The plaintiff, an employer, has filed a civil suit against the defendants seeking damages for injuries suffered by its employee in a traffic accident. [The plaintiff's employee was injured when he was hit by a vehicle owned by the first defendant and driven by the second defendant. As the employee's employer, the plaintiff has had to pay the employee's salary and medical costs. The plaintiff alleges the accident was solely due to the negligent driving of the second defendant and seeks reimbursement from the first defendant, as the second defendant's employer, for payments made to its injured employee.] The plaintiff seeks a decree for damages, interim interest, injunctions, receivership, attachment of property, costs, and any other relief.

1. CIVIL SUIT NO. _____ OF ______
IN THE HIGH COURT AT CALCUTTA
ORDINARY ORIGINAL CIVIL JURISDICTION
……… Plaintiff
-Versus-
……. Defendants
REGISTERED ADDRESS OF THE PLANTIFF
SI.
NO.
Name Plaintiff /
Defendant
Address
1. Plaintiff
Advocate-on-Record
For Plaintiff.

2. 2
CIVIL SUIT NO. ____ OF ______
IN THE HIGH COURT AT CALCUTTA
ORDINARY ORIGINAL CIVIL JURISDICTION
_____________________________________
……… Plaintiff
-Versus-
……. Defendants
CONCISE STATEMENT
The plaintiff prays for leave under Order 2 rule 2 of the Code of Civil
Procedure 1908 and claims a Decree for Rs. __________/-; Alternatively,
an enquiry into the damages suffered by the plaintiff as a result of the
actions of the defendant no.1 and/or its employees and a decree be
passed for such sum or sums as may be found due upon such enquiry;
Interim interest and interest upon judgement till recovery on the sum
decreed as in the prayers above at 18% per annum and/or at such rate
that is found fit and proper by this Hon’ble Court; Injunction; Receiver;
Attachment; Costs; Such further and other reliefs.
Dated this the ____ day of _________________.
ADVOCATE ON RECORD FOR PLAINTIFF.

3. 3
Civil Suit No. _____ of _________
IN THE HIGH COURT AT CALCUTTA
ORDINARY ORIGINAL CIVIL JURISDICTION
______________, a Company
incorporated under the provisions of
the Companies Act, 1956 and
having its Regional Office at ______
outside the jurisdiction of this
Hon’ble Court.
PLAINTIFF
-Versus-
1. __________, a Company within the
meaning of Companies Act, 1956
and having its ______ within the
jurisdiction of this Hon’ble Court.
2. ____________, working for gain at
inter alia __________within the
jurisdiction of this Hon’ble Court.
DEFENDANTS

4. 4
3. _______, residing at _________,
outside the jurisdiction of this
Hon’ble Court.
PRO FORMA DEFENDANT
The plaintiff states:
1. The plaintiff is a________________.
2. At all material times, _______ (the proforma defendant no. 3 named
above) was and is the employee of the plaintiff. His Employee
number is: No.________ and he was engaged under the ___________
and posted at the _____________of the consumers of the plaintiff.
3. On ______________, at about _____________. the said proforma
defendant no. 3 was on official duty at _______________ and was
taking steps to _________.
4. The said _________ belonged to and/or was being operated by the
ground handling agents for _______________ the defendant no.1
named above. The said _________ was being driven by one
_______________being the defendant no.2 named above, who is an
employee of the defendant no.1.

5. 5
5. The proforma defendant no.3 was doing his duty and was not at
fault for the said accident which occurred solely due to the
negligence of the defendant no.2, being the driver of the _______.
The said driver was arrested and criminal proceedings are pending
against him.
6. As a result of such accident, the pro forma defendant no. 3’s
_________________ when his left leg was amputated.
7. Immediately upon coming to learn about the incident, the plaintiff
lodged a complaint (First Information Report) on ______________,
regarding the same with the ______________ Police Station. In
addition thereto the plaintiff conducted its own enquiry into the
matter and prepared a detailed report _______________.
8. The _____________ also immediately conducted an enquiry on
______________ into the said incident leading to the amputation of
the left leg of the pro forma defendant no. 3 and submitted a
detailed report bearing reference no. ______________.
9. It shall appear from the facts stated above and from the said
contemporaneous reports that the said accident occurred solely

6. 6
due to the wrong and negligent driving of the said _______. The
particulars of negligence are set out more fully hereunder :-
a) The defendant no.2 failed and neglected _________ with due
care.
b) The defendant no.2 was ____________in a rash and reckless
manner even though he was well aware that there were several
persons.
c) The defendant no.2 failed to act with reasonable care and to
stop.
d) The said defendant no.2 failed to keep a proper look out.
e) The said defendant no. 2 failed to give sufficient warning of his
approach.
f) The said defendant no. 2 failed to apply his brakes sufficiently
or in time.
g) The said defendant no.2 failed to maneuver _____ so as to
avoid hitting the proforma defendant no.3.
h) Since the pro forma defendant no.3 is and was a bona fide
employee of the plaintiff and is covered by the Service Rule

7. 7
and Regulations of the plaintiff, the plaintiff is duty bound to
bear all statutory and employment obligations in respect of
the entitlement of the proforma defendant no.3 to
compensation in accordance with law.
10. The plaintiff’s Medical Board has declared the pro forma defendant
no. 3 as permanently disabled and he is being paid full salary as
he used to get before disablement. In that premises, though the
plaintiff is not at all getting the service of the Pro Forma Defendant
no.3 but is paying the monthly salary to him.
11. In view of the fact that the plaintiff has to pay the proforma
defendant no.3 his full salary until his retirement and the same
amounts to Rs. ___________/-. A schedule being Annexure “B”
hereto showing the detail of the said amounts is given hereinafter.
The plaintiff reserves its right to claim reimbursement of the said
sums to be incurred by the plaintiff from the defendants no. 1 and
2 in future.
12. The defendant no. 1 is an ________ company and carries on
business inter alia from its regional office at ______________ within
the jurisdiction of this Hon’ble Court. The defendant no.1 company

8. 8
is responsible for and is vicariously liable for the wrongful actions
of its employee the defendant no.2 who was in any event acting
under the employment of the defendant no.1 at the time the
accident occurred on ___________________.
13. The plaintiff in the facts and circumstances as aforesaid is entitled
to and claims from the defendant no. 1 a sum of Rs. ___________/-,
particulars of which is given herein below:
a. Rs. ______________/- - as compensation payable to the Pro
Forma Defendant no. 3 by the plaintiff under the provisions
of the Workmen’s Compensation Act, 1923
b. Rs. __________/- as the cost of hospitalization of the Pro
Forma Defendant no. 3 and his medical expenses as being
incurred by the plaintiff.
c. Rs. _________/- as the compensation paid by the plaintiff on
account on salaries to the Pro Forma Defendant no. 3
without getting any service from the Pro Forma Defendant
no. 3.
d. TOTAL : Rs. _______________/-

9. 9
14. The plaintiff is also entitled to interim interest and interest upon
judgement till recovery on the sum decreed as in the prayers above
at 18% per annum and/or at such rate that is found fit and proper
by this Hon’ble Court.
15. The plaintiff through its learned advocates demanded the aforesaid
sum by letter dated __________ from the defendant no. 1. The
defendant no. 1 in spite of receipt of the same failed and/or
neglected to pay the said sum or to reply to the said letter. A copy
of the said letter dated _____________ is annexed hereto and
marked Annexure “C”.
16. The plaintiff is the employer of the said the pro forma defendant
no.3 named above. The said proforma defendant no.3 was injured
and suffered loss and damage as a result of the negligent acts of
the ______________ being the defendant no. 2, who is the employee
of the defendant no.1 and/or its handling agent. The said accident
was caused during course of employment of the said _______ driver
while working for the defendant no.1 and as such the defendant
no.1 is liable and/or vicariously liable to recompense the damage
caused to the employee of the plaintiff and to the plaintiff. The pro
forma defendant no. 3 has subrogated his claim against the

10. 10
defendants in favour of the plaintiff and therefore there is no bar in
institution of the instant suit.
17. The plaintiff states that as an employer, the plaintiff has a general
right to be reimbursed from the said third party tortfeasor and/or
his employer the defendant no.1, for benefits paid by the plaintiff
to its employee for injuries caused by the said third party. The
plaintiff states that irrespective of any rights of the pro forma
defendant no.3, the plaintiff is entitled as the employer to bring
this action so as to vindicate its interest in being reimbursed for
payments made because of the third party's malfeasance.
18. The present suit is for a money claim. The Defendant no. 1 carries
on business from the said office at _____________ which is within
the aforesaid jurisdiction
19. No relief is being claimed against the defendant no. 2 and the Pro
Forma Defendant no.3 but their presence is required for proper
adjudication of the present suit.

11. 11
20. The cause of action hereof arose firstly on _______________________
and thereafter continues from day to day. The present suit is not
barred by any statute including the statute of limitation.
21. Inasmuch as the claim of the plaintiff exceeds Rs. 10 lacs this
Hon’ble High Court has and not the City Civil Court at Calcutta or
any other Civil Court the jurisdiction to receive, try and determine
the instant suit.
22. For the purpose of jurisdiction and court fees the suit is valued at
Rs. ________________ and ad-valorem court fees payable thereon
under the West Bengal Court Fees Act has duly been paid. In any
event, the plaintiff also undertakes to pay further court fees, if,
those already paid are found to be deficient.
23. In as much as the plaintiff is likely to have further claims against
the defendant no.1 arising out of the same series of facts and
circumstances mentioned above and since all such claims are not
immediately quantifiable, the plaintiff reserves its right to make
further claims against the defendant no. 1 in respect of the same
cause of action and seeks leave to institute the instant suit with
leave under Order 2 Rule 2 of the Code of Civil Procedure 1908.

12. 12
In the premises, the plaintiff prays for
leave under Order 2 rule 2 of the Code of
Civil Procedure 1908 and claims the
following reliefs:-
a. Decree for Rs. _____________/-;
b. Alternatively, as enquiry into the
damages suffered by the plaintiff as
a result of the actions of the
defendant no.1 and/or its
employees and a decree be passed
for such sum or sums as may be
found due upon such enquiry;
c. Interim interest and interest upon
judgement till recovery on the sum
decreed as in the prayers above at
18% per annum and/or at such rate
that is found fit and proper by this
Hon’ble Court;
d. Injunction;

13. 13
e. Receiver;
f. Attachment;
g. Costs.
h. Such further and other reliefs.
Advocate-on-record for
the Plaintiff.
V E R I F I C A T I O N
I, _____________, working for gain at ___________, the Authorised
Signatory of Plaintiff and the _________________ of the Plaintiff, do hereby
do hereby declare and state that the statements contained in paragraphs
1 to _______ and __ of the foregoing plaint including cause title thereof
are true to my knowledge and those contained in paragraphs
____________ and __ are my respectful submission before this Hon’ble
Court.

14. 14
I sign this verification in my Advocate’s Chamber at _____________ on this
____ day of ________________.
Settled by –
Advocate
Drawn by –
Advocate

15. 15
AFFIDAVIT
I, _____________, working for gain at __________, do hereby solemnly affirm
and say as follows:-
1. I am the Authorised Signatory of the plaintiff abovenamed. I am
also the ___________ of the plaintiff and a Principal officer thereof. I
have made myself acquainted with the facts and circumstances of
this and I am competent and duly authorized to make the
foregoing plaint and to affirm this affidavit on behalf of the
plaintiff.
2. That the statements made in paragraphs 1 to _____________ and
___ of the foregoing plaint including cause title thereof are true to
my knowledge and those contained in paragraphs _______ and __
are my respectful submission before this Hon’ble Court.
Solemnly affirmed by ___________ in
the Court House at Calcutta on this
the _____ day of _______________.
Before me
Commissioner

16. 16
LIST OF DOCUMENTS RELIED UPON BY THE PLAINTIFF
1. First Information Report lodged by the plaintiff on ____________,
regarding the incident in question with the _________ Police Station.
2. Documents relating to the criminal proceedings in connection with
the incident in question against the defendant no. 2.
3. Detailed Enquiry Report bearing reference No. __________ dated
__________ prepared on the basis on the enquiry conducted by the
concerned department of the plaintiff.
4. Detailed Enquiry Report bearing reference no. ____________ dated
___________ prepared by the ______________ on the basis of the
independent enquiry conducted by its officials.
5. Documents in support of salaries paid by the plaintiff to the
proforma defendant no. 3 between the periods ___________ to
_________.
6. Documents in support of compensation payable to the proforma
defendant no. 3 under the Workmen’s Compensation Act, 1923.
7. Documents in support of medical expenses incurred towards the
treatment of the proforma defendant no. 3.

17. 17
LIST OF DOCUMENTS PRODUCED WITH THE PLAINT
NIL
LIST OF DOCUMENTS ANNEXED WITH THE PLAINT
1. Annexure “A”- A schedule showing such detail of payments
made by the plaintiff to the pro forma defendant no.3 as
indicated in paragraph - 13 of the plaint.
2. Annexure “B”- A schedule showing such detail of payments
that the plaintiff has to pay the Pro Forma Defendant no.3 his
full salary until his retirement as stated in paragraph - 15 of the
plaint.
3. Annexure “C” – Copy of the letter dated _________ as stated in
paragraph - 19 of the plaint.

18. Annexure-A
SHEDULE- I
Detail of payments made by the plaintiff to the pro forma
defendant no.3 as stated below:
a. Rs. _______/- - as compensation payable to the Pro Forma
Defendant no. 3 by the plaintiff under the provisions of the
Workmen’s Compensation Act, 1923
b. Rs. _____/- – as the cost of hospitalization of the Pro Forma
Defendant no. 3 and his medical expenses as being incurred
by the plaintiff.
c. Rs. ________/- – as the compensation paid by the plaintiff on
account on salaries to the Pro Forma Defendant no. 3
without getting any service from the Pro Forma Defendant
no. 3.

19. 19
Annexure-B
SHEDULE- II
Detail of payments that the plaintiff has to pay the Pro Forma
Defendant no.3 his full salary until his retirement as stated below:
Salaries for the periods between
___________ to ________.
[______ x __] Rs. _________/-
TOTAL Rs. ___________/-

20. 20
CIVIL SUIT NO. ____ OF _____
IN THE HIGH COURT AT CALCUTTA
ORDINARY ORIGINAL CIVIL
JURISDICTION
……… Plaintiff
-Versus-
……. Defendants
P L A I N T