Bad Faith Insurance Complaint - Hawaii

COMPLAINT FOR INSURANCE BAD FAITH — HAWAI'I

TABLE OF CONTENTS

1. Caption
2. Introduction
3. Parties, Jurisdiction, and Venue
4. Factual Allegations
5. Count I — Breach of Contract
6. Count II — Tort of Bad Faith (Breach of Implied Covenant of Good Faith and Fair Dealing)
7. Count III — Negligent / Intentional Infliction of Emotional Distress
8. Damages
9. Prayer for Relief
10. Demand for Trial by Jury
11. Reservation of Rights
12. Signature and Service Blocks
13. Verification
14. Certificate of Service
15. Hawai'i Practice Notes
16. Sources and References

1. CAPTION

STATE OF HAWAI'I

CIRCUIT COURT OF THE [FIRST / SECOND / THIRD / FIFTH] CIRCUIT

CIVIL NO. [________________________________]

COMPLAINT FOR (1) BREACH OF CONTRACT; (2) BAD FAITH; (3) EMOTIONAL DISTRESS; DEMAND FOR JURY TRIAL; SUMMONS

Plaintiff, complaining of Defendants, alleges and says as follows:

2. INTRODUCTION

This is an action against an insurer that issued a policy of insurance to Plaintiff and then breached its contractual obligations and the implied covenant of good faith and fair dealing recognized by the Hawai'i Supreme Court in Best Place, Inc. v. Penn America Insurance Co., 82 Haw. 120, 920 P.2d 334 (1996). Defendant unreasonably delayed, lowballed, and ultimately denied a valid claim, engaging in conduct that constitutes unfair claim settlement practices under HRS § 431:13-103(11) and the common-law tort of bad faith.

3. PARTIES, JURISDICTION, AND VENUE

3.1. Plaintiff [PLAINTIFF NAME] ("Plaintiff" or "Insured") is, and at all relevant times was, a resident of [CITY/COUNTY], State of Hawai'i.

3.2. Defendant [INSURER NAME] ("Insurer") is, and at all relevant times was, a [STATE OF INCORPORATION] corporation authorized to transact, and in fact transacting, the business of insurance in the State of Hawai'i pursuant to a certificate of authority issued by the Hawai'i Insurance Commissioner under HRS Chapter 431.

3.3. Defendants DOES 1–10 are individuals or entities whose true names and capacities are presently unknown to Plaintiff. Plaintiff will amend to allege their true names and capacities once ascertained.

3.4. This Court has subject-matter jurisdiction pursuant to HRS § 603-21.5 (general civil jurisdiction of the circuit courts) because the amount in controversy exceeds the jurisdictional minimum of district court and the relief sought includes equitable and tort remedies beyond district court authority.

3.5. Venue is proper in this Circuit pursuant to HRS § 603-36 because the contract was issued and/or performed, and a substantial part of the events giving rise to the claim occurred, in [COUNTY], Hawai'i.

3.6. Defendant Insurer transacts business in Hawai'i and consented to suit in Hawai'i by accepting premiums and issuing the Policy here. Personal jurisdiction is proper under HRS § 634-35 (long-arm statute).

4. FACTUAL ALLEGATIONS

A. The Policy

4.1. On or about [DATE], Insurer issued Policy No. [POLICY NUMBER] (the "Policy") to Plaintiff, providing [TYPE OF COVERAGE — e.g., homeowner's, automobile, commercial property, UM/UIM] coverage with applicable limits of $[AMOUNT].

4.2. At all relevant times, Plaintiff paid all premiums when due and complied with all conditions precedent to coverage under the Policy.

B. The Loss and Claim

4.3. On or about [DATE OF LOSS], Plaintiff sustained a covered loss when [DESCRIBE LOSS — e.g., a hurricane caused wind and water damage to the insured premises; Plaintiff was struck by an underinsured motorist; etc.] (the "Loss").

4.4. On or about [DATE OF NOTICE], Plaintiff timely reported the Loss to Insurer and submitted a proof of loss / claim documentation as required by the Policy.

4.5. The Loss is a covered peril under the express terms of the Policy and is not subject to any applicable exclusion.

C. Insurer's Bad-Faith Conduct

4.6. Despite Plaintiff's full compliance with the Policy, Insurer engaged in a course of conduct designed to delay, underpay, and ultimately deny Plaintiff's valid claim, including the following:

• Failure to promptly investigate. Insurer failed to adopt and implement reasonable standards for prompt investigation of the claim, in violation of HRS § 431:13-103(11)(C).
• Failure to acknowledge or act reasonably promptly. Insurer failed to acknowledge and act reasonably promptly upon communications regarding the claim, in violation of HRS § 431:13-103(11)(B).
• Refusal to pay without reasonable investigation. Insurer refused to pay the claim without conducting a reasonable investigation based on all available information, in violation of HRS § 431:13-103(11)(D).
• Failure to affirm or deny within reasonable time. Insurer failed to affirm or deny coverage of the claim within a reasonable time after proof-of-loss statements were completed, in violation of HRS § 431:13-103(11)(E).
• Failure to attempt prompt, fair, equitable settlement. Insurer did not attempt in good faith to effectuate a prompt, fair, and equitable settlement of the claim in which liability had become reasonably clear, in violation of HRS § 431:13-103(11)(F).
• Forcing litigation. Insurer compelled Plaintiff to institute litigation to recover amounts due under the Policy by offering substantially less than the amounts ultimately recoverable, in violation of HRS § 431:13-103(11)(G).
• Misrepresentation of policy provisions. Insurer misrepresented pertinent facts and policy provisions relating to coverage, in violation of HRS § 431:13-103(11)(A).
• Unreasonable proof-of-loss demands. Insurer made unreasonable repeated requests for documentation that had already been provided or that was not material to coverage.

4.7. [INSERT SPECIFIC FACTS — e.g., dates of communications; names of adjusters; specific lowball offers; written denials; expert opinions ignored; manufactured policy interpretations].

4.8. Insurer's conduct was without any reasonable basis and was undertaken with knowledge of, or in reckless disregard of, the absence of any reasonable basis for the conduct.

4.9. Insurer's conduct was willful, wanton, oppressive, and undertaken with conscious indifference to the consequences and to the rights of Plaintiff.

5. COUNT I — BREACH OF CONTRACT

5.1. Plaintiff realleges and incorporates Paragraphs 1.1 through 4.9.

5.2. The Policy is a valid and enforceable contract of insurance between Plaintiff and Insurer.

5.3. Plaintiff performed all conditions precedent under the Policy, or any non-performance is excused.

5.4. The Loss is a covered peril and falls within the coverage afforded by the Policy.

5.5. Insurer breached the Policy by failing and refusing to pay benefits owed for the covered Loss.

5.6. As a direct and proximate result of Insurer's breach, Plaintiff has suffered damages in an amount to be proven at trial, but not less than $[AMOUNT], plus interest, costs, and attorneys' fees as provided by HRS § 431:10-242 where applicable.

6. COUNT II — TORT OF BAD FAITH (Breach of Implied Covenant of Good Faith and Fair Dealing)

6.1. Plaintiff realleges and incorporates Paragraphs 1.1 through 5.6.

6.2. Every contract of insurance issued in Hawai'i contains an implied covenant of good faith and fair dealing. Best Place, Inc. v. Penn Am. Ins. Co., 82 Haw. 120, 124, 920 P.2d 334, 338 (1996).

6.3. The Hawai'i Supreme Court has recognized that breach of the implied covenant by an insurer in handling first-party claims gives rise to an independent tort cause of action. Id. at 132, 920 P.2d at 346.

6.4. Insurer breached its duty of good faith and fair dealing through the conduct described in Paragraphs 4.6 through 4.9, including without limitation:

• Unreasonably delaying, denying, and underpaying the claim;
• Failing to conduct a reasonable, objective investigation;
• Constructing pretextual coverage defenses;
• Engaging in unfair claim settlement practices enumerated in HRS § 431:13-103(11) (offered as evidence of bad faith pursuant to Hough v. Pacific Ins. Co., Ltd., 83 Haw. 457, 927 P.2d 858 (1996)); and
• Placing its own pecuniary interests above its insured's.

6.5. Insurer's conduct was unreasonable, was undertaken with knowledge of the absence of any reasonable basis, and damaged the very protection and security Plaintiff sought to gain by purchasing insurance.

6.6. As a direct and proximate result, Plaintiff has suffered consequential damages including, without limitation, contract benefits, financial losses beyond policy limits, attorneys' fees, costs of investigation, emotional distress, and other damages to be proven at trial.

6.7. Insurer's conduct was wanton, oppressive, malicious, willful, and undertaken with conscious indifference to consequences, entitling Plaintiff to punitive damages pursuant to HRS § 431:10-240 and Masaki v. General Motors Corp., 71 Haw. 1, 780 P.2d 566 (1989).

7. COUNT III — NEGLIGENT / INTENTIONAL INFLICTION OF EMOTIONAL DISTRESS

7.1. Plaintiff realleges and incorporates Paragraphs 1.1 through 6.7.

7.2. Insurer's conduct, as alleged, was extreme and outrageous, exceeded all bounds of decency in a civilized community, and was undertaken intentionally or with reckless disregard of the substantial probability that severe emotional distress would result. Hac v. Univ. of Hawai'i, 102 Haw. 92, 73 P.3d 46 (2003).

7.3. As a direct and proximate result, Plaintiff suffered severe emotional distress including [describe symptoms — anxiety, sleeplessness, depression, physical manifestations, treatment].

8. DAMAGES

8.1. Contract Benefits. Policy benefits owed in an amount not less than $[AMOUNT].

8.2. Consequential / Tort Damages. Financial losses, including amounts in excess of Policy limits proximately caused by Insurer's bad-faith conduct.

8.3. Emotional Distress Damages. Compensation for mental anguish, anxiety, and emotional suffering.

8.4. Attorneys' Fees and Costs. Reasonable attorneys' fees and costs pursuant to HRS § 431:10-242 (assumpsit) and Best Place (recoverable as element of bad-faith damages).

8.5. Pre- and Post-Judgment Interest. At the legal rate pursuant to HRS § 478-2 / § 478-3.

8.6. Punitive Damages. Pursuant to HRS § 431:10-240 (punitive damages must be specifically included to be covered, and are recoverable from the insurer for its own wanton conduct) and Hawai'i common law, in an amount sufficient to punish and deter.

9. PRAYER FOR RELIEF

WHEREFORE, Plaintiff respectfully prays for judgment against Defendants as follows:

• A. Compensatory damages, including contract benefits and consequential damages, in an amount to be proven at trial;
• B. Damages for emotional distress;
• C. Punitive damages in an amount sufficient to punish Insurer and to deter similar conduct;
• D. Reasonable attorneys' fees and costs pursuant to HRS § 431:10-242 and applicable law;
• E. Pre-judgment and post-judgment interest at the legal rate;
• F. Costs of suit; and
• G. Such other and further relief as the Court deems just and equitable.

10. DEMAND FOR TRIAL BY JURY

Plaintiff hereby demands a trial by jury on all issues so triable as a matter of right pursuant to Hawai'i Rules of Civil Procedure 38 and Article I, Section 13 of the Hawai'i Constitution.

11. RESERVATION OF RIGHTS

Plaintiff reserves the right to amend this Complaint pursuant to HRCP 15 to add additional parties, claims, or theories as discovery may warrant, including without limitation claims under HRS Chapter 480 if facts develop establishing applicability.

12. SIGNATURE AND SERVICE BLOCKS

Date: [DATE]

Respectfully submitted,

[LAW FIRM NAME]

By: [________________________________]

[ATTORNEY NAME], Hawai'i Bar No. [####]

Counsel for Plaintiff

[STREET ADDRESS]

[CITY, HI ZIP]

Telephone: [NUMBER]

Email: [EMAIL]

13. VERIFICATION

STATE OF HAWAI'I

COUNTY OF [COUNTY]

I, [PLAINTIFF NAME], being first duly sworn, depose and state under penalty of perjury under the laws of the State of Hawai'i that I am the Plaintiff in the foregoing action; that I have read the foregoing Complaint and know the contents thereof; and that the same is true to my own knowledge except as to those matters stated upon information and belief, and as to those matters I believe them to be true.

[________________________________]

[PLAINTIFF NAME]

Subscribed and sworn to before me this [____] day of [_______________], 20[____].

[________________________________]

Notary Public, State of Hawai'i

(My Commission Expires: [_______________])

14. CERTIFICATE OF SERVICE

I hereby certify that on the [____] day of [_______________], 20[____], a true and correct copy of the foregoing COMPLAINT was duly served upon Defendant via the Hawai'i Judiciary's JEFS electronic filing system and/or by personal service through a duly authorized process server pursuant to HRCP 4, addressed as follows:

[INSURER REGISTERED AGENT IN HAWAI'I]
(See Hawai'i Insurance Division registry; default agent: Insurance Commissioner under HRS § 431:2-205 for foreign insurers)

[________________________________]

[ATTORNEY NAME]

15. HAWAI'I PRACTICE NOTES

• Bad-faith tort recognized. Best Place, Inc. v. Penn Am. Ins. Co., 82 Haw. 120, 920 P.2d 334 (1996), recognizes a first-party tort of bad faith. Hawai'i adopted the California Gruenberg standard: the insured need not show conscious awareness of wrongdoing or evil motive; conduct that damages the very protection the insured sought is sufficient.
• No private right under HRS § 431:13-103. Hough v. Pacific Ins. Co., Ltd., 83 Haw. 457, 927 P.2d 858 (1996), holds that Article 13 of Chapter 431 contains no private right of action — enforcement is by the Insurance Commissioner. However, statutory violations are admissible as evidence of common-law bad faith. Plead them as factual predicates within the bad-faith count, not as a stand-alone count.
• Statute of limitations. Tort bad faith: two (2) years from accrual (HRS § 657-7). Contract claims on the Policy: six (6) years (HRS § 657-1(1)). The bad-faith clock typically runs from claim denial or other wrongful conduct, not from the date of loss. Anderson v. State Farm, 75 Haw. 250 (1993).
• Punitive damages. HRS § 431:10-240 prohibits insurance coverage for punitive damages unless "specifically included." Punitive damages against the insurer for its own bad-faith conduct require clear and convincing evidence of wanton or oppressive conduct, malice, willful misconduct, or conscious indifference. Masaki v. Gen. Motors Corp., 71 Haw. 1 (1989); Best Place, 82 Haw. at 133.
• Attorneys' fees. HRS § 431:10-242 awards reasonable fees to prevailing insureds in actions "in the nature of an assumpsit" against insurers — this is a critical fee-shifting provision. Pair with assumpsit count.
• UDAP carve-out. Claims under HRS § 480-2 are generally NOT available against insurers for claims-handling conduct. Hawai'i Med. Ass'n v. Hawai'i Med. Serv. Ass'n, 113 Haw. 77, 148 P.3d 1179 (2006). Do not plead a § 480 count without confirming current case law.
• Removal risk. Out-of-state insurers will frequently remove under 28 U.S.C. § 1332 if the Policy benefits plus consequential and punitive damages exceed $75,000. Joining a Hawai'i resident agent or adjuster (where supportable) can defeat removal.
• Pre-suit demand. Although not statutorily required, a written pre-suit time-limited demand documenting the insurer's bad-faith conduct strengthens punitive damages exposure.
• Insurance Commissioner complaint. Filing a parallel complaint with the Hawai'i DCCA Insurance Division (1-844-808-DCCA) preserves regulatory pressure and creates a paper record. It is not a prerequisite to suit.

16. SOURCES AND REFERENCES

• HRS Chapter 431 (Insurance Code) — https://www.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-.htm
• HRS § 431:13-103 (Unfair Methods/Unfair Claim Settlement Practices) — https://www.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/HRS_0431-0013-0103.htm
• HRS § 431:10-240 (Punitive damages coverage) — https://law.justia.com/codes/hawaii/title-24/chapter-431/section-431-10-240/
• HRS § 431:10-242 (Attorneys' fees in actions on insurance policies) — https://www.capitol.hawaii.gov/hrscurrent/Vol09_Ch0431-0435H/HRS0431/
• HRS § 657-1, § 657-7 (Statutes of limitation) — https://www.capitol.hawaii.gov/hrscurrent/Vol13_Ch0601-0676/HRS0657/
• Best Place, Inc. v. Penn America Ins. Co., 82 Haw. 120, 920 P.2d 334 (1996) — https://law.justia.com/cases/hawaii/supreme-court/1996/16065-2.html
• Hough v. Pacific Insurance Co., Ltd., 83 Haw. 457, 927 P.2d 858 (1996) — https://law.justia.com/cases/hawaii/supreme-court/1996/16019-2.html
• Enoka v. AIG Hawai'i Ins. Co., 109 Haw. 537, 128 P.3d 850 (2006)
• Masaki v. General Motors Corp., 71 Haw. 1, 780 P.2d 566 (1989)
• Hac v. University of Hawai'i, 102 Haw. 92, 73 P.3d 46 (2003) (IIED standard)
• Hawai'i Rules of Civil Procedure — https://www.courts.state.hi.us/legal_references/rules/rulesOfCourt
• Hawai'i Insurance Division (DCCA) — https://cca.hawaii.gov/ins/

Disclaimer: This template is provided for informational purposes only and does not constitute legal advice. An attorney licensed in Hawai'i must review and customize this document before filing. Laws, citations, and court rules change frequently; verify all authorities before use.