Personal Injury Complaint - Auto Accident
STATE OF CONNECTICUT
SUPERIOR COURT
JUDICIAL DISTRICT OF [JUDICIAL DISTRICT] AT [COURTHOUSE LOCATION]
[PLAINTIFF FULL LEGAL NAME],
Plaintiff,
v. CIVIL ACTION NO.: [DOCKET NO.]
[DEFENDANT FULL LEGAL NAME(S)],
Defendant(s).
RETURN DATE: [TUESDAY, MONTH DAY, YEAR]
COMPLAINT – MOTOR VEHICLE PERSONAL INJURY ACTION
I. PARTIES
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Plaintiff, [PLAINTIFF NAME] (“Plaintiff”), is an individual residing at [PLAINTIFF ADDRESS], Connecticut.
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Defendant, [DRIVER DEFENDANT NAME] (“Driver”), is an individual residing at [DRIVER ADDRESS], Connecticut, and at all relevant times was the operator of the motor vehicle described herein.
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Defendant, [OWNER DEFENDANT NAME] (“Owner”), is an individual/entity with a principal place of business/residence at [OWNER ADDRESS], and at all relevant times was the owner of said motor vehicle and permitted Driver to operate it.
II. JURISDICTION AND VENUE
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This Court has subject-matter jurisdiction under Conn. Gen. Stat. § 51-164s because this is a civil action seeking money damages for personal injuries exceeding the jurisdictional minimum.
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Venue is proper in this Judicial District pursuant to Conn. Gen. Stat. § 51-345 because one or more defendants reside in, or the cause of action arose within, this District.
III. FACTUAL ALLEGATIONS
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On or about [DATE], at approximately [TIME], Plaintiff was lawfully operating a [YEAR/MAKE/MODEL] motor vehicle eastbound on [ROADWAY], in [TOWN], Connecticut.
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At that same time and place, Driver was operating a [YEAR/MAKE/MODEL] motor vehicle owned by Owner in the same vicinity.
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Driver, suddenly and without warning, [STRUCK/REAR-ENDED/FAILED TO YIELD TO] Plaintiff’s vehicle, causing a collision (the “Collision”).
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As a direct and proximate result of the Collision, Plaintiff sustained serious and painful personal injuries, incurred medical expenses, experienced lost wages and impairment of earning capacity, and endured significant physical and emotional pain and suffering, all of which are either permanent or likely to continue into the future.
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Plaintiff has complied with all conditions precedent to the initiation of this action, including, without limitation, exhaustion of any applicable no-fault medical-payments benefits and pre-suit notice requirements where applicable.
IV. COUNT ONE – NEGLIGENCE (Against Driver)
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Plaintiff repeats and realleges ¶¶1–10 as if fully set forth herein.
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Driver owed Plaintiff a duty to operate the motor vehicle with reasonable care, to obey all applicable traffic laws, and to maintain proper control and lookout.
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Driver breached that duty in one or more of the following ways:
a. Operating the vehicle at an unreasonable, improper, and unsafe speed;
b. Failing to keep a proper lookout for other vehicles lawfully upon the roadway;
c. Following Plaintiff’s vehicle more closely than was reasonable and prudent;
d. Failing to apply brakes in time to avoid the Collision;
e. Failing to remain within a single lane;
f. Otherwise operating the vehicle in violation of Connecticut motor-vehicle statutes and the common law duty of reasonable care.
- Driver’s negligence was the direct and proximate cause of the injuries and damages described in ¶9.
V. COUNT TWO – NEGLIGENCE PER SE (Statutory Violations Against Driver)
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Plaintiff repeats and realleges ¶¶1–14 as if fully set forth herein.
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At the time of the Collision, Driver was violating one or more Connecticut motor-vehicle statutes enacted for the safety of persons such as Plaintiff, including but not limited to statutes regulating speed, following distance, lane usage, right-of-way, and operation under the influence.
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Such statutory violations constitute negligence per se, directly and proximately causing Plaintiff’s injuries and damages.
VI. COUNT THREE – RECKLESS DISREGARD (Conn. Gen. Stat. § 14-295)
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Plaintiff repeats and realleges ¶¶1–17 as if fully set forth herein.
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Driver’s conduct was in violation of the specific statutes enumerated in Conn. Gen. Stat. § 14-295 and was performed with reckless disregard for the rights and safety of others, including Plaintiff.
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Pursuant to Conn. Gen. Stat. § 14-295, Plaintiff seeks an award of double or treble damages.
VII. COUNT FOUR – VICARIOUS LIABILITY (Against Owner)
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Plaintiff repeats and realleges ¶¶1–20 as if fully set forth herein.
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At all relevant times, Owner owned the vehicle operated by Driver and expressly or impliedly gave Driver permission to operate it.
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Under the doctrine of vicarious liability and Conn. Gen. Stat. § 52-183, Owner is legally responsible for Driver’s negligence and recklessness alleged herein.
VIII. DAMAGES
- As a direct and proximate result of Defendants’ acts and omissions, Plaintiff has sustained:
a. Past and future medical expenses;
b. Past and future lost wages and impairment of earning capacity;
c. Permanent and/or temporary disability;
d. Physical pain and suffering;
e. Mental anguish and emotional distress;
f. Loss of enjoyment of life and usual activities;
g. Property damage; and
h. Other economic and non-economic damages to be proven at trial.
- The amount in demand is greater than Fifteen Thousand Dollars ($15,000.00), exclusive of interest and costs.
IX. COMPARATIVE NEGLIGENCE NOTICE
- Pursuant to Conn. Gen. Stat. § 52-572h, Plaintiff’s recovery shall be diminished by the percentage of negligence, if any, attributable to Plaintiff but shall not be barred unless Plaintiff’s negligence is greater than 50 percent.
X. PRAYER FOR RELIEF
WHEREFORE, Plaintiff respectfully requests that the Court enter judgment in favor of Plaintiff and against Defendants, jointly and severally, and award:
- Compensatory damages in an amount to be determined by the trier of fact;
- Double or treble damages under Conn. Gen. Stat. § 14-295 (Count Three);
- Pre-judgment and post-judgment interest as allowed by law;
- Costs of suit;
- Such other and further relief as the Court deems just and proper.
XI. JURY DEMAND
Plaintiff hereby demands a trial by jury on all issues so triable.
XII. DESIGNATION FOR COURT-ANNEXED ARBITRATION
☐ Plaintiff elects to submit this case to court-annexed arbitration in accordance with Conn. Gen. Stat. § 52-549u et seq.
☐ Plaintiff does not elect arbitration at this time.
XIII. NOTICE REGARDING PRE-JUDGMENT REMEDIES
Plaintiff reserves the right to seek a pre-judgment remedy pursuant to Conn. Gen. Stat. § 52-278a et seq.
XIV. SIGNATURE BLOCK
Respectfully submitted,
PLAINTIFF,
[PLAINTIFF FULL LEGAL NAME]
By: ____________________________________
[ATTORNEY NAME] (Juris No. ______)
[LAW FIRM NAME]
[STREET ADDRESS]
[CITY, STATE, ZIP]
Tel: [PHONE] | Fax: [FAX]
Email: [EMAIL]
Its Attorney
XV. CERTIFICATION OF SERVICE
I hereby certify that a copy of the foregoing Complaint was or will be mailed or delivered electronically to all counsel and pro se parties of record in accordance with Practice Book § 10-14 on this [DAY] day of [MONTH], [YEAR].
/s/ [ATTORNEY NAME]
[ATTORNEY NAME]
END OF DOCUMENT
About This Template
Personal injury cases are brought by people who were hurt because of someone else's carelessness: car crashes, slip and falls, defective products, and more. Demand letters, settlement agreements, and court filings in these cases have to document the injuries, the medical treatment, the lost income, and the exact legal basis for holding the other side responsible. Well-prepared paperwork is what drives higher settlements and forces insurers to take the claim seriously.
Important Notice
This template is provided for informational purposes. It is not legal advice. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Last updated: May 2026
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