Personal Injury Complaint - Auto Accident

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PERSONAL INJURY – AUTO ACCIDENT

FORM COMPLAINT

Jurisdiction: West Virginia State Courts


TABLE OF CONTENTS

  1. Caption
  2. Complaint
    2.1 Preliminary Statement / Nature of Action
    2.2 Jurisdiction and Venue
    2.3 Parties
    2.4 Facts Common to All Counts
    2.5 Counts
    Count I — Negligence
    Count II — Negligence Per Se (optional)
    Count III — Negligent Entrustment / Respondeat Superior (optional)
    2.6 Damages
    2.7 Comparative Fault Statement
    2.8 Prayer for Relief
    2.9 Jury Demand
    2.10 Request for Service

  3. Verification

  4. Certificate of Counsel (Rule 11)

1. CAPTION

            IN THE CIRCUIT COURT OF [COUNTY] COUNTY, WEST VIRGINIA

[PLAINTIFF NAME],                                               )
     Plaintiff,                                                 )
                                                                )
v.                                                              )      Civil Action No. ___________
                                                                )
[DEFENDANT DRIVER NAME],                                        )
and                                                             )
[DEFENDANT OWNER / EMPLOYER NAME],                              )
     Defendants.                                                )

                                     COMPLAINT

2. COMPLAINT

2.1 Preliminary Statement / Nature of Action

  1. Plaintiff [PLAINTIFF NAME] (“Plaintiff”) brings this civil action arising from a motor-vehicle collision that occurred on [DATE OF ACCIDENT] in [LOCATION], West Virginia.
  2. Plaintiff seeks monetary relief for personal injuries and property damage proximately caused by Defendants’ negligent and unlawful conduct.

2.2 Jurisdiction and Venue

  1. This Court has subject-matter jurisdiction under W. Va. Const. art. VIII § 6 and W. Va. Code § 51-2-2 because the amount in controversy exceeds the jurisdictional minimum of the Magistrate Court and the acts giving rise to this claim occurred in this County.
  2. Venue is proper in this County pursuant to W. Va. Code § 56-1-1 because the collision occurred here and Defendants reside and/or conduct business here.

2.3 Parties

  1. Plaintiff is an adult resident of [PLAINTIFF COUNTY], West Virginia, residing at [ADDRESS].
  2. Defendant [DEFENDANT DRIVER NAME] (“Driver Defendant”) is an adult resident of [DRIVER COUNTY] with a principal residence at [ADDRESS].
  3. Defendant [DEFENDANT OWNER / EMPLOYER NAME] (“Owner/Employer Defendant”) is a [corporation / LLC / individual] with its principal place of business at [ADDRESS]. At all relevant times, Owner/Employer Defendant owned, leased, and/or had legal control of the vehicle operated by Driver Defendant.

2.4 Facts Common to All Counts

  1. On [DATE], at approximately [TIME], Driver Defendant operated a [YEAR/MAKE/MODEL] bearing VIN [VIN] and license plate [PLATE] in [DIRECTION] on [ROADWAY] near [LANDMARK].
  2. Driver Defendant failed to [describe act/omission — e.g., maintain lane, obey traffic signal, yield right-of-way], in violation of West Virginia traffic laws.
  3. As a direct and proximate result, Driver Defendant collided with Plaintiff’s vehicle, a [YEAR/MAKE/MODEL] travelling [DIRECTION].
  4. Plaintiff suffered serious bodily injury, including but not limited to [LIST INJURIES], incurred medical expenses, lost wages, property damage, pain, suffering, emotional distress, and loss of enjoyment of life.
  5. At all material times, Driver Defendant was acting within the scope of employment and/or agency for Owner/Employer Defendant, who had the right to control Driver Defendant’s operation of the vehicle.

2.5 Counts

COUNT I — NEGLIGENCE (Against All Defendants)
  1. Plaintiff incorporates ¶¶1-12 as if fully set forth herein.
  2. Driver Defendant owed Plaintiff a duty to operate the vehicle with reasonable care.
  3. Driver Defendant breached that duty by, inter alia, [SPECIFY BREACHES].
  4. Owner/Employer Defendant is liable under the doctrines of respondeat superior and negligent entrustment for Driver Defendant’s negligence and for its own failure to ensure competent operation of the vehicle.
  5. Defendants’ negligence was the direct and proximate cause of Plaintiff’s injuries and damages set forth below.
COUNT II — NEGLIGENCE PER SE (Optional)
  1. Plaintiff incorporates ¶¶1-17.
  2. Driver Defendant violated West Virginia traffic statutes and regulations including but not limited to [LIST STATUTORY VIOLATION, e.g., W. Va. Code § 17C-5-2 (DUI) or § 17C-15-1 (equipment)], constituting negligence per se.
COUNT III — NEGLIGENT ENTRUSTMENT / RESPONDEAT SUPERIOR (Optional)
  1. Plaintiff incorporates ¶¶1-19.
  2. Owner/Employer Defendant knew or should have known that Driver Defendant was [unlicensed / incompetent / impaired] and nevertheless entrusted the vehicle to Driver Defendant.
  3. Such entrustment was a proximate cause of Plaintiff’s injuries.

2.6 Damages

  1. Plaintiff has sustained:
    a. Past and future medical expenses;
    b. Past and future lost earnings and diminished earning capacity;
    c. Property damage to Plaintiff’s vehicle and personal property;
    d. Past and future pain, suffering, mental anguish, and loss of enjoyment of life;
    e. Permanent impairment and disability;
    f. Punitive damages to punish and deter Defendants’ willful, wanton, or reckless conduct, subject to statutory caps; and
    g. All other damages permissible under West Virginia law.

2.7 Comparative Fault Statement

  1. Plaintiff’s recovery shall be reduced, if at all, only in proportion to any percentage of fault attributed to Plaintiff, and Plaintiff shall be barred from recovery only if Plaintiff’s fault is greater than the combined fault of all Defendants, consistent with West Virginia’s modified comparative negligence framework.

2.8 Prayer for Relief

WHEREFORE, Plaintiff respectfully requests that this Court enter judgment in favor of Plaintiff and against Defendants, jointly and severally, for:

  1. Compensatory damages as proven at trial;
  2. Punitive damages as applicable and permitted by law;
  3. Pre- and post-judgment interest;
  4. Reasonable attorneys’ fees and litigation costs as allowed by law;
  5. Such other and further relief as the Court deems just and proper.

2.9 JURY DEMAND

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

2.10 Request for Service

Please serve each Defendant pursuant to Rule 4 of the West Virginia Rules of Civil Procedure at the following address(es):
• Driver Defendant: [ADDRESS]
• Owner/Employer Defendant: [ADDRESS / REGISTERED AGENT]


3. VERIFICATION

     I, [PLAINTIFF NAME], being first duly sworn, state that I have read the foregoing
Complaint and that the factual allegations are true and correct to the best of my
knowledge, information, and belief.

_________________________________        Date: ____________________
[PLAINTIFF NAME], Plaintiff

4. CERTIFICATE OF COUNSEL (Rule 11)

     I certify that to the best of my knowledge, information, and belief, formed after
reasonable inquiry, this pleading is well-grounded in fact and is warranted by existing
law or a good-faith argument for the extension, modification, or reversal of existing
law; and that it is not interposed for any improper purpose.

_________________________________
[ATTORNEY NAME] (WV Bar # ______)
[LAW FIRM]
[ADDRESS]
[PHONE] | [EMAIL]
Counsel for Plaintiff

END OF DOCUMENT

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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