---
title: "Notice of accident claim, fatal injury (MAIC Form F4)"
url: "https://ailawframework.com/precedents/personal-injury-and-compensation/form-qld-maic-noac-fatal"
type: "precedent"
site: "AI Law Framework"
id: "a21-form-qld-maic-noac-fatal"
area_id: "A21"
kind: "form"
ai_level: "yellow"
version: 1
task_ids: ["A21-T1-R5", "A21-T1-R1", "A21-T1-R15"]
law_stated_as_at: "2026-10-23"
---

# Notice of accident claim, fatal injury (MAIC Form F4)

> Link to the MAIC Notice of Accident Claim Form (Fatal Injury). The claimant certificate is a statutory declaration.

Canonical page: https://ailawframework.com/precedents/personal-injury-and-compensation/form-qld-maic-noac-fatal  
Law stated as at: 2026-10-23

Site index for agents: https://ailawframework.com/llms.txt

## Key facts

- Kind: Form. A form to complete, or a guide to completing an official one.
- Practice area: [Personal Injury & Compensation](https://ailawframework.com/precedents/personal-injury-and-compensation.md)
- Jurisdictions: Queensland
- AI level: Yellow. You and the tool draft together, with you directing. You check every statement you rely on.
- Law stated as at: 2026-10-23
- Status: Maintained. Checked on 2026-10-23 against the official form at maic.qld.gov.au and the 3 authorities it cites, for Queensland.

## When to use it

Use when a Queensland motor accident has caused death and the claimant gives notice under the Motor Accident Insurance Act 1994 before a damages action. Part A alone is for funeral and other expenses. A dependency claim needs Parts A and B. A living claimant uses the non-fatal form.

## Used for these tasks

- [Draft the pre-action notice or statutory claim form from the instructions](https://ailawframework.com/practice/personal-injury-and-compensation/draft-the-pre-action-notice-or-statutory-claim-form-from-the-instruction.md)
- [Calculate limitation and pre-action notice deadlines from the injury facts](https://ailawframework.com/practice/personal-injury-and-compensation/calculate-limitation-and-pre-action-notice-deadlines-from-the-injury-fac.md)
- [Triage a new injury enquiry against scheme eligibility](https://ailawframework.com/practice/personal-injury-and-compensation/triage-a-new-injury-enquiry-against-scheme-eligibility.md)

## How AI may be used

AI may check the current official form against the file and list what is missing; it writes nothing in a declaration or certificate, and the lawyer settles every statement the client signs or gives.

**AI may:**

- Check the draft is the current file from the official page and list every blank field and missing attachment
- Index the documents already on the file that the form calls for, with date and author
- Turn the published giving and response steps into a checklist for this matter

**AI must not:**

- Must not write any words in a statutory declaration, claimant certificate, medical certificate or other verification
- Must not sign, lodge, give or serve the form
- Must not decide whether a time limit has been met or whether an excuse is reasonable
- Must not choose between Part A only and Parts A and B

**The lawyer checks:**

- Death arose out of a Queensland motor vehicle accident and this fatal form is the current one
- Part A only is used for funeral and other expenses; dependency uses Parts A and B
- Section 37 is applied to [DATE OF ACCIDENT] and the first lawyer consultation
- The claimant certificate is made by the signatory as a statutory declaration

## Authorities

- [Motor Accident Insurance Act 1994 (Qld) s 37](https://www.legislation.qld.gov.au/view/whole/html/inforce/current/act-1994-009)
- [MAIC, Claims process resources](https://maic.qld.gov.au/resources/claims-process-resources/)
- [Notice of Accident Claim Form (Fatal Injury)](https://maic.qld.gov.au/wp-content/uploads/Notice-of-Accident-Claim-Form-Fatal-Injury.pdf)

## Official form

[Official form](https://maic.qld.gov.au/wp-content/uploads/Notice-of-Accident-Claim-Form-Fatal-Injury.pdf)

## Where this comes from

The official form is published by maic.qld.gov.au; this page is a completion guide. Last checked on 2026-10-23.

## Full text and drafting notes

The full text and the drafting notes are not part of this public page. Signed-in firm accounts can read them at https://ailawframework.com/precedents/personal-injury-and-compensation/form-qld-maic-noac-fatal and through the signed-in MCP connector https://ailawframework.com/mcp/firm.

*Practice guidance for planning and review. Confirm current primary sources and the requirements of the actual matter. This is general information, not legal advice.*