Bad Faith Insurance Complaint - Alabama

IN THE CIRCUIT COURT OF [COUNTY] COUNTY, ALABAMA

COMPLAINT FOR BREACH OF INSURANCE CONTRACT, BAD-FAITH REFUSAL TO PAY, AND DECLARATORY RELIEF

DEMAND FOR JURY TRIAL

Use limitation: This is a first-party direct-claim pleading for a policyholder seeking benefits under the policy. A third-party excess-settlement claim, workers' compensation dispute, health-benefit claim subject to a special statutory scheme, or claim governed by federal law requires different authority and allegations.

TABLE OF CONTENTS

1. Parties
2. Jurisdiction and Venue
3. Policy, Claim, and Denial Facts
4. Count I — Breach of Contract
5. Count II — Bad-Faith Refusal to Pay
6. Count III — Declaratory Relief
7. Prayer for Relief
8. Jury Demand and Signature

PARTIES

1. Plaintiff [PLAINTIFF NAME] is a ☐ natural person residing in [COUNTY] County, Alabama ☐ business entity with its principal Alabama office in [COUNTY] County.

2. Defendant [DEFENDANT INSURANCE COMPANY] is an insurance company that issued policy number [POLICY NUMBER] to Plaintiff and may be served through [REGISTERED AGENT AND ADDRESS].

JURISDICTION & VENUE

3. The amount in controversy exceeds $20,000, exclusive of interest and costs, giving this Court exclusive original civil jurisdiction under Ala. Code § 12-11-30(1).

4. Venue is proper in this County under Ala. Code § 6-3-7(a) because (check and plead the facts for every applicable route):

☐ a substantial part of the events or omissions giving rise to the claim occurred here;

☐ Defendant's principal Alabama office is here;

☐ Plaintiff resided or maintained its principal Alabama office here when the claim accrued and Defendant did business by agent here; or

☐ none of the preceding routes applies and Defendant was doing business by agent here when the claim accrued.

5. Plaintiff has reviewed the Policy for any enforceable appraisal, forum-selection, arbitration, notice, proof-of-loss, suit-limitation, or other pre-suit condition. Every condition required before suit has occurred, been performed, been excused, or been waived as follows: [PLEAD SPECIFIC FACTS].

POLICY, CLAIM, AND DENIAL FACTS

6. Defendant issued the Policy to Plaintiff for the period [EFFECTIVE DATES], with limits of $[LIMITS] and applicable deductibles of $[DEDUCTIBLES]. Attach or identify the complete Policy, including endorsements, as Exhibit A.

7. Plaintiff paid the premiums due and performed the obligations required before the loss, except as specifically excused or waived: [FACTS].

8. On [DATE OF LOSS], Plaintiff sustained the following loss: [FACTUAL DESCRIPTION].

9. The loss falls within the following insuring agreement, coverage grant, or endorsement: [QUOTE OR IDENTIFY POLICY LANGUAGE].

10. The following exclusions, limitations, or conditions invoked by Defendant do not bar coverage because: [POLICY-BASED AND FACTUAL RESPONSE].

11. Plaintiff gave notice on [DATE], submitted a proof of loss on [DATE], provided [DOCUMENTS / EXAMINATION / INSPECTION], and otherwise cooperated as follows: [FACTS].

12. Defendant ☐ denied the Claim ☐ failed to pay the undisputed amount ☐ delayed a coverage decision from [DATE] through [DATE]. Its written reasons were: [QUOTE OR SUMMARIZE EACH REASON]. Attach the operative letter as Exhibit B.

13. At the time of the refusal or continued nonpayment, Defendant possessed the following information establishing coverage and eliminating the stated grounds for denial: [SPECIFIC DOCUMENTS, TESTIMONY, INSPECTION RESULTS, OR ADMISSIONS].

14. Plaintiff alleges that Defendant lacked any reasonably legitimate or arguable factual or legal reason for the refusal because: [FACTS ADDRESSING EACH DENIAL GROUND].

15. If Plaintiff relies on an investigation-based method of proving bad faith, Defendant intentionally failed to determine whether a legitimate or arguable reason existed by: [IDENTIFY OMITTED STEPS, IGNORED EVIDENCE, PREDETERMINED OUTCOME, OR FAILURE TO SUBJECT RESULTS TO COGNITIVE REVIEW].

16. Plaintiff has sustained unpaid contractual benefits of $[AMOUNT] and the following additional injury proximately caused by the alleged bad faith: [ECONOMIC LOSS / MENTAL ANGUISH / OTHER COMPENSABLE HARM].

COUNT I

(Breach of Written Contract – Against Defendant)

17. Plaintiff incorporates paragraphs 1 through 16.

18. The Policy is a valid contract between Plaintiff and Defendant.

19. Plaintiff performed the conditions required for payment, or those conditions were excused or waived.

20. The Claim is covered under the Policy for the reasons pleaded above.

21. Defendant breached the Policy by refusing or failing to pay $[AMOUNT] in covered benefits when due.

22. Plaintiff seeks the unpaid benefits, other contract damages proved to be recoverable, and interest under Ala. Code § 8-8-8 to the extent applicable.

COUNT II

(Bad-Faith Refusal to Pay – Against Defendant)

23. Plaintiff incorporates paragraphs 1 through 22.

24. Alabama recognizes one tort of bad-faith refusal to pay, with different methods of proof rather than separate "normal" and "abnormal" torts. State Farm Fire & Casualty Co. v. Brechbill, 144 So. 3d 248, 257–58 (Ala. 2013).

25. Defendant and Plaintiff were parties to the Policy, Defendant breached it, and Defendant intentionally refused to pay the Claim.

26. When Defendant refused or continued to refuse payment, no reasonably legitimate or arguable factual or legal reason supported the refusal. National Security Fire & Casualty Co. v. Bowen, 417 So. 2d 179, 188 (Ala. 1982).

27. Defendant actually knew that no legitimate or arguable reason supported the refusal because: [FACTS SHOWING KNOWLEDGE AT THE TIME OF DECISION].

28. Alternatively or additionally, Defendant intentionally failed to determine whether a legitimate or arguable basis existed through the investigation failures pleaded in paragraph 15. The absence of a legitimate or arguable reason remains required for this method of proof. Brechbill, 144 So. 3d at 258.

29. For the ordinary refusal-to-pay method, Plaintiff alleges facts showing entitlement to judgment as a matter of law on the contract claim. National Savings Life Insurance Co. v. Dutton, 419 So. 2d 1357, 1362 (Ala. 1982).

30. Defendant's bad faith proximately caused the compensatory injuries identified in paragraph 16.

31. To the extent supported by clear and convincing evidence, Plaintiff seeks punitive damages for conduct meeting Ala. Code § 6-11-20, subject to §§ 6-11-21 and 6-11-27.

COUNT III

(Declaratory Relief – Against Defendant)

32. Plaintiff incorporates paragraphs 1 through 31.

33. An actual controversy exists concerning construction of the Policy and the parties' rights and obligations.

34. Under Ala. Code § 6-6-223, Plaintiff seeks a declaration identifying the applicable coverage, Defendant's payment obligation, and the parties' rights under the Policy.

PRAYER FOR RELIEF

WHEREFORE, Plaintiff prays for judgment against Defendant as follows:

1. Unpaid Policy benefits and other recoverable contract damages;

2. Compensatory damages proximately caused by bad faith, in amounts proved at trial;

3. Punitive damages only if the evidence satisfies Ala. Code §§ 6-11-20, 6-11-21, and 6-11-27;

4. Prejudgment interest under Ala. Code § 8-8-8 to the extent applicable and post-judgment interest under Ala. Code § 8-8-10;

5. A declaration of the parties' rights and obligations under the Policy;

6. Taxable costs; and

7. Other relief the Court may lawfully award.

JURY DEMAND

Plaintiff hereby demands trial by jury on all issues so triable.

SIGNATURE BLOCK

Dated: [DATE]

[LAW FIRM NAME]
Attorneys for Plaintiff [PLAINTIFF NAME]

By: ________________________________
[ATTORNEY NAME] (Bar No. ______)
[Email Address]
[Address]
[Phone] | [Fax]

SERVICE

Serve Defendant in the manner authorized by current Alabama law and court rules through:

FILING AND EVIDENCE CHECKLIST

☐ Confirm Circuit Court jurisdiction and the selected Ala. Code § 6-3-7 venue route.

☐ Review the complete Policy, declarations, endorsements, exclusions, conditions, appraisal clause, suit-limitation clause, and any arbitration or forum provision.

☐ Attach or accurately identify the Policy and operative denial letter.

☐ Plead facts eliminating each denial ground based on information available when Defendant acted.

☐ Identify evidence supporting the absence of a legitimate or arguable reason; disagreement or weak investigation alone is not enough.

☐ If relying on investigation failures, plead the omitted steps and how the evidence eliminates every legitimate or arguable reason.

☐ Plead punitive damages only when the facts support the statutory proof standard and principal-liability routes.

☐ Do not request attorney fees without an independently verified contract, statute, or other Alabama authority.

☐ File the current civil cover sheet, summons, complaint, exhibits, local forms, filing fee or approved hardship request, and proof of service.

SOURCES AND REFERENCES

• Ala. Code §§ 12-11-30, 6-3-7, 6-6-223, 6-11-20, 6-11-21, 6-11-27, 8-8-8, and 8-8-10 — https://alison.legislature.state.al.us/code-of-alabama
• National Security Fire & Casualty Co. v. Bowen, 417 So. 2d 179 (Ala. 1982)
• National Savings Life Insurance Co. v. Dutton, 419 So. 2d 1357 (Ala. 1982)
• State Farm Fire & Casualty Co. v. Brechbill, 144 So. 3d 248 (Ala. 2013)

End of Document