Claim no: [insert claim number]

In the county court at [insert]

Between

1. [INSERT CLAIMANT’S NAME]        Claimant

1. -and-

1. [INSERT FIRST Defendant’S NAME]        First Defendant

1. -and-

1. Motor Insurers’ Bureau        Second Defendant

Particulars of claim

1. 1. 1

      [Insert pre-amble if applicable eg The Claimant is [insert details]]

   1. 2

      At all material times:

      1. (a)

         The Claimant was [insert details eg the driver of]

      1. (b)

         The First Defendant was the driver of [insert details eg registration number]

   1. 3

      The Second Defendant is joined to the proceedings for the reasons set out further below.

   1. 4

      [Insert circumstances of the accident]

   1. 5

      [Insert particulars