Uninsured/Underinsured Motorist Complaint
UNINSURED / UNDERINSURED MOTORIST COMPLAINT
Table of Contents
- Caption
- Parties
- Jurisdiction and Venue
- General Allegations
- Policy Identification and Coverage
- UM vs. UIM Status
- Count One — Breach of Contract (UM/UIM Benefits)
- Count Two — Bad Faith
- Damages
- Jury Demand
- Prayer for Relief
Caption
IN THE SUPERIOR COURT OF THE STATE OF ARIZONA
IN AND FOR THE COUNTY OF [COUNTY NAME]
| [PLAINTIFF FULL NAME], | Case No.: [________________________________] |
| Plaintiff, | |
| v. | COMPLAINT |
| [INSURANCE COMPANY NAME], | (Uninsured/Underinsured Motorist) |
| Defendant. |
Parties
-
Plaintiff, [PLAINTIFF FULL NAME] ("Plaintiff"), is an individual residing at [PLAINTIFF ADDRESS], [CITY], [COUNTY] County, Arizona [ZIP CODE], and is an insured under the automobile insurance policy described herein.
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Defendant, [INSURANCE COMPANY NAME] ("Defendant Insurer"), is an insurance company authorized to transact business in the State of Arizona, with its principal place of business at [INSURER ADDRESS].
-
[JOHN/JANE DOE] ("Uninsured/Underinsured Motorist") is an individual who, at all relevant times, operated a motor vehicle [☐ without liability insurance / ☐ with liability insurance inadequate to compensate Plaintiff's damages].
Jurisdiction and Venue
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This Court has jurisdiction over this matter pursuant to A.R.S. § 12-123 and the Arizona Constitution, Art. VI, § 14.
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The amount in controversy exceeds $10,000.00, exclusive of interest and costs.
-
Venue is proper in [COUNTY] County pursuant to A.R.S. § 12-401 because [☐ the accident occurred in this county / ☐ Defendant transacts business in this county / ☐ Plaintiff resides in this county].
General Allegations
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On or about [DATE OF ACCIDENT], at approximately [TIME], Plaintiff was [☐ operating / ☐ a passenger in] a motor vehicle on [STREET/HIGHWAY/ROUTE], in or near [CITY], [COUNTY] County, Arizona.
-
At said time and place, the Uninsured/Underinsured Motorist negligently operated a motor vehicle, proximately causing a collision with Plaintiff's vehicle.
-
The Uninsured/Underinsured Motorist was negligent in one or more of the following respects:
☐ Operating a vehicle at an excessive or unreasonable speed (A.R.S. § 28-701)
☐ Failure to yield the right of way (A.R.S. § 28-772)
☐ Following too closely (A.R.S. § 28-730)
☐ Driving under the influence (A.R.S. § 28-1381)
☐ Failure to obey a traffic control device (A.R.S. § 28-644)
☐ Improper lane change (A.R.S. § 28-729)
☐ Use of a portable wireless communication device while driving (A.R.S. § 28-914)
☐ Failure to maintain a proper lookout
☐ Other: [________________________________]
- As a direct and proximate result of the above-described negligence, Plaintiff sustained serious bodily injuries and damages.
Policy Identification and Coverage
-
At the time of the accident, Plaintiff was insured under an automobile insurance policy issued by Defendant Insurer, Policy No. [POLICY NUMBER], effective from [POLICY START DATE] to [POLICY END DATE] (the "Policy").
-
The Policy includes uninsured motorist ("UM") bodily injury coverage with limits of $[UM LIMIT PER PERSON] per person / $[UM LIMIT PER ACCIDENT] per accident.
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The Policy includes underinsured motorist ("UIM") bodily injury coverage with limits of $[UIM LIMIT PER PERSON] per person / $[UIM LIMIT PER ACCIDENT] per accident.
-
Plaintiff has paid all premiums due under the Policy and has complied with all conditions precedent.
-
At the time of the policy application, Plaintiff [☐ accepted UM coverage / ☐ accepted UIM coverage / ☐ did not validly reject UM coverage on the form approved by the Director of Insurance].
Notice and Time Limits
-
Plaintiff provided written notice to Defendant Insurer of the intent to pursue a UM/UIM claim within three years of the date of the accident, as required by A.R.S. § 12-555.
-
This Complaint is filed within three years of the date written notice was provided to Defendant Insurer, as required by A.R.S. § 12-555.
Stacking Provisions
- ☐ Plaintiff has multiple vehicles or coverages under the Policy; however, Defendant Insurer has limited coverage to one policy or coverage per accident as permitted by A.R.S. § 20-259.01(H).
☐ Plaintiff contends stacking applies because [________________________________].
UM vs. UIM Status
Select one:
☐ Uninsured Motorist (UM) Claim:
- The at-fault motorist was uninsured at the time of the accident in that [☐ no bodily injury liability policy was in effect / ☐ the at-fault motorist is unknown (hit-and-run) / ☐ the at-fault motorist's insurer denied coverage or is insolvent].
☐ Underinsured Motorist (UIM) Claim:
-
The at-fault motorist maintained bodily injury liability coverage with limits of $[TORTFEASOR POLICY LIMIT], which is less than Plaintiff's UIM coverage limits.
-
Plaintiff has exhausted the at-fault motorist's bodily injury liability limits and received $[AMOUNT RECOVERED FROM TORTFEASOR] in [☐ settlement / ☐ judgment].
-
Defendant Insurer was provided with timely written notice and the opportunity to consent to the settlement with the tortfeasor's insurer.
-
UIM coverage does not provide coverage for a claim against an uninsured motorist in addition to any applicable UM coverage, per A.R.S. § 20-259.01.
Count One
Breach of Contract (UM/UIM Benefits)
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Plaintiff re-alleges and incorporates by reference paragraphs 1 through 23.
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The Policy constitutes a valid and enforceable contract between Plaintiff and Defendant Insurer.
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Plaintiff has performed all obligations and satisfied all conditions precedent required under the Policy.
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Defendant Insurer has breached the Policy by failing and refusing to pay UM/UIM benefits owed to Plaintiff despite proper and timely demand.
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As a direct and proximate result of Defendant Insurer's breach, Plaintiff has been damaged in an amount to be proven at trial.
Count Two
Bad Faith
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Plaintiff re-alleges and incorporates by reference paragraphs 1 through 28.
-
Under Arizona law, an insurer owes a duty of good faith and fair dealing to its insureds. Noble v. National American Life Ins. Co., 128 Ariz. 188 (1981). An insurer that unreasonably denies, delays, or underpays a valid claim may be liable for the tort of bad faith. Rawlings v. Apodaca, 151 Ariz. 149 (1986).
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Defendant Insurer acted in bad faith by:
☐ Unreasonably delaying investigation and/or processing of the claim
☐ Denying benefits without a reasonable basis in law or fact
☐ Failing to make a prompt, fair, and equitable settlement
☐ Refusing to pay an amount clearly owed while disputing only the excess
☐ Compelling the insured to initiate litigation by offering substantially less than amounts ultimately recovered
☐ Other: [________________________________]
- Defendant Insurer's bad faith conduct was knowing, intentional, and without reasonable cause, entitling Plaintiff to compensatory and punitive damages.
Damages
- As a result of the accident and Defendant Insurer's breaches, Plaintiff has suffered the following damages:
☐ Past medical expenses: $[AMOUNT]
☐ Future medical expenses: $[AMOUNT]
☐ Past lost wages/earnings: $[AMOUNT]
☐ Future lost wages/earning capacity: $[AMOUNT]
☐ Pain and suffering (past and future): $[AMOUNT]
☐ Mental anguish and emotional distress: $[AMOUNT]
☐ Physical disability and disfigurement: $[AMOUNT]
☐ Loss of enjoyment of life: $[AMOUNT]
☐ Loss of consortium (if applicable): $[AMOUNT]
☐ Punitive damages (bad faith claim): According to proof
☐ Prejudgment interest (A.R.S. § 44-1201)
☐ Attorney's fees (A.R.S. § 12-341.01 — contractual claims)
☐ Costs of suit
Jury Demand
Plaintiff hereby demands a trial by jury on all issues so triable.
Prayer for Relief
WHEREFORE, Plaintiff demands judgment against Defendant Insurer as follows:
- Compensatory damages in an amount to be determined at trial;
- UM/UIM benefits in the full amount owed under the Policy;
- Punitive damages for Defendant Insurer's bad faith;
- Prejudgment interest pursuant to A.R.S. § 44-1201;
- Attorney's fees pursuant to A.R.S. § 12-341.01;
- Costs of this action; and
- Such other and further relief as this Court deems just and equitable.
Respectfully submitted,
[ATTORNEY NAME], State Bar of Arizona No. [BAR NUMBER]
[FIRM NAME]
[FIRM ADDRESS]
[CITY], Arizona [ZIP CODE]
Telephone: [________________________________]
Email: [________________________________]
Attorney for Plaintiff
State-Specific Notes — Arizona
| Topic | Detail |
|---|---|
| UM Mandatory? | Mandatory offer by insurer; insured may reject on Director-approved form (A.R.S. § 20-259.01) |
| UIM Mandatory? | Optional — must be affirmatively elected by insured; insurer must offer (§ 20-259.01) |
| UM vs. UIM | Separate and distinct coverages; UIM does not cover UM claims and vice versa |
| Stacking | Generally prohibited — insurer may limit to one coverage per accident for multiple vehicles owned by same insured (§ 20-259.01(H)) |
| Notice Requirement | Written notice to insurer within 3 years of accident (A.R.S. § 12-555) |
| Time to Sue/Arbitrate | Within 3 years of written notice (A.R.S. § 12-555) |
| Arbitration | Common per policy terms; § 12-555 references arbitration as alternative to suit |
| Bad Faith | Tort of bad faith recognized — Noble, 128 Ariz. 188; Rawlings, 151 Ariz. 149 |
| SOL — Contract | 6 years for written contracts (A.R.S. § 12-548) |
| SOL — Personal Injury | 2 years (A.R.S. § 12-542) |
| Attorney's Fees | Recoverable in contract actions under A.R.S. § 12-341.01 |
| Hit-and-Run | Physical contact generally required; check policy terms |
| Exhaustion (UIM) | Must exhaust tortfeasor's limits; insurer consent to settlement advisable |
Sources and References
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