(1) This rule applies in relation to an originating claim that includes a claim for damages for death or personal injury caused by, or arising out of, negligence or breach of statutory duty by an employer (the incident ).
(2) The statement of claim for the originating claim must include, and is sufficient if it includes, the following:
(a) if the cause of action is based on negligence—the time, date, place and circumstances of the negligence claimed, including the acts or omissions making up the negligence;
(b) if the cause of action is based on negligence and the negligence claimed was that of someone (other than the defendant) for whose negligence the defendant is vicariously liable—particulars of the person, and particulars of the claim for vicarious liability;
(c) if the cause of action is based on breach of statutory duty—the name and provision of the statute and a precise statement of the acts or omissions making up the breach claimed;
(d) for a claim for personal injury—details of the nature and extent of the injuries and disabilities resulting from the incident, as far as is known, that is enough (if possible) to enable the defendant to nominate the kind of expert required to examine the plaintiff;
(e) the name of each health professional who has treated the plaintiff for the injuries and disabilities, and for any condition exacerbated by the injury or disability;
(f) the nature of any claim for past or future economic loss, as far as is known, including (if relevant) the name and address of each employer of the plaintiff during a reasonable period before and since the incident;
(g) the jurisdiction that the plaintiff claims is the Territory or State of connection for the “b title="A1951-2">Workers Compensation Act 1951
, section 182D (Applicable substantive law for damages claims).
Note 1 See approved form 2.4 (Statement of claim—employment death or personal injury) AF2014-26
.
Note 2 A statement of claim is a pleading (see dict, def pleading ) and therefore must comply with pt 2.6 (Pleadings).