IN THE COURT OF COMMON PLEAS OF [COUNTY] COUNTY, PENNSYLVANIA
CIVIL DIVISION

[PLAINTIFF FULL LEGAL NAME],
  Plaintiff,
v.
[DEFENDANT INSURANCE COMPANY] (a [STATE] corporation),
  Defendant.

Civil Action No.: __

COMPLAINT IN CIVIL ACTION
(Breach of Insurance Contract & Statutory Bad Faith – 42 Pa. Cons. Stat. § 8371)

TABLE OF CONTENTS

1. Preliminary Statement
2. Parties
3. Jurisdiction & Venue
4. Definitions
5. Factual Allegations
   5.1 The Policy
   5.2 The Covered Loss
   5.3 Plaintiff’s Claim & Defendant’s Handling
   5.4 Defendant’s Bad-Faith Conduct
6. Causes of Action
   Count I Breach of Contract
   Count II Statutory Bad Faith – 42 Pa. Cons. Stat. § 8371
7. Prayer for Relief
8. Jury Demand
9. Notice to Defend (Pa.R.C.P. 1018.1)
10. Verification
11. Certificate of Service

[// GUIDANCE: Delete the Table of Contents before filing if local practice discourages it.]

1. PRELIMINARY STATEMENT

1. Plaintiff brings this action to recover contractual benefits and to obtain statutory remedies for Defendant’s unreasonable, frivolous, and intentional refusal to honor its obligations under the Policy, in violation of Pennsylvania’s bad-faith insurance statute, 42 Pa. Cons. Stat. § 8371.

2. PARTIES

2. Plaintiff, [PLAINTIFF NAME] (“Plaintiff”), is an adult individual residing at [ADDRESS], [CITY], Pennsylvania.
3. Defendant, [DEFENDANT INSURANCE COMPANY] (“Defendant”), is an insurance company organized under the laws of [STATE OF INCORPORATION] with its principal place of business at [ADDRESS]. Defendant is licensed to transact insurance business in the Commonwealth of Pennsylvania and regularly does so.

3. JURISDICTION & VENUE

4. This Court has subject-matter jurisdiction pursuant to 42 Pa. Cons. Stat. § 931 and 42 Pa. Cons. Stat. § 8371.
5. Venue is proper in this County under Pa.R.C.P. 1006 because (a) the cause of action arose here, (b) Defendant regularly conducts business here, and/or (c) the insured property is located here.
6. All conditions precedent to suit, including timely notice of claim and proof-of-loss requirements, have been satisfied, waived, or excused.

4. DEFINITIONS

For ease of reference, the following terms, when capitalized, have the meanings ascribed below:

“Claim” – Plaintiff’s demand for coverage and payment submitted to Defendant on [DATE OF CLAIM].
“Loss” – The covered event occurring on or about [DATE OF LOSS] that gave rise to the Claim.
“Policy” – Homeowners/Commercial Property Policy No. [POLICY NUMBER], effective [POLICY TERM], issued by Defendant to Plaintiff.
“Bad-Faith Conduct” – The acts and omissions set forth in ¶¶ 19-29, infra, constituting Defendant’s lack of a reasonable basis and knowingly or recklessly disregarding its lack of a reasonable basis to deny or delay benefits.

[// GUIDANCE: Feel free to expand or modify definitions to match the specific policy type and claim facts.]

5. FACTUAL ALLEGATIONS

5.1 The Policy

7. On or about [POLICY INCEPTION DATE], Defendant issued the Policy to Plaintiff, providing [TYPE OF COVERAGE] coverage up to $[LIMITS].
8. The Policy was in full force and effect at all relevant times, and Plaintiff paid all required premiums.

5.2 The Covered Loss

9. On [DATE OF LOSS], Plaintiff sustained a sudden and accidental Loss to the insured property located at [PROPERTY ADDRESS] when [BRIEF DESCRIPTION OF PERIL, e.g., “a windstorm caused substantial roof damage resulting in interior water intrusion”].
10. The Loss constitutes a peril insured against under the Policy.

5.3 Plaintiff’s Claim & Defendant’s Handling

11. Plaintiff promptly notified Defendant of the Loss and submitted a Claim on [DATE].
12. Plaintiff fully cooperated with Defendant’s investigation, including providing access, documentation, examinations under oath (if any), and sworn proof of loss.
13. Despite clear evidence of covered damage, Defendant [denied, under-paid, and/or unreasonably delayed] payment of benefits.

5.4 Defendant’s Bad-Faith Conduct

14. Defendant acted in bad faith, inter alia, by:
    a. Failing to conduct a prompt, thorough, and fair investigation;
    b. Misrepresenting pertinent Policy provisions and Pennsylvania law;
    c. Ignoring or rejecting estimates, photographs, and expert reports supporting the Claim;
    d. Placing its financial interests above those of its insured;
    e. Offering grossly inadequate payment without reasonable basis;
    f. Unreasonably withholding undisputed amounts;
    g. Compelling Plaintiff to initiate litigation to recover Policy benefits to which Plaintiff is clearly entitled.
15. Defendant knew or recklessly disregarded the fact that it lacked a reasonable basis for its coverage position.

6. CAUSES OF ACTION

COUNT I – Breach of Contract

16. Plaintiff incorporates ¶¶ 1-15 as though fully set forth herein.
17. The Policy is a valid, enforceable contract.
18. Defendant materially breached the Policy by failing to pay amounts due and owing for the Loss.
19. As a direct and proximate result, Plaintiff suffered damages including, but not limited to, unpaid Policy benefits, consequential damages, interest, and costs.

COUNT II – Statutory Bad Faith (42 Pa. Cons. Stat. § 8371)

20. Plaintiff incorporates ¶¶ 1-19 as though fully set forth herein.
21. Defendant’s Bad-Faith Conduct, as defined supra, was knowing, reckless, and without reasonable basis.
22. Pursuant to 42 Pa. Cons. Stat. § 8371, Plaintiff is entitled to:
    a. Interest on the amount of the Claim at the prime rate of interest plus 3%;
    b. Punitive damages; and
    c. Court costs and reasonable attorney fees.

[// GUIDANCE: Allegations may be supplemented to track the precise misconduct discovered in discovery.]

7. PRAYER FOR RELIEF

WHEREFORE, Plaintiff respectfully requests that the Court enter judgment in Plaintiff’s favor and against Defendant, and award:
1. Compensatory damages for breach of contract in an amount in excess of $50,000, plus delay damages pursuant to Pa.R.C.P. 238;
2. Statutory interest, punitive damages, attorney fees, and costs under 42 Pa. Cons. Stat. § 8371;
3. Pre- and post-judgment interest at the maximum rate allowed by law;
4. Injunctive relief compelling Defendant to comply with its Policy obligations and promptly pay covered benefits; and
5. Such other and further relief as the Court deems just and proper.

8. JURY DEMAND

Plaintiff demands a trial by jury on all issues so triable as of right.

9. NOTICE TO DEFEND

(Required by Pa.R.C.P. 1018.1)

NOTICE
You have been sued in court. If you wish to defend against the claims set forth in this Complaint, you must take action within twenty (20) days after this Complaint and Notice are served, by entering a written appearance personally or by attorney and filing in writing with the court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the Plaintiff. You may lose money or property or other rights important to you.
 YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER.
 IF YOU CANNOT