> ### PRE-ACTION PROTOCOL FOR PERSONAL INJURY CLAIMS

> ### ANNEX A

> ### LETTER OF CLAIM

> | To Defendant Dear Sirs
> Re: | Claimant's full name Claimant's full address Claimant's Clock or Works Number Claimant's Employer (name and address)
> We are instructed by the above named to claim damages in connection with an accident at work/ road traffic accident / tripping accident on dayof(year) at (place of accident which must be sufficiently detailed to establish location) Please confirm the identity of your insurers. Please note that the insurers will need to see this letter as soon as possible and it may affect your insurance cover and/or the conduct of any subsequent legal proceedings if you do not send this letter to them. The circumstances of the accident are:- (brief outline) The reason why we are alleging fault is: (simple explanation e.g. defective machine, broken ground) A description of our clients' injuries is as follows:- (brief outline) (In cases of road traffic accidents) Our client (state hospital reference number) received treatment for the injuries at name and address of hospital). He is employed as (occupation) and has had the following time off work (dates of absence). His approximate weekly income is (insert if known). If you are our client's employers, please provide us with the usual earnings details which will enable us to calculate his financial loss. We are obtaining a police report and will let you have a copy of the same upon your undertaking to meet half the fee. We have also sent a letter of claim to (name and address) and a copy of that letter is attached. We understand their insurers are (name, address and claims number if known). At this stage of our enquiries we would expect the documents contained in parts (insert appropriate parts of standard disclosure list) to be relevant to this action. A copy of this letter is attached for you to send to your insurers. Finally we expect an acknowledgement of this letter within 21 days by yourselves or your insurers. Yours faithfully

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