NSW coal industry
Insurance
PDF (5 MB)
Suitable Duties in the Spotlight
Insurance
PDF (387 KB)
What is an Injury Management Consultant?
Insurance
PDF (1 MB)
What is an Independent Medical Examination?
Insurance
PDF (2 MB)

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