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Rules of the Superior Courts

Appendix: CC

Personal Injuries Actions (Civil Liability and Courts Act 2004) : S.I. No. 248 of 2005

Forms: Schedule 1
Forms:
No. 1 ¦ No. 2 ¦ No. 3 ¦ No. 4 ¦ No. 5
Download & fill in this form
App. CC No. 1 - Personal Injuries Summons.doc
PERSONAL INJURIES SUMMONS

O. 1A, r. 3

THE HIGH COURT

20…. No……

Between A.B., ............. Plaintiff,

and C.D., ................ Defendant.

To the defendant ..............

(occupation)

who is ordinarily resident at .................. in the County of ...........

This personal injuries summons requires you to enter an appearance in person or by solicitor in the Central Office, Four Courts, Dublin in the above action within eight days after the summons has been served on you (exclusive of the day of such service).

And TAKE NOTICE that if you do not enter an appearance the plaintiff may proceed in this action, and judgment may be given in your absence.

BY ORDER,

Chief Justice of Ireland,

the ... day of ..... two thousand ……

N.B. - This summons is to be served within twelve calendar months from the date hereof, unless the time for service has been extended by the Court.

The defendant may appear to this summons by entering an appearance either personally or by solicitor at the Central Office, Four Courts, Dublin.


INDORSEMENT OF CLAIM.

The plaintiff's claim is for the reliefs set out herein for personal injuries suffered by the plaintiff [or state capacity in which the plaintiff sues] as follows:

[The indorsement of claim on a personal injuries summons shall

(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 plaintiff alleged to have been occasioned by the wrong of the defendant;

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

      (iv) each instance of negligence by the defendant, and

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

The following is a suggested format in which the indorsement might be presented:

1. Description of the parties;

2. The nature of the claim;

3. The acts of the defendant alleged to constitute a wrong, each instance of negligence by the defendant, all other relevant circumstances in relation to the commission of the said wrong and any other assertion or plea concerning same;

4. The injuries to the plaintiff alleged to have been occasioned by the wrong of the defendant;

5. The reliefs sought;

6. (Where appropriate) the particulars required by Order 4, rule 3A.


SCHEDULE

Particulars of Items of Special Damage


(Full particulars should be set out. Add additional sheets if necessary)

(Particulars of a general allegation should be set out in the indorsement under the paragraph containing such allegation and headed "Particulars of …etc." Where same are lengthy, they may alternatively be scheduled to the indorsement or set out in additional sheets appended to the Personal Injuries Summons at time of issue and service.) ]

(Signed) _________

This summons was issued by the plaintiff ............

OR

This summons was issued by .............., solicitor for the plaintiff, whose registered place of business is ............

The plaintiff's personal details are as follows:

1. The address at which the Plaintiff ordinarily resides is: ............ (state address accurately). The plaintiff's address for service, if different from the plaintiff's address mentioned above, should also be stated here:

2. Plaintiff's occupation:

3. Plaintiff's date of birth: .... Day:.... Month ...... Year

4. Plaintiff's Personal Public Service Number:

(If the Plaintiff has not been issued with a Personal Public Service Number, this must be stated) ...........

INDORSEMENT OF SERVICE

This summons was served by me at .............. on the defendant ............. on ........ day the ...........day of ............. , 20

Indorsed the .... day of ............ 20 ...

(Signed)......

(Address)

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No. 2

PERSONAL INJURIES DEFENCE.


O. 1A, r. 8

THE HIGH COURT

20…. No……

Between A.B., ................... Plaintiff,

and C.D., ....................... Defendant.

Delivered on the ........ day of ......... two thousand ……………. by AB of (registered place of business) solicitor for the defendant.

TAKE NOTICE that the defence of the defendant to the claim of the plaintiff made by personal injuries summons dated the ..... day of ...... two thousand ………. is as follows:

[A defence to a personal injuries action shall:

(a) specify-

      (i) the allegations specified, or matters pleaded, in the personal injuries summons of which the defendant does not require proof,

      (ii) the allegations specified, or matters pleaded in the personal injuries summons of which he or she requires proof,

      (iii) the grounds upon which the defendant claims that he or she is not liable for any injuries suffered by the plaintiff, and

      (iv) where the defendant alleges that some or all of the personal injuries suffered by the plaintiff were occasioned in whole or in part by the plaintiff's own acts, the grounds upon which he or she so alleges, and

(b) contain full and detailed particulars of each denial or traverse, and of each allegation, assertion or plea, comprising the defendant's defence and, where appropriate, a counter-schedule setting out the defence to items of special damage claimed by the plaintiff.

COUNTER-SCHEDULE

DEFENCE TO ITEMS OF SPECIAL DAMAGE CLAIMED BY THE PLAINTIFF


(add additional sheets if necessary)

(Particulars of a general denial, traverse, allegation, assertion or plea should be set out in the Defence under the paragraph containing same and headed "Particulars of …etc." Where same are lengthy, they may alternatively be scheduled to the Defence or set out in additional sheets appended to the Defence at time of service.)]

(Signed) ______________

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No. 3

PERSONAL INJURIES COUNTERCLAIM


O. 1A, r. 8

INDORSEMENT OF COUNTERCLAIM

The defendant's counterclaim is for the reliefs set out herein for personal injuries suffered by the defendant as follows:

[A personal injuries counterclaim shall

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

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

      (ii) the injuries to the defendant alleged to have been occasioned by the wrong of the plaintiff;

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

      (iv) each instance of negligence by the plaintiff, and

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

The following is a suggested format in which the indorsement might be presented:

1. Description of the parties;

2. The nature of the counterclaim;

3. The acts of the plaintiff alleged to constitute a wrong, each instance of negligence by the plaintiff, all other relevant circumstances in relation to the commission of the said wrong and any other assertion or plea concerning same;

4. The injuries to the defendant alleged to have been occasioned by the wrong of the plaintiff;

5. The reliefs sought;

6. (Where appropriate) the particulars required by Order 4, rule 3A.


SCHEDULE

Particulars of Items of Special Damage


(Full particulars should be set out. Add additional sheets if necessary)

(Particulars of a general allegation should be set out in the indorsement under the paragraph containing such allegation and headed "Particulars of …etc." Where same are lengthy, they may alternatively be scheduled to the indorsement or set out in additional sheets appended to the counterclaim at time of service.) ]

This defendant's personal details are as follows:

1. Address of defendant's ordinary residence:

(state address accurately). The defendant's address for service, if different from the address mentioned above, should be stated here: .........

2. Defendant's occupation:

3. Defendant's date of birth: ..... Day: ........... Month ..........Year ...

4. Defendant's Personal Public Service Number:

(If the Defendant has not been issued with a Personal Public Service Number, this must be stated) ................

(Signed) ______________

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No. 4

AFFIDAVIT OF VERIFICATION


O. 1A, r. 10

THE HIGH COURT

20…. No……

Between A.B., ................. Plaintiff,

and C.D., ............. Defendant.

I, AB, ……………….. of …………………. , the (plaintiff, defendant or state other capacity or authority) in the above-entitled proceedings, aged eighteen years and upwards MAKE OATH and say as follows:

1. I beg to refer to the contents of the (personal injuries summons, defence, reply, further information etc. - as the case may be) delivered herein on behalf of the (plaintiff/ defendant) on the ….. day of ………….. 20 …. *[upon which this affidavit is endorsed] *[and upon a true copy of which marked "A" I have signed my name prior to the swearing hereof].

2. The assertions, allegations and information contained in the said (personal injuries summons, etc.) which are within my own knowledge are true. I honestly believe that the assertions, allegations and information contained in the said (personal injuries summons, etc.) which are not within my own knowledge are true.

3. I am aware that it is an offence to make a statement in this affidavit that is false or misleading in any material respect and that I know to be false or misleading.

SWORN etc

*Delete if inapplicable.

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No. 5

NOTICE OF OFFER OF TERMS OF SETTLEMENT


O. 1A, r. 13

THE HIGH COURT

20…. No……

Between A.B., ................. Plaintiff,

and C.D., ..................... Defendant.

TAKE NOTICE that for the purposes of section 17 of the Civil Liability and Courts Act 2004 the *plaintiff/defendant is willing to settle the above-entitled action upon the following terms:

TERMS OTHER THAN THOSE AS TO COSTS:

TERMS AS TO COSTS:

[or]

TAKE NOTICE that for the purposes of section 17 of the Civil Liability and Courts Act 2004 the defendant is not prepared to pay any sum of money to the plaintiff in settlement of above-entitled action.

Signed: ____________

Date:

*Delete whichever inapplicable

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