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
- First Count — Breach of Contract (UM/UIM Benefits)
- Second Count — Bad Faith / CUIPA-CUTPA
- Damages
- Jury Demand
- Prayer for Relief
Caption
SUPERIOR COURT
JUDICIAL DISTRICT OF [JUDICIAL DISTRICT], AT [CITY]
| [PLAINTIFF FULL NAME], | Docket No.: [________________________________] |
| Plaintiff, | |
| v. | COMPLAINT |
| [INSURANCE COMPANY NAME], | (Uninsured/Underinsured Motorist) |
| Defendant. | Return Date: [________________________________] |
Parties
-
The Plaintiff, [PLAINTIFF FULL NAME] ("Plaintiff"), is an individual residing at [PLAINTIFF ADDRESS], [CITY], Connecticut [ZIP CODE], and is an insured under the automobile insurance policy described herein.
-
The Defendant, [INSURANCE COMPANY NAME] ("Defendant Insurer"), is an insurance company authorized to transact business in the State of Connecticut, 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
-
This Court has jurisdiction over this matter pursuant to Conn. Gen. Stat. § 51-164s and the Connecticut Constitution, Art. V.
-
The amount in controversy exceeds $15,000.00, exclusive of interest and costs.
-
Venue is proper in the Judicial District of [JUDICIAL DISTRICT] pursuant to Conn. Gen. Stat. § 51-345 and Practice Book § 3-1 because [☐ the accident occurred in this judicial district / ☐ Defendant transacts business in this judicial district / ☐ Plaintiff resides in this judicial district].
General Allegations
-
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/TOWN], Connecticut.
-
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 (Conn. Gen. Stat. § 14-218a)
☐ Failure to yield the right of way (Conn. Gen. Stat. § 14-245)
☐ Following too closely (Conn. Gen. Stat. § 14-240)
☐ Operating under the influence (Conn. Gen. Stat. § 14-227a)
☐ Failure to obey a traffic control signal (Conn. Gen. Stat. § 14-299)
☐ Improper lane change (Conn. Gen. Stat. § 14-236)
☐ Distracted driving / use of hand-held mobile device (Conn. Gen. Stat. § 14-296aa)
☐ 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.
-
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.
-
The UM/UIM coverage limits are [☐ equal to the liability limits purchased / ☐ less than liability limits per Plaintiff's written request, but not below $25,000/$50,000].
Conversion Coverage
- ☐ Plaintiff elected underinsured motorist conversion coverage under Conn. Gen. Stat. § 38a-336(e) with limits of $[CONVERSION LIMIT PER PERSON] per person / $[CONVERSION LIMIT PER ACCIDENT] per accident.
☐ Conversion coverage was not elected.
Anti-Stacking Provision
- Connecticut law prohibits stacking of UM/UIM coverage limits. Regardless of the number of:
☐ Policies issued
☐ Vehicles or premiums shown on the Policy
☐ Premiums paid
☐ Persons covered
☐ Vehicles involved in the accident
☐ Claims made
the UM/UIM coverage applicable to this claim is limited to the single highest applicable coverage limit of $[APPLICABLE LIMIT] per person / $[APPLICABLE LIMIT] per accident.
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 total damages.
-
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.
-
The UIM coverage available is the difference between the UIM policy limits and the amount recovered from the tortfeasor's liability policy.
First Count
Breach of Contract (UM/UIM Benefits)
-
Plaintiff re-alleges and incorporates by reference paragraphs 1 through 22.
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The Policy constitutes a valid and enforceable contract between Plaintiff and Defendant Insurer.
-
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.
-
As a direct and proximate result of Defendant Insurer's breach, Plaintiff has been damaged in an amount to be proven at trial.
Second Count
Bad Faith / CUIPA-CUTPA
-
Plaintiff re-alleges and incorporates by reference paragraphs 1 through 27.
-
Defendant Insurer's conduct constitutes an unfair claim settlement practice in violation of the Connecticut Unfair Insurance Practices Act ("CUIPA"), Conn. Gen. Stat. § 38a-816(6), in that Defendant Insurer:
☐ Failed to acknowledge and act reasonably promptly upon communications with respect to claims
☐ Failed to adopt and implement reasonable standards for the prompt investigation and processing of claims
☐ Refused to pay claims without conducting a reasonable investigation based upon all available information
☐ Failed to affirm or deny coverage of claims within a reasonable time after proof-of-loss statements were completed
☐ Did not attempt in good faith to effectuate prompt, fair, and equitable settlements
☐ Compelled Plaintiff to institute litigation to recover amounts due by offering substantially less than amounts ultimately recovered
☐ Other: [________________________________]
- Defendant Insurer's conduct, constituting a general business practice, also violates the Connecticut Unfair Trade Practices Act ("CUTPA"), Conn. Gen. Stat. § 42-110b, entitling Plaintiff to damages, punitive damages, and attorney's fees under Conn. Gen. Stat. § 42-110g.
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 (CUTPA claim): According to proof
☐ Prejudgment interest (Conn. Gen. Stat. § 37-3a)
☐ Attorney's fees (CUTPA — Conn. Gen. Stat. § 42-110g)
☐ 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 pursuant to CUTPA, Conn. Gen. Stat. § 42-110g;
- Attorney's fees pursuant to CUTPA;
- Prejudgment interest pursuant to Conn. Gen. Stat. § 37-3a;
- Costs of this action; and
- Such other and further relief as this Court deems just and equitable.
THE PLAINTIFF,
[PLAINTIFF FULL NAME]
By: [________________________________]
[ATTORNEY NAME], Juris No. [JURIS NUMBER]
[FIRM NAME]
[FIRM ADDRESS]
[CITY], Connecticut [ZIP CODE]
Telephone: [________________________________]
Email: [________________________________]
Attorney for Plaintiff
State-Specific Notes — Connecticut
| Topic | Detail |
|---|---|
| UM/UIM Mandatory? | Mandatory at limits equal to liability limits; insured may request lesser amount in writing (min $25,000/$50,000) (§ 38a-336) |
| Double-Limits Offer | Insurer must offer UM/UIM at twice the liability limits |
| Default if Not Reduced | Coverage at liability limits; if double offer not made, may be deemed at twice BI limits |
| Stacking | Prohibited — limits from multiple policies or vehicles cannot be combined (§ 38a-336) |
| Conversion Coverage | Insurer must offer UIM conversion coverage (§ 38a-336(e)); NOT subject to anti-stacking rules |
| UIM Calculation | Gap coverage — UIM limits reduced by amounts recovered from tortfeasor |
| Arbitration | Per policy terms; common but not statutorily mandated |
| Bad Faith | No common-law bad faith tort; remedy through CUIPA (§ 38a-816) and CUTPA (§ 42-110b) |
| CUIPA/CUTPA | Requires "general business practice" for CUIPA-based CUTPA claim; punitive damages and attorney's fees available |
| SOL — Contract | 6 years (Conn. Gen. Stat. § 52-576) |
| SOL — Negligence | 2 years (Conn. Gen. Stat. § 52-584) |
| 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