Plaintiff of civil complaint: ×, gender, Han nationality, born on, ID number: address: ×× Room 2, ordered to compensate plaintiff for vehicle loss; 3. The defendant was ordered to pay the plaintiff RMB for mental damages; 4. The legal fees and appraisal fees in this case shall be borne by the defendant. Facts and reasons (content of traffic accident identification and proportion of responsibility) The plaintiff was confirmed as "XXXXXXXXX, X-level disability" by the disability assessment of the appraisal center on X, X, X. The two sides have not yet reached an agreement on compensation. Therefore, in order to safeguard their legitimate rights and interests, the plaintiff brought a lawsuit to your hospital in accordance with the law and requested the court to make a judgment. To the holder of the District People's Court: (signature) year month day.

legal ground

Road traffic safety law

Seventy-fourth traffic accident compensation disputes, the parties may request the traffic administrative department of the public security organ for mediation, or directly bring a civil lawsuit to the people's court. After mediation by the traffic administrative department of the public security organ, if the parties fail to reach an agreement or fail to perform the mediation after it takes effect, the parties may bring a civil lawsuit to the people's court.