Particulars of Claim for Workplace Injury (Employer's Liability)

A template Particulars of Claim for a personal injury suffered in the course of employment, for a claim in the County Court of England & Wales. The claimant alleges injury caused by an accident arising out of and in the course of employment with the defendant employer.

How to use this template - Replace every [SQUARE-BRACKET] field before use. - Employers' liability claims are generally brought in negligence. Note that since section 69 of the Enterprise and Regulatory Reform Act 2013, a breach of most health and safety regulations no longer gives an automatic right to compensation by itself, such breaches are pleaded as evidence of negligence. - This must comply with the Civil Procedure Rules (CPR) and the relevant Pre-Action Protocol (sending a letter of claim first). A statement of truth is required. - Personal injury claims have strict time limits: generally three years from the date of injury or, if later, the claimant's date of knowledge. Special rules apply for children (time runs from the 18th birthday) and protected parties lacking capacity. Get advice promptly. - This is a skeleton, a solicitor should settle the final pleading and the medical/loss evidence.

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IN THE COUNTY COURT AT [COURT] Claim No: [CLAIM NUMBER]

BETWEEN [CLAIMANT FULL NAME], Claimant and [DEFENDANT / EMPLOYER NAME], Defendant

PARTICULARS OF CLAIM

1. At all material times the Claimant was employed by the Defendant as a [JOB TITLE] at [WORKPLACE ADDRESS].

1. On [DATE OF ACCIDENT], in the course of that employment, the Claimant suffered personal injury caused by an accident at work, namely [BRIEF DESCRIPTION OF WHAT HAPPENED].

1. The accident was caused by the negligence of the Defendant, its employees or agents.

Particulars of negligence

The Defendant: (a) failed to provide a safe place of work and safe means of access; (b) failed to provide safe plant and equipment, namely [SPECIFY]; (c) failed to provide a safe system of work, or to enforce it; (d) failed to carry out an adequate risk assessment of [TASK/AREA]; (e) failed to provide adequate training, instruction or supervision; (f) failed to provide suitable personal protective equipment, namely [SPECIFY]; (g) exposed the Claimant to a foreseeable risk of injury which it could and should have prevented.

Note: tailor these to the facts; plead any relevant breaches of health and safety regulations as evidence of negligence.

1. By reason of the above, the Claimant has suffered pain, injury, loss and damage.

Particulars of injury

[DESCRIBE INJURIES, e.g. fracture of the left wrist, soft-tissue back injury], as set out in the medical report of [EXPERT NAME] dated [DATE]. The Claimant's date of birth is [DOB].

Particulars of special damage

[ITEMISE FINANCIAL LOSSES, e.g. loss of earnings of £[AMOUNT]; medical/treatment costs of £[AMOUNT]; travel of £[AMOUNT]], as set out in the attached Schedule of Loss.

1. The Claimant claims interest on damages under section 69 of the County Courts Act 1984 at such rate and for such period as the Court thinks fit.

AND THE CLAIMANT CLAIMS: (1) Damages [limited to £[AMOUNT] / not exceeding £[AMOUNT]]; (2) Interest under section 69 of the County Courts Act 1984.

Statement of truth

I believe that the facts stated in these Particulars of Claim are true. I understand that proceedings for contempt of court may be brought against anyone who makes, or causes to be made, a false statement in a document verified by a statement of truth without an honest belief in its truth.

Signed: __________________ [CLAIMANT NAME / SOLICITOR] Date: [DATE]

[CLAIMANT'S SOLICITORS' NAME AND ADDRESS FOR SERVICE]

--- This template is a starting point and not legal advice. Personal injury litigation is time-limited and fact-sensitive, have a qualified solicitor settle the pleading and evidence before issuing. Governing law: England & Wales.