Uninsured/Underinsured Motorist Complaint - California

UNINSURED / UNDERINSURED MOTORIST COMPLAINT

Table of Contents

1. Caption
2. Parties
3. Jurisdiction and Venue
4. General Allegations
5. Policy Identification and Coverage
6. UM vs. UIM Status
7. First Cause of Action — Breach of Contract (UM/UIM Benefits)
8. Second Cause of Action — Breach of Implied Covenant of Good Faith and Fair Dealing
9. Damages
10. Arbitration Demand
11. Prayer for Relief
12. Verification

Caption

SUPERIOR COURT OF THE STATE OF CALIFORNIA

COUNTY OF [COUNTY NAME]

Parties

1. Plaintiff [PLAINTIFF FULL NAME] ("Plaintiff") is an individual residing in [CITY], [COUNTY] County, California, and is an insured under the automobile insurance policy described herein.

2. Defendant [INSURANCE COMPANY NAME] ("Defendant Insurer") is an insurance company authorized to transact business in the State of California, with its principal place of business at [INSURER ADDRESS].

3. [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

4. This Court has jurisdiction over this action pursuant to the California Constitution, Article VI, § 10.

5. Venue is proper in [COUNTY] County pursuant to Cal. Civ. Proc. Code § 395 because [☐ the accident occurred in this county / ☐ Plaintiff resides in this county / ☐ Defendant transacts business in this county].

General Allegations

6. On or about [DATE OF ACCIDENT], at approximately [TIME], Plaintiff was [☐ operating / ☐ a passenger in] a motor vehicle on [STREET/HIGHWAY], in [CITY], [COUNTY] County, California.

7. At said time and place, the Uninsured/Underinsured Motorist negligently operated a motor vehicle, causing a collision with Plaintiff's vehicle.

8. The Uninsured/Underinsured Motorist's negligent acts include but are not limited to:

☐ Failure to maintain a safe speed
☐ Failure to yield the right of way
☐ Failure to maintain a proper lookout
☐ Following too closely
☐ Driving under the influence of alcohol or drugs
☐ Running a red light or stop sign
☐ Improper lane change
☐ Other: [________________________________]

9. As a direct and proximate result of the collision, Plaintiff sustained serious bodily injuries, incurred medical expenses, lost wages, and experienced pain and suffering.

Policy Identification and Coverage

10. 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").

11. The Policy provides uninsured motorist ("UM") bodily injury coverage with limits of $[UM LIMIT PER PERSON] per person / $[UM LIMIT PER ACCIDENT] per accident.

12. The Policy provides underinsured motorist ("UIM") bodily injury coverage with limits of $[UIM LIMIT PER PERSON] per person / $[UIM LIMIT PER ACCIDENT] per accident.

13. Plaintiff has paid all premiums due under the Policy and has complied with all conditions precedent.

14. Plaintiff did not execute a valid written rejection of UM/UIM coverage as contemplated by Cal. Ins. Code § 11580.2(a)(1).

UM vs. UIM Status

Select one:

☐ Uninsured Motorist (UM) Claim:

15. The at-fault motorist was uninsured at the time of the accident within the meaning of Cal. Ins. Code § 11580.2(c), in that [☐ the at-fault motorist had no bodily injury liability insurance in effect / ☐ the at-fault motorist is unknown (hit-and-run) / ☐ the at-fault motorist's insurer is insolvent].

☐ Underinsured Motorist (UIM) Claim:

16. The at-fault motorist maintained bodily injury liability coverage with limits of $[TORTFEASOR POLICY LIMIT], which is less than the UM/UIM limits of Plaintiff's Policy, thereby qualifying as an "underinsured motor vehicle" under Cal. Ins. Code § 11580.2(p).

17. Plaintiff has exhausted or is prepared to exhaust the at-fault motorist's liability policy limits and has obtained [☐ a settlement / ☐ a judgment] in the amount of $[AMOUNT RECOVERED FROM TORTFEASOR].

18. Defendant Insurer was given written notice and the opportunity to advance the tortfeasor's policy limits or consent to the settlement, as required by the Policy.

First Cause of Action

Breach of Contract (UM/UIM Benefits)

19. Plaintiff incorporates by reference all preceding paragraphs.

20. The Policy constitutes a valid and enforceable contract between Plaintiff and Defendant Insurer.

21. Plaintiff has performed all conditions, covenants, and obligations required under the Policy, or has been excused from performance.

22. Defendant Insurer has breached the Policy by failing and refusing to pay UM/UIM benefits owed to Plaintiff, despite Plaintiff's timely demand.

23. As a direct and proximate result of Defendant Insurer's breach, Plaintiff has been damaged in an amount to be proven at trial, but not less than $[ESTIMATED DAMAGES].

Second Cause of Action

Breach of the Implied Covenant of Good Faith and Fair Dealing (Insurance Bad Faith)

24. Plaintiff incorporates by reference all preceding paragraphs.

25. Every insurance contract in California contains an implied covenant of good faith and fair dealing requiring the insurer to act fairly and in good faith in handling claims.

26. Defendant Insurer breached the implied covenant by:

☐ Unreasonably delaying investigation of the claim
☐ Failing to conduct a thorough and fair investigation
☐ Unreasonably denying benefits without basis
☐ Failing to attempt in good faith to effectuate a prompt and fair settlement
☐ Compelling Plaintiff to initiate litigation/arbitration to recover amounts due
☐ Other: [________________________________]

27. Defendant Insurer's conduct was a substantial factor in causing Plaintiff harm, including emotional distress and economic damages.

28. If supported by clear and convincing evidence, Defendant Insurer acted with oppression, fraud, or malice and satisfies an applicable corporate gate under Cal. Civ. Code § 3294(b), permitting consideration of punitive damages under § 3294(a).

Damages

29. As a result of the accident and Defendant Insurer's breaches, Plaintiff has suffered and continues to suffer 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]
☐ Emotional distress: $[AMOUNT]
☐ Loss of consortium (if applicable): $[AMOUNT]
☐ Property damage: $[AMOUNT]
☐ Punitive damages (bad faith claim only): According to proof
☐ Prejudgment interest
☐ Attorney's fees and costs

Arbitration Demand

30. To the extent required by the Policy and Cal. Ins. Code § 11580.2(f), Plaintiff demands arbitration of the UM/UIM coverage dispute and requests appointment of a neutral arbitrator pursuant to Cal. Civ. Proc. Code § 1281.6.

Prayer for Relief

WHEREFORE, Plaintiff prays for judgment against Defendant Insurer as follows:

1. For compensatory damages in an amount according to proof at trial;
2. For UM/UIM policy benefits in the full amount owed under the Policy;
3. For punitive damages for Defendant Insurer's bad faith conduct;
4. For prejudgment interest as permitted by law;
5. For costs of suit incurred herein;
6. For attorney's fees as permitted by law; and
7. For such other and further relief as this Court deems just and proper.

Verification

I, [PLAINTIFF FULL NAME], declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Dated: [__/__/____]

Signature: [________________________________]
Printed Name: [PLAINTIFF FULL NAME]

RESPECTFULLY SUBMITTED,

[ATTORNEY NAME], State Bar No. [BAR NUMBER]
[FIRM NAME]
[FIRM ADDRESS]
[CITY], California [ZIP CODE]
Telephone: [________________________________]
Email: [________________________________]
Attorney for Plaintiff

State-Specific Notes — California

Sources and References

• Cal. Ins. Code § 11580.2 — Legislative Information
• Cal. Veh. Code § 16056 — Legislative Information
• Cal. Civ. Proc. Code § 1281.6 — Legislative Information
• Cal. Civ. Code § 3294 — Legislative Information
• UM/UIM Arbitration — Advocate Magazine
• Tornai v. CSAA Ins. Exchange (2023) 98 Cal.App.5th 974 (breach-of-contract UM/UIM claim subject to compelled arbitration)
• Kortmeyer v. Cal. Ins. Guarantee Assn. (1992) 9 Cal.App.4th 1285 (arbitration is condition precedent to suit on UM/UIM benefits)