Personal Injury Complaint - Slip and Fall
ATTORNEY FOR PLAINTIFF
[LAW FIRM NAME]
[Address]
[City, State ZIP]
[Telephone] | [Facsimile]
Attorney I.D. No.: [######]
E-Mail: [EMAIL]
SUPERIOR COURT OF NEW JERSEY
LAW DIVISION — [COUNTY] COUNTY
| [PLAINTIFF FULL NAME], | Docket No.: [______________] |
| Plaintiff, | |
| Civil Action | |
| v. | |
| COMPLAINT AND JURY DEMAND | |
| [DEFENDANT ENTITY NAME] d/b/a [TRADE NAME], and | (Slip-and-Fall – Premises Liability) |
| JOHN/JANE DOES 1-10 (fictitious individuals), and | |
| XYZ CORPS 1-10 (fictitious entities), | |
| Defendants. |
TABLE OF CONTENTS
- Document Header
- Definitions
- Operative Allegations
- Count I – Premises Liability / Negligence
- Damages
- Jury Demand
- Prayer for Relief
- Certification of Counsel (R. 4:5-1)
- Verification
I. DOCUMENT HEADER
1. Parties & Caption
See above caption. Plaintiff is an adult resident of [County, State]. Defendant [ENTITY] is a [state] [corporation/LLC] authorized to do business in New Jersey with its principal place of business at [address].
2. Recitals
a. On or about [INCIDENT DATE] ("Incident Date"), Plaintiff lawfully entered the interior/exterior premises located at [PREMISES ADDRESS] (the "Premises").
b. While on the Premises, Plaintiff suffered severe bodily injuries after slipping/tripping and falling (the "Incident").
3. Effective Date & Jurisdiction
This pleading is filed pursuant to the New Jersey Court Rules on this ___ day of [MONTH], 20[YY]. Jurisdiction and venue are proper in this Court under N.J. Court Rule 4:3-2 and, as to allocation of fault, N.J.S.A. 2A:15-5.1 et seq.
II. DEFINITIONS
For ease of reference, the following terms are capitalized herein:
- "Incident" – the slip-and-fall event of [INCIDENT DATE] described in this Complaint.
- "Incident Date" – [DATE].
- "Plaintiff" – [PLAINTIFF FULL NAME].
- "Defendant" or "Premises Owner" – [DEFENDANT ENTITY NAME].
- "Premises" – the building, land, curtilage, fixtures, appurtenances, parking areas, walkways, and all other improvements located at [ADDRESS] and owned, occupied, leased, or controlled by Defendant at all relevant times.
III. OPERATIVE ALLEGATIONS
A. Parties
-
Plaintiff is, and at all relevant times was, a lawful invitee/business patron on the Premises.
-
Defendant is, and at all relevant times was, responsible for the ownership, maintenance, inspection, repair, and control of the Premises.
-
JOHN/JANE DOES 1-10 are persons whose identities are presently unknown who negligently caused or contributed to the Incident. XYZ CORPS 1-10 are unknown business entities liable for the Incident. Plaintiff will amend this Complaint upon discovery of their identities.
B. Jurisdiction & Venue
-
The amount in controversy exceeds the jurisdictional threshold of the Special Civil Part and this matter is properly filed in the Law Division.
-
Venue lies in [COUNTY] pursuant to N.J. Court Rule 4:3-2 because the cause of action arose in this county and/or Defendant resides or conducts business here.
C. Factual Allegations
-
On the Incident Date, Plaintiff was walking [describe location, e.g., "down Aisle 3 of Defendant's retail store"].
-
Plaintiff slipped on a hazardous condition, namely [describe—e.g., "an accumulation of liquid without warning signs"] (the "Dangerous Condition").
-
The Dangerous Condition existed for an unreasonable period and/or was created by Defendant or its agents.
-
Defendant had actual and/or constructive notice of the Dangerous Condition and failed to remedy or warn.
-
As a direct and proximate result, Plaintiff sustained serious injuries including but not limited to [list injuries], incurred medical expenses, and suffered pain, impairment, and loss of enjoyment of life.
D. Notice Requirements
- To the extent required by law, Plaintiff provided timely notice, or Defendant otherwise had actual notice, of Plaintiff's claims arising from the Incident.
E. Comparative Fault Preservation
- Pursuant to the New Jersey Comparative Negligence Act, N.J.S.A. 2A:15-5.1 et seq., Plaintiff's recovery shall be diminished only by any percentage of negligence, if any, attributable to Plaintiff, and barred only if such percentage is 51% or greater. Plaintiff denies any comparative fault.
IV. COUNT I – PREMISES LIABILITY / NEGLIGENCE
-
Plaintiff repeats and realleges Paragraphs 1-15 as if fully set forth herein.
-
Defendant owed Plaintiff a duty of reasonable care to maintain the Premises in a safe condition, to inspect for hazards, to remediate dangerous conditions, and to warn lawful visitors of same, commensurate with Plaintiff's status as an invitee, licensee, or trespasser as set forth in Paragraph 4 above.
-
Defendant breached those duties by:
a. Failing to properly inspect and maintain the Premises;
b. Creating and/or permitting the Dangerous Condition to exist;
c. Failing to post warnings or barriers; and
d. Otherwise acting with negligence, carelessness, and recklessness.
- Defendant's breach was the direct and proximate cause of Plaintiff's injuries and damages.
V. DAMAGES
- As a result of Defendant's negligence, Plaintiff suffered:
- Past and future medical expenses;
- Past and future lost wages and loss of earning capacity;
- Pain and suffering, disability, impairment, and loss of enjoyment of life;
- Property damage (if applicable); and
- Such other damages as may be proved at trial.
- Plaintiff reserves the right to seek punitive damages if discovery warrants. Any award of punitive damages must be supported by clear and convincing evidence of actual malice or wanton and willful disregard under N.J.S.A. 2A:15-5.12, and is subject to the cap under N.J.S.A. 2A:15-5.14 (the greater of $350,000 or five times compensatory damages).
VI. JURY DEMAND
- Plaintiff demands a trial by jury on all issues so triable as of right under N.J. Const. art. I, ¶ 9 and N.J. Court Rule 1:8-1.
VII. PRAYER FOR RELIEF
WHEREFORE, Plaintiff respectfully requests judgment against Defendants, jointly and severally to the extent permitted under N.J.S.A. 2A:15-5.3, for:
a. Compensatory damages;
b. Punitive damages where allowed and warranted;
c. Pre- and post-judgment interest;
d. Costs of suit and reasonable attorney's fees as allowed by law;
e. Such other and further relief as the Court deems just and equitable.
VIII. CERTIFICATION OF COUNSEL (R. 4:5-1(b)(2))
I certify that, to the best of my knowledge, the matter in controversy is not the subject of any other pending or contemplated action, arbitration, or administrative proceeding, nor are any other parties expected to be joined. I further certify that confidential personal identifiers have been redacted from documents submitted to the court in accordance with R. 1:38-7(b).
[ATTORNEY NAME], Esq.
Dated: __________
IX. VERIFICATION
[PLAINTIFF NAME], being duly sworn, deposes and says: I am the Plaintiff in the foregoing matter; I have read the Complaint; the allegations are true to the best of my knowledge, information, and belief.
_____________________________
[PLAINTIFF NAME]
Sworn and subscribed before me
this ___ day of __________, 20__
________________________________
Notary Public of New Jersey
My Commission Expires: __________
X. SIGNATURE BLOCK
Respectfully submitted,
[LAW FIRM NAME]
Attorneys for Plaintiff
By: _________________________________
[ATTORNEY NAME], Esq.
Dated: __________________
END OF COMPLAINT
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: July 2026
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