IN THE ☐ CIRCUIT/SUPERIOR COURT

[___] COUNTY, STATE OF INDIANA

[PLAINTIFF FULL LEGAL NAME],
  Plaintiff,

v. Cause No.: ☐
[// GUIDANCE: Clerk supplies
case number upon filing]

[DEFENDANT FULL LEGAL NAME],
  Defendant.

COMPLAINT FOR PERSONAL INJURY AND
DEMAND FOR TRIAL BY JURY

[// GUIDANCE: Verify local filing requirements (e-filing portal, appearance form, summons, filing fee) before submission. Indiana Trial Rules 3, 4 & 5 control initiation and service of civil actions.]

TABLE OF CONTENTS

1. Parties ............................................................................................................... 2
2. Jurisdiction and Venue ..................................................................................... 2
3. Factual Allegations ............................................................................................ 3
4. Count I – Negligence ........................................................................................ 4
5. Damages ............................................................................................................ 5
6. Prayer for Relief ................................................................................................. 6
7. Jury Demand ..................................................................................................... 7
8. Certification of Service ..................................................................................... 7
9. Verification (Optional) ....................................................................................... 8

1. PARTIES

1.1 Plaintiff [PLAINTIFF NAME] (“Plaintiff”) is an individual resident of [Street Address, City, Indiana ZIP], and at all relevant times resided in [County] County, Indiana.

1.2 Defendant [DEFENDANT NAME] (“Defendant”) is [an individual/a corporation/other entity] with principal place of business at [Address]. Defendant may be served with process at [Registered Agent/Address].

2. JURISDICTION AND VENUE

2.1 This Court has subject-matter jurisdiction under Indiana’s constitutional grant of general civil jurisdiction to circuit and superior courts and pursuant to Indiana Code governing tort claims.

2.2 Personal jurisdiction is proper because Defendant [resides in, maintains its principal place of business in, and/or committed tortious acts within] the State of Indiana.

2.3 Venue lies in this Court under Indiana Trial Rule 75(A)(1)–(3) in that the events giving rise to this action occurred in [County] County and/or Defendant resides or does business here.

3. FACTUAL ALLEGATIONS

3.1 On or about [Date], at approximately [Time], Plaintiff was lawfully present at/on [Exact Location].

3.2 At that time and place, Defendant [describe negligent act/omission—e.g., “operated a motor vehicle while distracted and failed to yield the right of way”].

3.3 Defendant owed Plaintiff a duty of reasonable care under Indiana common-law negligence principles.

3.4 Defendant breached that duty by [specific acts/omissions].

3.5 As a direct and proximate result of Defendant’s breach, Plaintiff suffered bodily injuries including but not limited to [list injuries], incurred medical expenses, lost wages, experienced pain and suffering, and sustained other damages described herein.

3.6 Plaintiff has complied with all conditions precedent to the filing of this action, including any statutory notice requirements, if applicable.

4. COUNT I – NEGLIGENCE

4.1 Plaintiff realleges and incorporates Paragraphs 1.1 through 3.6 as though fully set forth herein.

4.2 Duty. Defendant owed Plaintiff a duty to exercise reasonable care for the safety of others consistent with Indiana’s ordinary negligence standard.

4.3 Breach. Defendant breached the duty by the acts and omissions detailed above.

4.4 Causation. Defendant’s breach was both the actual and proximate cause of Plaintiff’s injuries.

4.5 Damages. Plaintiff suffered the damages set forth in Section 5 below.

4.6 Comparative Fault. Pursuant to Indiana’s Comparative Fault Act, Plaintiff’s recovery, if any, should be reduced only by the percentage of fault, if any, attributed to Plaintiff, and Plaintiff’s action is barred only if Plaintiff’s fault exceeds 50 percent.

4.7 Joint and Several Liability. To the extent more than one tortfeasor is found liable and Indiana law permits, Plaintiff seeks judgment against each Defendant for that party’s comparative share of fault, together with all available relief against parties liable under theories of vicarious liability or concerted action.

5. DAMAGES

Subject to Indiana’s statutory damage limitations, Plaintiff seeks:

a. Past and future medical expenses;
b. Past and future lost wages and loss of earning capacity;
c. Compensation for pain, suffering, mental anguish, and loss of enjoyment of life;
d. Property damage (if applicable);
e. Pre- and post-judgment interest as allowed by law;
f. Reasonable costs of this action;
g. Punitive damages in an amount permissible under the Indiana punitive damages cap (currently the greater of three times compensatory damages or \$50,000), to deter and punish willful and wanton misconduct; and
h. All other relief the Court deems just and proper.

[// GUIDANCE: Remove punitive-damage request if facts do not support “willful and wanton” or “gross negligence,” or if punitive damages are strategically unwise.]

6. PRAYER FOR RELIEF

WHEREFORE, Plaintiff respectfully requests that the Court enter judgment in favor of Plaintiff and against Defendant as follows:

1. Awarding compensatory damages in an amount to be proven at trial;
2. Awarding punitive damages consistent with statutory caps, if supported by the evidence;
3. Awarding costs, expenses, and prejudgment interest;
4. Ordering such other and further relief as the Court deems equitable and just.

7. DEMAND FOR TRIAL BY JURY

Pursuant to Indiana Trial Rule 38 and Article 1, Section 20 of the Indiana Constitution, Plaintiff hereby demands trial by jury on all issues so triable.

8. CERTIFICATE OF SERVICE

I certify that on the ___ day of __________ 20__, a copy of the foregoing was served upon the following parties/attorneys of record via [e-filing system/certified mail/hand delivery] in accordance with Indiana Trial Rule 5:

• [Name & address of counsel/party]

/ / /

9. VERIFICATION (Optional – use if local rule or strategic considerations warrant)

I, [PLAINTIFF NAME], affirm under the penalties for perjury that the foregoing representations are true to the best of my knowledge, information, and belief.

____________________________________
[PLAINTIFF NAME]

Date: ________________

ATTORNEY SIGNATURE BLOCK

Respectfully submitted,

[LAW FIRM NAME]
[Street Address] | [City], Indiana [ZIP]
Tel.: [___] Fax: [___]
E-mail: [___]

By: _________________________________
[ATTORNEY NAME], #________-__
Attorney for Plaintiff

[// GUIDANCE: Include Indiana Supreme Court Bar Number and comply with Ind. Admission & Discipline Rule 23 for attorney signature format.]