A1 Letter of claim - Where insurers known

Dear Sirs (insurance company)

Re: Claimant's Full Name
Claimant's Full Address
Claimant's Date of Birth
Claimant's Payroll or Reference Number
Claimant's Employer (name and address)
Claimant's National Insurance Number

"We are instructed by the above named to claim damages in connection with

an accident at work/road traffic accident/tripping accident on day of

(year) at (place of accident -which must be sufficiently detailed to establish location.

The circumstances of the accident are:-
(brief outline and simple explanation e.g. defective machine, vicarious liability)

Your insured failed to:-
(brief details of the common law and/or statutory breaches)

Out client's injuries are as follows:-
(brief outline)

i. Our client received treatment for the injuries at (name and address of GP/treating hospital).

(in cases of road traffic accident)

ii. Our client's motor Insurers are:-

Our client is still suffering from the effects of his/her injury. We invite you to participate with us in addressing his/her immediate needs by use of rehabilitation.

He is employed as (occupation) and has had the following time off work (dates of absence). His approximate weekly income is (insert if known).

We are obtaining a police report and will let you have a copy of same upon your undertaking to meet half the fee.

At this stage of our enquiries we would expect the undernoted documents to be relevant to this claim.

This is a claim which we propose should be negotiated in terms of the Voluntary Pre-Action Protocol as agreed between the Law Society of Scotland and the Forum of Scottish Claims Managers".

Yours faithfully

A2 Where Insurers Not Known

As A1 but omit Date of Birth and National Insurance Number.

Remove "Insured" from paragraph - "Your Insured failed to"

Final Paragraph to read:

"You should acknowledge receipt of this letter, forward it to your Insurers and ask them to advise us within 21 days of the date of this letter whether the cases is to proceed as a Voluntary Pre-Action Protocol Claim".

Yours faithfully

B Response to Letter of Claim

Claimant's solicitor

Dear Sirs,

Re: Claimant's Full Name

Claimant's Full Address

Claimant's Payroll or Reference No.

Employer (name and address)

"We are the Insurers of __________________ and acknowledge your letter of ______. We confirm that this claim is to be/is not to be handled under the Voluntary Pre-Action Protocol and the Forum of Scottish Claims Managers.

We will notify you of our decision on liability within three months of this date. If liability is denied, in whole or in part, we will write to you further in respect of documents requested by you as soon as is practicable.

Yours faithfully

C Letter of Instruction of Medical Expert

Dear Sir,

RE (Name and Address)
Date of Birth
Telephone No.
Date of Accident
"We act on behalf of the above named in connection with a claim for damages arising out of an accident which occurred on _____. On that date our client was involved in a road accident/an industrial accident and sustained (brief description of injuries). Our client was unfit for work until _____ /remains unfit for work.

We should be obliged if you would examine our client and provide a full and detailed report dealing with the injuries sustained, treatment received and present condition, dealing in particular with the capacity for work, if relevant and giving a prognosis.

Please send our client an appointment direct for this purpose. Should you be able to offer a cancellation appointment, please contact us direct. We confirm we will be responsible for your reasonable fee.

We are obtaining the GP and hospital records and will forward them to you when they are to hand/or please request the GP and hospital records direct and advise that any invoice for the provision of these records should be forwarded to us. (Please provide details of GP and hospitals attended).

We look forward to receiving your report as soon as possible. If there is likely to be any unusual delay in providing the report, please telephone us receipt of these instructions.

When acknowledging these instructions, it would assist if you could give an estimate as to the likely timescale for the provision of your report and also an indication as to your fee.
Yours faithfully

D Form of Statement of Value of Claim - Court of Session Form 43.9