IN THE SESSIONS COURT OF MALAYA
IN KUALA LUMPUR, MALAYSIA
(CIVIL DIVISION)
SUIT NO: [___-___-____]
BETWEEN
[PLAINTIFF NAME]
(NRIC: [NRIC])
...PLAINTIFF
AND
1. [DEFENDANT 1]
(NRIC: [NRIC])
...DEFENDANTS
STATEMENT OF CLAIM
1) The Plaintiff is [PLAINTIFF NAME] (NRIC: [NRIC]), a citizen of Malaysia of full age, having registered address at [ADDRESS]. At the material time, the Plaintiff was a [occupation].
2) The First Defendant is [DEFENDANT 1] (NRIC: [NRIC]), having registered address at [address]. At the material time, [role of defendant].
3) On [DATE], an accident occurred at [LOCATION] which caused injury to the Plaintiff.
PARTICULARS OF PLAINTIFF'S INJURY
4) As a result of the accident, the Plaintiff suffered the following injuries:
[No injuries recorded — populate the calculator above]
[Medical and Specialist reports to be attached]
PARTICULARS OF SPECIAL DAMAGES
5) The Plaintiff has incurred special damages [to be itemised — none recorded].
PARTICULARS OF GENERAL DAMAGES
6) The Plaintiff claims general damages for pain, suffering and loss of amenities. With reference to the Bar Council Malaysia Revised Compendium of Personal Injury Awards (2018) (and contemporary precedent), the assessment is:
[Calculator output — no injuries recorded]
PRAYER FOR RELIEF
7) The Plaintiff therefore claims against the Defendants, jointly and severally:
a) Special damages [to be itemised];
b) General damages [to be assessed];
c) Interest on special damages at 4% per annum from the date of filing the suit to the date of judgment;
d) Interest on general damages at 8% per annum from the date of filing the suit to the date of judgment;
e) Costs of this action;
f) Such further or other relief as this Honourable Court may deem fit.
Dated: [DATE]
..............................................
PLAINTIFF'S SOLICITOR
STATEMENT OF CLAIM filed by [FIRM NAME], Solicitors for the Plaintiff, having address at [FIRM ADDRESS].