Form

Road Traffic Accident Small Claims – Other

Claim under the Pre-Action Protocol for Personal Injury Claims below the Small Claims Limit in Road Traffic Accidents

• From: HM Courts & Tribunals Service
• Published: 10 May 2021
• Last updated: 2 June 2021 — See all updates

Applies to England and Wales

Documents

Acknowledgment of Service

PDF, 97.1 KB, 6 pages

This file may not be suitable for users of assistive technology.

Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email hmctsforms@justice.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Cydnabyddiad Cyflwyno

PDF, 74.8 KB, 7 pages

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If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email hmctsforms@justice.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Example claim form - specimen only

PDF, 657 KB, 6 pages

This file may not be suitable for users of assistive technology.

Request an accessible format.

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email hmctsforms@justice.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Details

These forms are for claims concerning low value road traffic accident (RTA) related personal injury claims.

Defendants of a claim should complete and return the ‘Acknowledgement of Service’ form. You have 14 days from the date on which you were served to respond. Please read all the guidance on the form.

The example claim form is published for information only. If you are a claimant, you cannot use this specimen form – you must use the Official Injury Claim Service to make your claim.

For more information on these claims, please visit our guidance for professionals on the Whiplash Reform Programme.

Find more court and tribunal forms by category.

Find out how HM Courts and Tribunals Service uses personal information you give when you fill in a form.

Published 10 May 2021
Last updated 2 June 2021 + show all updates

1. 2 June 2021

   Specimen form added.

2. 10 May 2021

   First published.