Personal Injury Complaint - Auto Accident - Hawaii
IN THE CIRCUIT COURT OF THE ☐[CIRCUIT NUMBER] CIRCUIT
STATE OF HAWAIʻI
| Party | Role |
|---|---|
| ☐[PLAINTIFF FULL NAME], | Plaintiff, |
| v. | Civil No. ☐[to be assigned] (Tort—Motor Vehicle Accident) |
| ☐[DEFENDANT FULL NAME], | Defendant. |
COMPLAINT; DEMAND FOR JURY TRIAL; OPTIONAL VERIFICATION;
SUMMONS TO ISSUE; INITIAL SERVICE CHECKLIST
TABLE OF CONTENTS
- Document Header
- Definitions
- Jurisdiction & Venue
- Compliance With Hawai‘i No-Fault Statute
- Factual Allegations
-
Causes of Action
6.1 Count I – Negligence
6.2 Count II – Traffic-Rule Violation as Evidence of Negligence (optional)
6.3 Count III – Loss of Consortium (optional) -
Comparative Negligence Allegations
- Damages
- Prayer for Relief
- Jury Demand
- Court-Annexed Arbitration
- Costs
- Optional Verification (Hawai‘i R. Civ. P. 11(a))
- Initial Service of Process
1. DOCUMENT HEADER
1.1 Plaintiff ☐[PLAINTIFF FULL NAME] (“Plaintiff”) brings this Complaint against Defendant ☐[DEFENDANT FULL NAME] (“Defendant”) arising out of a motor-vehicle collision that occurred on ☐[DATE] at or near ☐[LOCATION] (the “Subject Accident”).
1.2 This action seeks recovery of special, general, and, where authorized, punitive damages, together with costs and such other relief as the Court deems just and equitable.
2. DEFINITIONS
For purposes of this Complaint:
(a) “Subject Vehicle” means the ☐[year/make/model] operated by Defendant at the time of the Subject Accident.
(b) “Plaintiff Vehicle” means the ☐[year/make/model] owned/operated by Plaintiff.
(c) “Serious Injury Threshold” refers to the statutory prerequisites to maintain a tort action under Hawai‘i’s Motor Vehicle Insurance Law, Haw. Rev. Stat. ch. 431:10C.
3. JURISDICTION & VENUE
3.1 This Court has subject-matter jurisdiction pursuant to Haw. Rev. Stat. § 603-21.5.
3.2 Venue is proper in this Circuit under Haw. Rev. Stat. § 603-36 because (a) the Subject Accident occurred within this Circuit and/or (b) Defendant resides or can be served here.
3.3 The amount in controversy exceeds $5,000, this matter is triable of right by a jury, and Plaintiff demands trial by jury in this Complaint under Haw. Rev. Stat. § 604-5(b). No specific damages amount is requested in this pleading.
4. COMPLIANCE WITH HAWAI‘I NO-FAULT STATUTE
4.1 Under Hawai‘i’s no-fault Motor Vehicle Insurance Law, Haw. Rev. Stat. § 431:10C-306(a), tort liability for accidental harm arising from a motor vehicle accident is abolished unless one of the exceptions in § 431:10C-306(b) applies.
4.2 Plaintiff satisfies at least one statutory exception to the abolition of tort liability in that (select all that apply):
(a) ☐ Plaintiff’s accident-related personal injury protection benefits incurred, paid, or payable equal or exceed $5,000, as calculated under Haw. Rev. Stat. § 431:10C-306(b)(4); and/or
(b) ☐ Plaintiff suffered a significant permanent loss of use of a part or function of the body, Haw. Rev. Stat. § 431:10C-306(b)(2); and/or
(c) ☐ Plaintiff suffered a permanent and serious disfigurement resulting in mental or emotional suffering, Haw. Rev. Stat. § 431:10C-306(b)(3); and/or
(d) ☐ Death occurred as a result of the Subject Accident, Haw. Rev. Stat. § 431:10C-306(b)(1).
4.3 Plaintiff has complied with all applicable notice and claim requirements under Haw. Rev. Stat. ch. 431, art. 10C.
4.4 Accordingly, Plaintiff is legally entitled to pursue tort remedies against Defendant.
4.5 This action is timely under Haw. Rev. Stat. § 431:10C-315(b). The accident occurred on ☐[DATE]; the last accident-related motor-vehicle insurance or optional-benefit payment, if any, was on ☐[DATE OR NONE]; and the last accident-related workers' compensation or public-assistance payment, if any, was on ☐[DATE OR NONE]. The filing date is within two years after the latest applicable date.
5. FACTUAL ALLEGATIONS
5.1 On ☐[DATE] at approximately ☐[TIME], Defendant operated the Subject Vehicle on ☐[STREET/ROUTE].
5.2 Defendant negligently ☐[describe specific act—e.g., failed to yield, exceeded the speed limit, drove while distracted], causing the Subject Vehicle to collide with the Plaintiff Vehicle.
5.3 As a direct and proximate result, Plaintiff sustained severe bodily injuries including, without limitation, ☐[list injuries], incurred medical expenses, and suffered pain, mental anguish, loss of enjoyment of life, and other damages.
5.4 At all relevant times, Plaintiff exercised reasonable care and was lawfully operating the Plaintiff Vehicle.
6. CAUSES OF ACTION
6.1 COUNT I – NEGLIGENCE
6.1.1 Plaintiff re-alleges and incorporates Paragraphs 1 through 5 as though fully set forth herein.
6.1.2 Defendant owed Plaintiff a duty to operate the Subject Vehicle with reasonable care, obey traffic laws, and avoid foreseeable risk of harm.
6.1.3 Defendant breached that duty by ☐[insert specific breaches].
6.1.4 Defendant’s breach was the actual and proximate cause of Plaintiff’s injuries and damages.
6.1.5 WHEREFORE, Plaintiff prays for judgment as set forth in Section 9 below.
6.2 COUNT II – TRAFFIC-RULE VIOLATION AS EVIDENCE OF NEGLIGENCE (optional)
6.2.1 Defendant violated ☐[identify traffic statute/regulation] intended to protect persons such as Plaintiff.
6.2.2 The violation is evidence of negligence to be weighed with all other evidence. Defendant’s negligent conduct caused Plaintiff’s damages as alleged.
6.3 COUNT III – LOSS OF CONSORTIUM (optional)
6.3.1 ☐[SPOUSE/PARTNER NAME] (“Consortium Plaintiff”) is the lawful spouse/domestic partner of Plaintiff.
6.3.2 As a direct result of Defendant’s negligence, Consortium Plaintiff has been deprived of Plaintiff’s companionship, services, society, and consortium.
7. COMPARATIVE NEGLIGENCE ALLEGATIONS
7.1 Should Defendant assert comparative negligence, Plaintiff affirmatively alleges that Plaintiff’s negligence, if any, is not greater than the negligence of Defendant (or, if more than one defendant, the aggregate negligence of the defendants against whom recovery is sought), such that recovery is not barred under Hawai‘i’s modified comparative negligence rule, Haw. Rev. Stat. § 663-31.
7.2 Plaintiff further alleges that any comparative negligence attributable to Plaintiff is minimal relative to Defendant’s misconduct, and that any damages awarded should be diminished only in proportion to the percentage of negligence, if any, so attributed to Plaintiff.
7.3 If more than one Defendant is found liable, Plaintiff alleges that joint and several liability applies to this motor-vehicle-accident tort action for both economic and noneconomic damages pursuant to Haw. Rev. Stat. § 663-10.9(2)(F), except as otherwise limited by § 663-10.9(4) (highway maintenance/design claims) or § 663-10.5 (government-entity tortfeasors), which impose a proportional-share (several) liability standard in those specific circumstances.
8. DAMAGES
8.1 Special Damages (economic):
(a) Past medical expenses;
(b) Future medical care;
(c) Past wage loss; and
(d) Future loss of earning capacity.
8.2 General Damages (non-economic): Pain and suffering, mental anguish, loss of enjoyment of life, and other intangible harms in an amount to be proven at trial.
8.3 Property Damage: Repair or replacement of Plaintiff Vehicle and personal property, as proved at trial.
8.4 Punitive Damages: Plaintiff reserves the right to seek punitive damages upon a showing, by clear and convincing evidence, that Defendant intended to harm Plaintiff, recklessly disregarded a substantial risk of harm to Plaintiff, or otherwise acted in an outrageous or malicious manner, consistent with Hawai‘i law. Guieb v. Guieb, 571 P.3d 382 (Haw. 2025) (adopting Restatement (Third) of Torts: Remedies § 39). There is no general statutory cap on punitive damages in Hawai‘i.
9. PRAYER FOR RELIEF
WHEREFORE, Plaintiff respectfully prays for:
(a) Judgment against Defendant for all special and general damages in amounts to be proven at trial;
(b) Punitive damages where authorized;
(c) Pre- and post-judgment interest as permitted by law;
(d) Taxable litigation costs as allowed by law;
(e) General relief within the minimum jurisdictional limits of this Court and such other relief as the Court deems just and proper.
10. JURY DEMAND
Pursuant to Article I, Section 13 of the Hawai‘i Constitution and Hawai‘i Rules of Civil Procedure Rule 38, Plaintiff hereby demands a trial by jury on all issues so triable.
11. COURT-ANNEXED ARBITRATION
For a tort action with a probable jury award value of $150,000 or less, calculated before any reduction for liability and excluding interest and costs, HRS § 601-20 requires submission to the mandatory, nonbinding court-annexed arbitration program, subject to the program's arbitrability determination. The Court may remove an action from the program.
12. COSTS
Plaintiff seeks taxable litigation costs as allowed by law. This negligence claim against the tortfeasor does not itself support attorneys’ fees under HRS §§ 607-14 or 431:10C-211.
13. OPTIONAL VERIFICATION
Hawai‘i R. Civ. P. 11(a) does not generally require a pleading to be verified unless another rule or statute specifically requires it. Complete this section only if a verified complaint is appropriate for the claims filed.
I, ☐[PLAINTIFF NAME], declare under penalty of perjury that I am the Plaintiff in the above-entitled action; I have read the foregoing Complaint and know its contents; and the same is true of my own knowledge except as to those matters stated on information and belief, and as to those matters I believe them to be true.
DATED: ☐[City], Hawai‘i, ☐[DATE].
________________________________________
☐[PLAINTIFF NAME]
14. INITIAL SERVICE OF PROCESS
Do not use a Rule 5 or JEFS certificate as a substitute for initial service on an unserved defendant. After filing, obtain the clerk-issued summons under HRCP Rule 4(a), serve the summons and Complaint together by the Rule 4(d) method applicable to each defendant, and have the process server make proof of service under Rule 4(g).
| Service-control item | Verified entry |
|---|---|
| Clerk-issued summons received | ☐ Yes ☐ No |
| Defendant and legal capacity | ☐[________________________________] |
| Rule 4(d) service method | ☐[________________________________] |
| Process server | ☐[________________________________] |
| Date and time served | ☐[__/__/____] ☐[____] |
| Proof of service filed | ☐ Yes ☐ No — filing date: ☐[__/__/____] |
SIGNATURE BLOCK
Respectfully submitted,
☐[LAW FIRM NAME]
By: ___________________________________
☐[ATTORNEY NAME]
Hawai‘i Bar No. ☐☐
☐[Firm Address]
Tel: ☐[___-___-____] | Fax: ☐[___-___-____]
Email: ☐[[email protected]]
Attorneys for Plaintiff
About this template
- Last updated
- October 30, 2026
- Jurisdiction
- Hawaii
- Category
- Personal Injury
Legal authority
- Haw. Rev. Stat. § 431:10C-315(b) (motor-vehicle tort filing deadline)
- Haw. Rev. Stat. § 601-20 (court-annexed arbitration for qualifying tort cases)
- Haw. Rev. Stat. § 663-31 (modified comparative negligence)
- Haw. Rev. Stat. § 663-10.9 (modified joint and several liability)
- Haw. Rev. Stat. § 431:10C-306 (no-fault abolition of tort liability; serious-injury threshold)
- Haw. Rev. Stat. § 603-21.5 (circuit court jurisdiction)
- Haw. Rev. Stat. § 604-5(b) (circuit filing with complaint jury demand when the amount exceeds $5,000)
- Haw. Rev. Stat. § 663-1.3 (no specified damages amount in personal-injury complaint)
- Haw. Rev. Stat. § 603-36 (venue)
- Haw. R. Civ. P. 8, 11, 38
- Guieb v. Guieb, 571 P.3d 382 (Haw. 2025) (punitive-damages standard)
- Haw. R. Civ. P. 4(a), (d), and (g) (summons, initial service, and proof)
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.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
The statutes this template relies on are listed under Legal authority.
HRS § 603-21.5(a)(3) (checked October 30, 2026): "Civil actions and proceedings, in addition to those listed in sections 603-21.6, 603-21.7, and 603-21.8"
HRS § 604-5(b) (checked October 30, 2026): "If the demand is made in the complaint and the matter is triable of right by a jury, the action may be commenced in the circuit court if the amount in controversy exceeds $5,000."
HRS § 663-1.3(a) (checked October 30, 2026): "no complaint, counterclaim, cross claim or third party claim nor any amendment to such pleadings shall specify the amount of damages prayed for"
Guieb v. Guieb, 156 Hawaiʻi 162, 571 P.3d 382 (2025) (checked October 30, 2026): "We adopt our new standard from the Restatement (Third) of Torts § 39 Punitive Damages:"
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