[A personal injuries counterclaim must contain a statement entitled “Statement of Counterclaim” which must

(a) set out, in numbered paragraphs, full and detailed particulars of—

(i) the nature of the claim and of each allegation, assertion or plea comprising that claim;

(ii) the injuries to the respondent alleged to have been occasioned by the wrong of the claimant;

(iii) the acts of the claimant constituting the said wrong and the circumstances relating to the commission of the said wrong;

(iv) each instance of negligence by the claimant,


(b) contain a schedule of full particulars of all items of special damage in respect of which the respondent is making a claim, and

(c) give details of the basis upon which jurisdiction is claimed.

1. DESCRIPTION OF PARTIES

2. WRONG ALLEGED AGAINST THE CLAIMANT (OR AGAINST EACH CLAIMANT)

3. PARTICULARS OF THE ACTS OF THE CLAIMANT (OR OF EACH CLAIMANT) CONSTITUTING THE WRONG AND OF THE CIRCUMSTANCES RELATING TO THE COMMISSION OF THE WRONG

(Full particulars should be set out)

4. PARTICULARS OF EACH INSTANCE OF NEGLIGENCE BY THE CLAIMANT (OR BY EACH CLAIMANT)

(Full particulars should be set out)

5. PARTICULARS OF THE INJURIES TO THE RESPONDENT OCCASIONED BY THE WRONG OF THE CLAIMANT (OR OF EACH CLAIMANT)

6. RELIEFS CLAIMED BY THE RESPONDENT

7. The bringing of this personal injuries counterclaim requires to be authorised in accordance with *section 14 *section 17 *section 32 *section 36 *section 49

*rules under section 46(3) of the Personal Injuries Assessment Board Act 2003 and these personal injuries proceedings have been authorised by the Personal Injuries Assessment Board, under *section 14 *section 17 *section 32 *section 36

*section 49 *rules under section 46(3) by authorisation dated the .....day of ......20.... under reference number ........