The most important form that needs to be filled out is the Notice of Appeal form. This form must be completed and faxed or delivered to the Automobile Injury Compensation Appeal Commission no later than 90 days from the day you received your Internal Review decision letter. Upon receipt of this form, the Commission will begin the process for hearing your appeal.

Appeal Applications

Notice of Appeal Online Submission (you will receive an automated reference/confirmation number and the option to print upon submission)

Notice of Withdrawal Applications


The fax number for the AICAC is: 1 (204) 948-2402

We are located at:

301-428 Portage Avenue
Winnipeg, MB
R3C 0E2

If you need assistance filling out this form, please call 204-945-4155 or 1-855-548-7443 (ask for the Automobile Injury Compensation Appeal Commission).