Personal Injury Complaint - Auto Accident - Minnesota
STATE OF MINNESOTA
DISTRICT COURT ― ___ JUDICIAL DISTRICT
COUNTY OF [COUNTY]
Court File No.: ___________
| Party | Role |
|---|---|
| [PLAINTIFF FULL LEGAL NAME], | Plaintiff, |
| v. | |
| [DEFENDANT FULL LEGAL NAME(S)], | Defendant(s). |
COMPLAINT FOR PERSONAL INJURY
ARISING OUT OF A MOTOR VEHICLE ACCIDENT
TABLE OF CONTENTS
- Document Header
- Definitions
- Parties
- Jurisdiction & Venue
- Factual Allegations
- Compliance with Minnesota No-Fault Thresholds
- Cause of Action – Negligence
- Damages
- Comparative Fault Allegations
- Prayer for Relief
- Demand for Jury Trial
- Verification & Acknowledgment
- Certificate of Service
1. DOCUMENT HEADER
1.1 Complaint Date. This Complaint is dated [DATE] and is intended for service with a summons in the District Court for [COUNTY] County, Minnesota.
1.2 Governing Law. All claims and defenses shall be determined under Minnesota substantive law and the Minnesota Rules of Civil Procedure.
2. DEFINITIONS
For purposes of this Complaint, the following capitalized terms shall have the meanings set forth below:
a. “Accident” means the motor vehicle collision that occurred on [MM/DD/YYYY] at or near [ADDRESS OR INTERSECTION], City of [CITY], Minnesota.
b. “Subject Vehicle(s)” means the vehicle operated by Defendant [DEF NAME], VIN [VIN], and, where applicable, the vehicle occupied by Plaintiff [PLAINTIFF NAME], VIN [VIN].
c. “No-Fault Act” means the Minnesota No-Fault Automobile Insurance Act, Minn. Stat. §§ 65B.41–65B.71.
d. “Threshold” means the statutory thresholds for maintaining a tort action under Minn. Stat. § 65B.51, subd. 3.
e. “Date of Loss” means the date of the Accident, [MM/DD/YYYY].
3. PARTIES
3.1 Plaintiff. Plaintiff [PLAINTIFF NAME] is an individual resident of [COUNTY], Minnesota and, at all material times, was lawfully operating or occupying the Subject Vehicle.
3.2 Defendant(s).
a. [DEFENDANT DRIVER NAME] is an individual resident of [COUNTY/STATE] who at all material times owned/operated the Subject Vehicle described above.
b. [DEFENDANT OWNER NAME] (if different) is the titled owner of the Subject Vehicle and is vicariously liable pursuant to Minn. Stat. § 169.09, subd. 5a.
4. JURISDICTION & VENUE
4.1 Subject-Matter Jurisdiction. This Court has jurisdiction over this civil action pursuant to Minn. Const. art. VI, § 3 and Minn. Stat. § 484.01.
4.2 Personal Jurisdiction. Defendant(s) are subject to personal jurisdiction in Minnesota because they reside in, transact business in, and/or committed tortious acts within the state.
4.3 Venue. Venue is proper in this County under Minn. Stat. § 542.09 because the Accident occurred here and/or at least one Defendant resides here.
5. FACTUAL ALLEGATIONS
5.1 On [DATE], at approximately [TIME], Plaintiff was [driving/passenger] in the Subject Vehicle traveling [DIRECTION] on [ROAD].
5.2 Defendant [DEF NAME] was operating the Subject Vehicle traveling [DIRECTION] on [ROAD].
5.3 Defendant had a duty to operate the Subject Vehicle with reasonable care, obey traffic laws, maintain proper lookout, and control speed.
5.4 Defendant breached that duty by, inter alia:
a. Failing to obey a traffic control device;
b. Following too closely;
c. Driving at an unsafe speed;
d. Failing to yield the right-of-way; and/or
e. Operating the vehicle while distracted or impaired.
5.5 As a direct and proximate result of Defendant’s negligence, the Accident occurred, causing serious bodily injuries and other damages to Plaintiff.
6. COMPLIANCE WITH MINNESOTA NO-FAULT THRESHOLDS
6.1 Pursuant to Minn. Stat. § 65B.51, subd. 3, Plaintiff has sustained injuries and losses that exceed the Threshold because one or more of the following applies:
a. The sum of reasonable medical expense benefits paid or payable (exclusive of diagnostic X-rays and non-remedial rehabilitation) exceeds $4,000; and/or
b. Plaintiff has suffered permanent disfigurement; and/or
c. Plaintiff has suffered permanent injury; and/or
d. Plaintiff has suffered death (for wrongful-death actions) or disability -- meaning the inability to engage in substantially all of Plaintiff's usual and customary daily activities -- for 60 days or more.
6.2 All required written notices have been provided to Plaintiff’s no-fault insurer, and any applicable coordination of benefits has been satisfied or will be resolved post-judgment.
7. CAUSE OF ACTION – NEGLIGENCE
7.1 Plaintiff restates and realleges ¶¶ 1–6 as if fully set forth herein.
7.2 Defendant owed Plaintiff a duty of reasonable care in the ownership, maintenance, and operation of the Subject Vehicle.
7.3 Defendant breached that duty as detailed above.
7.4 Defendant’s breaches were the direct and proximate cause of Plaintiff’s injuries and damages, including past and future:
a. Medical expenses;
b. Wage loss and loss of earning capacity;
c. Pain, suffering, and emotional distress;
d. Loss of the enjoyment of life;
e. Property damage; and
f. Incidental and consequential expenses.
7.5 WHEREFORE, Plaintiff seeks judgment as set forth in the Prayer for Relief.
8. DAMAGES
8.1 Plaintiff seeks an amount exceeding $50,000 exclusive of interest and costs, to be fully proven at trial.
8.2 Punitive Damages. This Complaint does not assert a claim for punitive damages. As required by Minn. Stat. § 549.191, Plaintiff reserves the right to move, after commencement of this action and upon a supporting affidavit showing a prima facie case under Minn. Stat. § 549.20 (clear and convincing evidence of Defendant's deliberate disregard for the rights or safety of others), to amend the pleadings to add a claim for punitive damages.
8.3 Any recovery of damages shall be subject to statutory limitations, if any, but Plaintiff pleads the maximum amount allowable by law.
9. COMPARATIVE FAULT ALLEGATIONS
9.1 Plaintiff denies any comparative fault.
9.2 In the alternative, pursuant to Minn. Stat. § 604.01, Plaintiff's contributory fault, if any, was not greater than the fault of each person against whom recovery is sought and does not bar recovery against that person; any allowed damages should be reduced only by the percentage of fault attributable to Plaintiff.
9.3 If more than one Defendant is liable, contributions are generally proportional to fault. A person is jointly and severally liable for the whole award under § 604.02, subd. 1 only when fault exceeds 50 percent, the person participates in a common scheme or plan resulting in injury, the person commits an intentional tort, or liability arises under the listed environmental/public-health laws.
10. PRAYER FOR RELIEF
WHEREFORE, Plaintiff respectfully requests that the Court enter judgment:
A. Awarding [SELECT ONE: $[AMOUNT] in unliquidated damages / reasonable damages in an amount greater than $50,000];
B. Awarding costs, disbursements, and prejudgment interest as allowed by law;
C. Reserving Plaintiff's right to move to amend this Complaint to add a claim for punitive damages pursuant to Minn. Stat. § 549.191, should the evidence warrant;
D. Granting such other and further relief as the Court deems just and equitable.
11. DEMAND FOR JURY TRIAL
Plaintiff demands a trial by jury on all issues so triable under Minn. Const. art. I, § 4 and Minn. R. Civ. P. 38.
12. VERIFICATION & SANCTIONS ACKNOWLEDGMENT
I, [PLAINTIFF NAME], state: I declare under penalty of perjury that everything I have stated in this document is true and correct.
___________________________________
[PLAINTIFF NAME], Plaintiff
Signed on [DATE] in [COUNTY] County, [STATE].
Acknowledgment under Minn. Stat. § 549.211, subd. 1: Plaintiff acknowledges that sanctions may be imposed under Minn. Stat. § 549.211.
Date: _______________ ___________________________________
[ATTORNEY NAME] (#________)
[LAW FIRM NAME]
[ADDRESS]
[PHONE] | [EMAIL]
Attorney for Plaintiff
13. INITIAL SERVICE RECORD
At filing: Provide the district court administrator a completed Form CIV117 Civil Cover Sheet under Minn. Gen. R. Prac. 104. This non-family personal injury action is outside Rule 111.01's listed exceptions.
Serve the summons and complaint on each defendant under Minn. R. Civ. P. 3.01–3.02 and 4. Service or another Rule 3.01 event commences the action against that defendant; file the action within one year of commencement under Rule 5.04(a), absent a timely stipulation extending that period. Record each defendant's service separately. Under Rule 4.06, obtain the serving sheriff's or peace officer's certificate, the other server's affidavit, the defendant's written acknowledgment, or the publication affidavit as applicable. The proof should state the time, place, and manner of service when service is not by publication.
| Defendant | Date and time | Place | Manner of service | Server / proof |
|---|---|---|---|---|
| [DEFENDANT] | [DATE / TIME] | [ADDRESS] | [METHOD] | [NAME / PROOF TYPE] |
About this template
- Last updated
- November 9, 2026
- Jurisdiction
- Minnesota
- Category
- Personal Injury
Legal authority
- Minn. Stat. §§ 65B.41–65B.71 (Minnesota No-Fault Automobile Insurance Act)
- Minn. Stat. § 65B.51, subd. 3 (no-fault tort threshold)
- Minn. Stat. § 604.01 (comparative fault; person-specific not-greater-than comparison)
- Minn. Stat. § 604.02, subd. 1 (several liability with four listed joint-liability categories)
- Minn. Stat. § 169.09, subd. 5a (driver deemed agent of owner)
- Minn. Stat. § 541.05, subd. 1(5) (six-year statute of limitations for personal injury)
- Minn. Stat. § 549.20 (punitive damages standard)
- Minn. Stat. § 549.191 (procedure to add a punitive damages claim by motion)
- Minn. Stat. § 484.01 (district court jurisdiction)
- Minn. Stat. § 542.09 (venue)
- Minn. R. Civ. P. 8.01 (damages demand)
- Minn. Gen. R. Prac. 104 (civil cover sheet at filing)
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.
Minn. Gen. R. Prac. 104(b) (checked November 9, 2026): "If the case is a non-family civil case other than those listed in Rule 111.01, basic information about the case in a Civil Cover Sheet"
Minn. R. Civ. P. 3.01 (checked November 7, 2026): "A civil action is commenced against each defendant: (a) when the summons is served upon that defendant"
Minn. R. Civ. P. 5.04(a) (checked November 7, 2026): "Any action that is not filed with the court within one year of commencement against any party is deemed dismissed with prejudice"
Minn. Stat. § 549.211, subd. 1 (checked November 6, 2026): "a signed acknowledgment stating that the parties acknowledge that sanctions may be imposed under this section."
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