IN THE VERMONT SUPERIOR COURT
[COUNTY] UNIT │ CIVIL DIVISION
Docket No. _______
______,
Plaintiff,
v.
_____,
Defendant(s).
_____/
COMPLAINT FOR PERSONAL INJURY
(Slip-and-Fall – Premises Liability)
AND DEMAND FOR TRIAL BY JURY
[// GUIDANCE: Insert the correct county, docket number (assigned by the clerk), and complete party names exactly as they appear in any pre-suit correspondence or insurance materials.]
TABLE OF CONTENTS
- Parties .............................................................................................. 2
- Jurisdiction, Venue & Jury Demand ...................................... 2
- Definitions ..................................................................................... 3
- Factual Allegations ........................................................................ 4
- Count I – Negligence (Premises Liability) ................................. 6
- Comparative Fault Allegation (12 V.S.A. § 1036) ...................... 7
- Damages ........................................................................................ 7
- Prayer for Relief ............................................................................ 8
- Reservation of Rights & Amendment ...................................... 9
- Verification, Signature & Certifications ................................ 9
[// GUIDANCE: Delete the Table of Contents after filing if the clerk’s office or local rules prohibit it.]
1. PARTIES
1.1 Plaintiff. [PLAINTIFF FULL LEGAL NAME], an individual residing at [PLAINTIFF ADDRESS] (“Plaintiff”).
1.2 Defendant. [DEFENDANT FULL LEGAL NAME], a [TYPE OF ENTITY OR INDIVIDUAL] with a principal place of business/residence at [DEFENDANT ADDRESS] (“Defendant”).
1.3 Additional Parties. [IF APPLICABLE: John Doe 1-5, currently unknown persons or entities whose identities will be added upon discovery.]
2. JURISDICTION, VENUE & JURY DEMAND
2.1 Subject-Matter Jurisdiction. This Court has jurisdiction pursuant to Vt. Const. ch. II, § 31 and V.R.C.P. 3.
2.2 Personal Jurisdiction. Defendant is subject to personal jurisdiction in Vermont because Defendant [is domiciled in Vermont / conducts systematic and continuous business in Vermont / committed the tortious conduct in Vermont].
2.3 Venue. Venue is proper in this Unit under 12 V.S.A. § 402 because the cause of action arose in this county.
2.4 Jury Demand. Plaintiff demands a trial by jury on all issues so triable as of right pursuant to V.R.C.P. 38 and the Seventh Amendment to the U.S. Constitution.
3. DEFINITIONS
For purposes of this Complaint, the following capitalized terms have the meanings given below. These definitions apply throughout the pleading unless the context clearly indicates otherwise.
“Incident” means the slip-and-fall event that occurred on [DATE OF INCIDENT] at the Premises.
“Premises” means the property commonly known as [STREET ADDRESS OR KNOWN DESCRIPTION] owned, operated, or controlled by Defendant at all relevant times.
“Hazardous Condition” means the [wet floor/accumulated ice/snow/debris/uneven surface], which was unreasonably dangerous, not open or obvious, and not adequately warned of or remedied by Defendant.
4. FACTUAL ALLEGATIONS
4.1 On or about [DATE OF INCIDENT] at approximately [TIME], Plaintiff lawfully entered the Premises for the purpose of [BUSINESS INVITE / SOCIAL GUEST / LICENSEE DESCRIPTION].
4.2 At all relevant times, Defendant owned, operated, maintained, managed, and/or controlled the Premises, including the area where the Incident occurred.
4.3 A Hazardous Condition existed in the [specific location, e.g., “main entrance vestibule”] of the Premises.
4.4 The Hazardous Condition was the foreseeable result of Defendant’s failure to:
(a) inspect the Premises within reasonable intervals;
(b) remove or remediate the hazard; and
(c) warn invitees, including Plaintiff, of the hazard.
4.5 Defendant had actual or constructive notice of the Hazardous Condition by virtue of [prior complaints / employee observations / duration of the condition], yet failed to act reasonably.
4.6 As Plaintiff attempted to [walk/exit/enter] the Premises, Plaintiff slipped/tripped on the Hazardous Condition, fell, and sustained serious bodily injuries, including but not limited to [LIST INJURIES].
4.7 Plaintiff’s injuries required medical treatment, resulting in past and future medical expenses, lost wages, diminished earning capacity, pain and suffering, and loss of enjoyment of life.
4.8 Plaintiff complied with all applicable notice requirements, including any mandated by insurance policies, lease provisions, or municipal ordinances.
[// GUIDANCE: If the defendant is a municipality or the State of Vermont, insert compliance with 12 V.S.A. § 5604 (claims against the State) or local notice statutes. If purely private, no formal pre-suit statutory notice is required in Vermont.]
5. COUNT I – NEGLIGENCE (PREMISES LIABILITY)
5.1 Plaintiff realleges and incorporates ¶¶ 1.1–4.8 as though fully set forth herein.
5.2 Duty. Defendant owed Plaintiff, a lawful entrant, a duty of reasonable care to keep the Premises in a reasonably safe condition, inspect for hazards, remedy hazards within a reasonable time, and warn of any latent dangers.
5.3 Breach. Defendant breached that duty by:
(a) Allowing the Hazardous Condition to remain;
(b) Failing to provide adequate warning (signage, barricades, etc.); and
(c) Failing to establish or follow reasonable inspection and maintenance protocols.
5.4 Causation. Defendant’s breach was the direct and proximate cause of Plaintiff’s injuries.
5.5 Damages. Plaintiff suffered the damages described in Section 7 below.
6. COMPARATIVE FAULT ALLEGATION
(12 V.S.A. § 1036)
6.1 Plaintiff asserts that any negligence attributable to Plaintiff is equal to or less than the negligence attributable to Defendant and/or other responsible parties, such that Plaintiff’s recovery is not barred under Vermont’s modified comparative fault statute, 12 V.S.A. § 1036.
6.2 To the extent Defendant claims comparative negligence, Plaintiff denies such allegations and demands strict proof.
7. DAMAGES
7.1 Economic Damages
(a) Past medical expenses: $[_]
(b) Future medical expenses: $[_]
(c) Past lost wages: $[_]
(d) Future loss of earning capacity: $[_]
7.2 Non-Economic Damages
(a) Pain and suffering—past and future
(b) Emotional distress
(c) Loss of enjoyment of life
7.3 Pre- and post-judgment interest as allowed by law.
7.4 Costs as provided under V.R.C.P. 54(d).
[// GUIDANCE: Vermont presently has no statutory cap on personal-injury damages for private defendants; remove or modify if Defendant is subject to sovereign immunity or other statutory cap.]
8. PRAYER FOR RELIEF
WHEREFORE, Plaintiff respectfully requests that the Court enter judgment in Plaintiff’s favor and against Defendant as follows:
A. Compensatory damages in an amount sufficient to fully and fairly compensate Plaintiff;
B. Pre- and post-judgment interest as permitted by 12 V.S.A. § 2903;
C. Costs and allowable expenses;
D. Such further relief as the Court deems just and equitable.
9. RESERVATION OF RIGHTS & AMENDMENT
Plaintiff reserves the right to amend this Complaint to add additional causes of action, parties, or damages as discovery may reveal, pursuant to V.R.C.P. 15.
10. VERIFICATION, SIGNATURE & CERTIFICATIONS
[// GUIDANCE: Some Vermont counties require verification in personal-injury cases; confirm with local rules. Delete if inapplicable.]
I, [PLAINTIFF NAME], being duly sworn, depose and state that the foregoing Complaint is true and accurate to the best of my knowledge, information, and belief.
[PLAINTIFF NAME], Plaintiff
Date: _______
Respectfully submitted,
[ATTORNEY NAME], Esq.
[VT BAR # ____]
[FIRM NAME]
[ADDRESS]
[TELEPHONE] │ [EMAIL]
Counsel for Plaintiff
Date: _______
Certificate of Service
I certify that on the _ day of _, 20__, I served a copy of this Complaint on:
[DEFENSE COUNSEL OR DEFENDANT ADDRESS]
by [U.S. Mail / hand delivery / electronic service pursuant to V.R.C.P. 5].
[ATTORNEY NAME], Esq.
[// GUIDANCE FOR PRACTITIONERS]
- Statute of Limitations: 12 V.S.A. § 512 provides a three-year limitations period for personal-injury actions. Verify incident date before filing.
- Municipal or State Defendants: Strict notice and timing requirements apply (see 12 V.S.A. § 5604 and relevant municipal charters).
- Service of Process: Follow V.R.C.P. 4 for summons issuance and service, including special rules for corporations and out-of-state defendants.
- Comparative Fault: Plead in anticipation of affirmative defenses to preserve the right to jury apportionment under 12 V.S.A. § 1036.
- Discovery Preservation: Send a litigation-hold letter to Defendant to prevent spoliation of surveillance footage or maintenance logs.
- Medical Records Authorization: Obtain HIPAA-compliant authorization to expedite discovery and facilitate settlement discussions.
- Damages Worksheet: Maintain a running spreadsheet of expenses and wage loss to support mandatory disclosures under V.R.C.P. 26(a)(1).
[END OF TEMPLATE]