IN THE COUNTY COURT AT [insert] Claim No: BETWEEN [A.B.] Claimant -and- [C.D.] Defendant ______________________________________________________________ PARTICULARS OF CLAIM ______________________________________________________________ 1 At all material times the Claimant was the [owner and] driver of a [make, model] motor vehicle, registration number [insert registration number] and the Defendant was the driver of a [make, model] motor vehicle, registration number [insert registration number]. 2 [Details of accident] 3 [The Claimant relies upon an admission of liability made by the Defendant/the Defendant’s insurance company on [insert day/month/year]]. [The accident was caused by the negligence of the Defendant.] [PARTICULARS OF NEGLIGENCE] 3.1 [particulars relevant to case] 3.2 […] 4 By reason of the negligence of the Defendant, the Claimant [who was born on [insert day/month/year]] has suffered [pain, injury,] loss and damage. PARTICULARS OF INJURY 4.1 The Claimant suffered [brief details of injury]. 4.2 Further particulars of the Claimant's medical condition are contained in a report of [insert details of medical report] dated [insert day/month/year] attached. PARTICULARS OF LOSS AND DAMAGE [The damages claimed are set out in the schedule of loss attached.] 4.2.1 Hire Charges £[insert amount] 4.2.2 [Repairs £[insert amount]] 4.2.3 [Other items of special damage £[insert amount]] 5 The Claimant hired a [make, model] motor vehicle, registration number [insert