A ‘Statement of Claim’ is a relatively standardized document that contains the basic facts relating to your accident (time, date, location, parties involved, type and model of vehicle, description of how the collision occurred, type of injuries suffered, type of treatments required, etc.). A typical Statement of Claim would be very similar to the following example:

Statement of facts relied on:

1. At all material times hereto, the Plaintiff JOHN SMITH (hereinafter referred to as “Mr. Smith”) was a resident of Calgary, Alberta and was the owner and operator of a [Describe vehicle] which is hereinafter referred to as “the Plaintiff’s vehicle”.

2. The Defendant JACK JONES, (hereinafter referred to as “Mr. Jones”), so far as is known to the Plaintiff, was at all material times, a resident of Calgary, Alberta and was the owner, operator and driver of a [Describe vehicle] which is hereinafter referred to as “the Defendant’s vehicle”.

3. On or about [date], at approximately [time] a.m. / p.m. in Calgary, Alberta, the Plaintiff’s vehicle was waiting at a red light, planning to head north on [location].

4. Mr. Jones while operating the Defendant’s vehicle approached the Plaintiff’s vehicle from behind at such an excessive speed and without paying proper or any attention, that Mr. Jones was unable to stop before hitting the Plaintiff’s vehicle.

The collision described was caused by the negligence of Mr. Jones, particulars of which are as follows:

    a) Driving without keeping a proper, or any, lookout;

    b) Driving without due care and attention, and without reasonable consideration for other persons using the highway;

    c) Driving at a rate of speed that was unreasonable, having regard to all of the circumstances of the case;

    d) Operating a motor vehicle which was not equipped with proper brakes, or alternatively, failing to apply the brakes in time so as to avoid a collision;

    e) Failing to yield or take any evasive action to avoid a collision, or alternatively, failing to take such action in a timely manner;

    f) Failing to operate the Defendant’s vehicle under proper, or any, control;

    g) Failing to keep, or to ensure, that the Defendant’s vehicle was in good mechanical condition;

    h) Driving while the ability of Mr. Jones to operate a motor vehicle was impaired by the use of drugs, alcohol, weariness or other cause;

    i) Operating the Defendant’s vehicle in a manner that was dangerous to the public, having regard to all of the circumstances, including the nature, condition and use of such place and the amount of traffic that at the time was or might reasonably be expected to be on such place;

    j) Such further and other particulars of negligence as may be proven at the trial of this action.

    The Plaintiff pleads the provisions of the Traffic Safety Act, R.S.A. 2000, c. T-6, as amended.

6. As a result of the negligence of the Defendant and the consequent collision described, Mr. Smith sustained, and in respect of some areas, continues to sustain severe and painful personal injuries, therapy and treatment, some particulars of which are as follows:

    a) Suffers from debilitating headaches;

    b) Suffers from pain, tingling, numbness and stiffness throughout the neck, shoulders and back;

    c) Has reduced strength and limited movement and flexibility throughout the shoulders, neck, and back;

    d) Required to attend numerous chiropractic and physiotherapy treatments and ongoing therapy;

    e) Required to attend for x-rays and numerous medical examinations;

    f) Required to use analgesics, muscle relaxants and other medication;

    g) Suffers from persistent restriction of movement in neck, arms, shoulders and back, to the extent that Mr. Smith is unable to carry out normal daily activities or, where able to do so, carries such activities while experiencing pain;

    h) Suffers from serious impairment of physical and cognitive functions that has resulted in being substantially unable to perform the essential tasks of employment and occupation and normal activities of daily living since the collision, which is not expected to improve substantially;

    i) Required to give up and to limit numerous activities and events which had been a prior source of pleasure and fulfillment;

    j) Anticipates further medical complications in the future;

    k) Will incur further medical, chiropractic, and other rehabilitative expenses;

7. As a further result of the injuries suffered, Mr. Smith necessarily incurred expenses and loss of income, some of which are yet to be determined and for which Mr. Smith will seek leave at the trial of this action to amend the Statement of Claim herein to include a claim for such damages.

8. As a further result of the negligence of the Defendant and the consequent collision described, Mr. Smith was unable to carry out typical household keeping tasks and activities, being completely unable to carry out many such activities, to this day, and in other instances, able to carry such duties only with concomitant pain.

9. As a further result of the injuries suffered by Mr. Smith, Mr. Smith’s family and friends have provided and will continue to provide valuable and necessary money, goods and services outside the normal duties expected of them, including:  nursing and assistance with personal care, case management services, house and yard services, transportation, and child care.  These individuals have also incurred out of pocket expenses and loss of income.  Mr. Smith claims compensation for the value of these items in trust for the providers thereof.

10. As this action relates to a tort committed in Alberta, there is a real and substantial connection between Alberta and the facts on which the claim in this action is based.  Therefore, if need be, there are grounds to serve this document outside Alberta as per Rule 11.25 of the Alberta Rules of Court.

11. The Plaintiff proposes that the trial of this action be held at the Court House at Calgary, Alberta.

The Statement of Claim must be filed within 2 years of the date of your accident or your claim will expire (with very few limited exceptions) under the Limitations Act of Alberta. The Statement of Claim is filed at the Court of Queen’s Bench of Alberta and the cost for filing the Statement of Claim is currently $250.00. The court clerk at the court house will stamp your copy of the Statement of Claim to show the date that the Statement of Claim was filed at the court house.